Illness and death are not optional. Patients have a right to determine how they approach them.

Pharmaceutical companies have too much influence over the education of physicians in this country. They have too much control over the evaluation of their own products, and that's a conflict of interest. I think the industry needs to be regulated, but I've never suggested taking it out of the market altogether.

The use of psychoactive drugs - including both antidepressants and antipsychotics - has exploded...[yet] 'the tally of those who are disabled...increased nearly two and a half times.

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.

Brand-name drugs have no competition, since the government grants them very long, exclusive marketing rights.

Over the past two decades the pharmaceutical industry has moved very far from its original high purpose of discovering and producing useful new drugs. Now primarily a marketing machine to sell drugs of dubious benefit, this industry uses its wealth and power to co-opt every institution that might stand in its way, including the US Congress, the FDA, academic medical centers, and the medical profession itself.

Why should anyone - the state, the medical profession, or anyone else - presume to tell someone else how much suffering they must endure as their life is ending?