A march of folly.

Folly, as defined by Barbara Tuchman, is “the pursuit of policy contrary to the self-interest of the constituency or state involved . . . folly is a policy that is counter-productive.” Current trends in cancer incidence and mortality rates, education, research, and societal mores and views combine to present a number of antithetical propositions. A review of these propositions highlights the need for ethical reflection and studies on end-of-life issues affecting cancer patients and their families, lest we also embark on a “march of folly.” Examples of these conflicted conditions occur in relation to cancer incidence and mortality, the shift from institutional to community care, education and research, communication and the health care workforce, and euthanasia and physician-assisted suicide. What follows are my own musings on these problems and the promising aspects of modern end-of-life care. My colleagues will have their own list.

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