RESEARCH STARTER

Terminal illness

A terminal illness is defined as a medical condition for which no curative treatment exists, and it is likely to lead to the patient's incapacitation or death in the near future. Patients facing such illnesses may choose various pathways, including treatments aimed at alleviating symptoms and improving comfort, or alternative therapies, often in hopes of better outcomes. The emotional impact of a terminal diagnosis can be profound, often leading individuals through stages of grief, as outlined by the Kübler-Ross model, which includes denial, anger, bargaining, depression, and acceptance. These stages reflect common reactions, although responses can vary significantly among individuals.

In addition to medical concerns, legal matters also become critical, as patients may need to finalize wills, healthcare directives, and other arrangements while they are still able. The topic of euthanasia is closely related to terminal illness, as some patients consider ending their own lives to escape suffering, a subject that remains contentious and is legally restricted in many areas. Understanding the complexities surrounding terminal illness, including physical symptoms and emotional responses, can provide valuable insights for both patients and their loved ones as they navigate this challenging experience.

Full Article

A terminal illness is a disease or medical condition for which no curative treatment exists and which will likely result in the permanent incapacitation or death of the patient in the relatively near future. People with such conditions may opt for treatment programs intended to slow the progression of symptoms, reduce pain, or improve their physical and/or psychological comfort. In other cases, patients may pursue holistic, alternative, experimental, or otherwise unproven treatments in the hope that the divergent protocol may improve their prognosis. Some may opt to cease treatment altogether to allay uncomfortable side effects.

While it is common for people who have received a terminal diagnosis to progress through a framework of well-known and emotional stages of grief, which are not always universal or linear, others may react differently. The concept of active or passive euthanasia, or the intentional act by a physician to end a patient’s life (as requested by the patient) to end suffering (active euthanasia), or withdrawing or withholding life-support systems at the patient’s request (passive euthanasia), is closely related to terminal illness and has emerged as a noteworthy topic of debate.

Background

While many diseases and medical conditions can result in the death of the patient, a terminal illness is differentiated by the lack of proven treatment programs that can cure the disease or the progression of the disease to the point that curative treatment will no longer be effective. Medical professionals stress the importance of early diagnosis for potentially terminal illnesses, such as cancer, which stand a statistically superior chance of being successfully treated if detected before they have the opportunity to spread beyond the primary site into other parts of the body.

Beyond the medical implications of terminal illness, patients must typically take interpersonal relationships and legal issues into account in the immediate aftermath of a terminal diagnosis. Terminal illnesses often exact a deep psychological and emotional toll on loved ones, and the patient may use the opportunity to resolve conflicts or achieve unmet personal goals before the disease progresses to its final stages. From a legal standpoint, patients facing terminal illnesses may have to make complicated and difficult decisions regarding their wills, property, health care directives or advance directives, and final wishes regarding the handling of their remains.

The widely accepted legal definitions of terminal illness largely align with the medical definition but also address questions related to the patient’s cognitive state and ability to make important end-of-life decisions. From a legal standpoint, it is necessary for the patient to be of sound mind when making such decisions for them to be legally binding.

To prevent complications regarding an ill or injured individual’s medical treatment, people can elect to file what is known as a living will. Living wills are legal documents that cover an individual’s wishes regarding life-sustaining medical procedures in the event that the individual finds themselves unable to communicate those wishes on their own. They can be created at any stage of a person’s life, so long as the individual is of the age of majority and has the cognitive ability to make the decisions covered by the document. People who do not already have a living will frequently elect to make one after receiving a terminal diagnosis, especially in cases where the terminal disease is expected to leave them physically or neurologically incapacitated.

Overview

While a universally applicable model for the psychological and physical progression of a terminal illness does not exist, some aspects do apply to a significant percentage of cases. The Kübler-Ross model is the best-known example of how a person copes with a terminal diagnosis and contains five distinct stages. The theory was developed by Swiss-born psychiatrist Elisabeth Kübler-Ross and was first described in her seminal 1969 book On Death and Dying.

According to the Kübler-Ross model, the first stage in dealing with a terminal diagnosis is denial. At this stage, the patient does not accept the diagnosis and refuses to believe that the illness will result in their death. Denial is frequently accompanied by isolation, during which the patient eschews contact with other people.

In the second stage, the patient typically becomes angry and may lash out at strangers, acquaintances, friends, and loved ones. It is also common for a terminally ill person in the anger stage to project hostility onto caregivers, including doctors and nurses.

The third stage is known as the bargaining stage, and Kübler-Ross noted in On Death and Dying that this stage is particularly difficult to study or quantify, as it typically takes place entirely within the patient’s internal world. The patient may attempt to strike a deal with God or other religious figures, agreeing to become a better person in exchange for prolonged life. Alternately, the bargaining stage may consist of the patient trying to postpone their inevitable death so that they can survive long enough to achieve personal goals that have not yet been met.

In the fourth stage, the patient may sink into a prolonged depression, realizing that loss of life cannot be avoided. The patient may give up their career, hobbies, or favorite activities, seeing no point in continuing to pursue them. Kübler-Ross differentiated between “reactive depression,” which mourns for things the patient has already lost, and “preparatory depression,” which is sadness felt for things that are yet to come, such as the grief loved ones will feel when the terminal illness finally results in the patient’s death.

Finally, the patient progresses into the acceptance stage. In most cases, this stage is marked by a resigned attitude toward death. Kübler-Ross noted that some patients continue to fight their terminal illnesses right up to the moment of death, and those who do will not experience the acceptance stage.

The physical symptoms of terminal illnesses vary depending on the nature of the disease, but they also tend to follow a generalized pattern as the individual nears the end of their life. It is common for terminally ill people to become frail, losing weight and muscle mass while feeling weak and fatigued. Many patients experience feeling too hot or too cold, as terminal illnesses frequently affect the body’s ability to control its internal temperature. Patients tend to eat and drink less and frequently lapse into unconsciousness during the final phases of the illness before passing away.

The controversial question of human euthanasia is closely linked to terminal illness. While some people would prefer to end their own lives rather than endure the pain, debilitation, and indignity of terminal illnesses, voluntary active euthanasia (VAE), in which the doctor takes an active role in carrying out the patient’s wish, and medical aid in dying (MAID; formerly known as physician-assisted suicide, or PAS), in which the doctor makes the means of ending life available to the patient, remain illegal in some countries. Some form of euthanasia or medical aid in dying is legally available to patients with the capacity to make healthcare decisions in Belgium (both VAE and MAID), Canada (MAID), Colombia (VAE), Germany (MAID), Japan (passive euthanasia), Luxembourg (both), the Netherlands (both), and Switzerland (MAID). However, strict country-specific due care criteria must be met to ensure the process is ethical and legal, with many countries requiring mandatory reviews to verify that all protocols were followed. Several US states and the District of Columbia allow MAID; active euthanasia is illegal throughout the country.


Bibliography

Annadurai, Kalaivani, et al. “Euthanasia: Right to Die with Dignity.” Journal of Family Medicine and Primary Care, vol. 3, no. 4, Oct. 2014, p. 477. National Library Of Medicine, www.ncbi.nlm.nih.gov/pmc/articles/PMC4311376/, doi:10.4103/2249-4863.148161. Accessed 3 Mar. 2026.

Bates, Alan T., and Julia A. Kearney. “Understanding Death with Limited Experience in Life: Dying Children’s and Adolescents’ Understanding of Their Own Terminal Illness and Death.” Current Opinion in Supportive and Palliative Care, vol. 9, no. 1, Mar. 2015, pp. 40–45.

“End of Life Care.” NHS, Crown copyright, www.nhs.uk/conditions/end-of-life-care/. Accessed 3 Mar. 2026.

Granger, Kate. “Terminal Cancer: How to Live with Dying.” The Guardian, 19 Sept. 2012, www.theguardian.com/lifeandstyle/2012/sep/19/terminal-cancer-how-to-live-with-dying. Accessed 3 Mar. 2026.

“In Your State.” Death with Dignity, 11 Mar. 2025, deathwithdignity.org/states/. Accessed 3 Mar. 2026.

Kübler-Ross, Elisabeth. On Death and Dying. Macmillan Publishers, 1969.

“Medical Aid in Dying Is Not Assisted Suicide, Suicide or Euthanasia.” Compassion and Choices, 2026, compassionandchoices.org/resource/not-assisted-suicide/. Accessed 10 Mar. 2026.

McHugh, Neil, et al. “Extending Life for People with a Terminal Illness: A Moral Right and an Expensive Death? Exploring Societal Perspectives.” BMC Medical Ethics, vol. 16, no. 14, 2015, doi:10.1186/s12910-015-0008-x. Accessed 3 Mar. 2026.

Patel, Paragi. “Research Roundup: Psychological Interventions for Individuals Coping with a Terminal Illness.” American Psychological Association Services, Inc., APA, 10 May 2024, www.apaservices.org/practice/ce/expert/psychological-interventions-terminal-illness. Accessed 3 Mar. 2026.

Saenz, Jessica. “Achieving Quality of Life for People with Advanced Cancer through Individualized Care.” Mayo Clinic Comprehensive Cancer Center Blog, 29 June 2022, cancerblog.mayoclinic.org/2022/06/29/achieving-quality-of-life-for-people-with-advanced-cancer-through-individualized-care/. Accessed 3 Mar. 2026.

“Terminal Illness.” Cleveland Clinic, 15 Oct. 2024, my.clevelandclinic.org/health/articles/terminal-illness. Accessed 3 Mar. 2026.

Treem, Jonathan. “Medical Aid in Dying: Ethical and Practical Issues.” J Adv Pract Oncol, vol. 14, no. 3, pp. 207-211, doi:10.6004/jadpro.2023.14.3.5. Accessed 10 Mar. 2026.

Full Article

A terminal illness is a disease or medical condition for which no curative treatment exists and which will likely result in the permanent incapacitation or death of the patient in the relatively near future. People with such conditions may opt for treatment programs intended to slow the progression of symptoms, reduce pain, or improve their physical and/or psychological comfort. In other cases, patients may pursue holistic, alternative, experimental, or otherwise unproven treatments in the hope that the divergent protocol may improve their prognosis. Some may opt to cease treatment altogether to allay uncomfortable side effects.

While it is common for people who have received a terminal diagnosis to progress through a framework of well-known and emotional stages of grief, which are not always universal or linear, others may react differently. The concept of active or passive euthanasia, or the intentional act by a physician to end a patient’s life (as requested by the patient) to end suffering (active euthanasia), or withdrawing or withholding life-support systems at the patient’s request (passive euthanasia), is closely related to terminal illness and has emerged as a noteworthy topic of debate.

Background

While many diseases and medical conditions can result in the death of the patient, a terminal illness is differentiated by the lack of proven treatment programs that can cure the disease or the progression of the disease to the point that curative treatment will no longer be effective. Medical professionals stress the importance of early diagnosis for potentially terminal illnesses, such as cancer, which stand a statistically superior chance of being successfully treated if detected before they have the opportunity to spread beyond the primary site into other parts of the body.

Beyond the medical implications of terminal illness, patients must typically take interpersonal relationships and legal issues into account in the immediate aftermath of a terminal diagnosis. Terminal illnesses often exact a deep psychological and emotional toll on loved ones, and the patient may use the opportunity to resolve conflicts or achieve unmet personal goals before the disease progresses to its final stages. From a legal standpoint, patients facing terminal illnesses may have to make complicated and difficult decisions regarding their wills, property, health care directives or advance directives, and final wishes regarding the handling of their remains.

The widely accepted legal definitions of terminal illness largely align with the medical definition but also address questions related to the patient’s cognitive state and ability to make important end-of-life decisions. From a legal standpoint, it is necessary for the patient to be of sound mind when making such decisions for them to be legally binding.

To prevent complications regarding an ill or injured individual’s medical treatment, people can elect to file what is known as a living will. Living wills are legal documents that cover an individual’s wishes regarding life-sustaining medical procedures in the event that the individual finds themselves unable to communicate those wishes on their own. They can be created at any stage of a person’s life, so long as the individual is of the age of majority and has the cognitive ability to make the decisions covered by the document. People who do not already have a living will frequently elect to make one after receiving a terminal diagnosis, especially in cases where the terminal disease is expected to leave them physically or neurologically incapacitated.

Overview

While a universally applicable model for the psychological and physical progression of a terminal illness does not exist, some aspects do apply to a significant percentage of cases. The Kübler-Ross model is the best-known example of how a person copes with a terminal diagnosis and contains five distinct stages. The theory was developed by Swiss-born psychiatrist Elisabeth Kübler-Ross and was first described in her seminal 1969 book On Death and Dying.

According to the Kübler-Ross model, the first stage in dealing with a terminal diagnosis is denial. At this stage, the patient does not accept the diagnosis and refuses to believe that the illness will result in their death. Denial is frequently accompanied by isolation, during which the patient eschews contact with other people.

In the second stage, the patient typically becomes angry and may lash out at strangers, acquaintances, friends, and loved ones. It is also common for a terminally ill person in the anger stage to project hostility onto caregivers, including doctors and nurses.

The third stage is known as the bargaining stage, and Kübler-Ross noted in On Death and Dying that this stage is particularly difficult to study or quantify, as it typically takes place entirely within the patient’s internal world. The patient may attempt to strike a deal with God or other religious figures, agreeing to become a better person in exchange for prolonged life. Alternately, the bargaining stage may consist of the patient trying to postpone their inevitable death so that they can survive long enough to achieve personal goals that have not yet been met.

In the fourth stage, the patient may sink into a prolonged depression, realizing that loss of life cannot be avoided. The patient may give up their career, hobbies, or favorite activities, seeing no point in continuing to pursue them. Kübler-Ross differentiated between “reactive depression,” which mourns for things the patient has already lost, and “preparatory depression,” which is sadness felt for things that are yet to come, such as the grief loved ones will feel when the terminal illness finally results in the patient’s death.

Finally, the patient progresses into the acceptance stage. In most cases, this stage is marked by a resigned attitude toward death. Kübler-Ross noted that some patients continue to fight their terminal illnesses right up to the moment of death, and those who do will not experience the acceptance stage.

The physical symptoms of terminal illnesses vary depending on the nature of the disease, but they also tend to follow a generalized pattern as the individual nears the end of their life. It is common for terminally ill people to become frail, losing weight and muscle mass while feeling weak and fatigued. Many patients experience feeling too hot or too cold, as terminal illnesses frequently affect the body’s ability to control its internal temperature. Patients tend to eat and drink less and frequently lapse into unconsciousness during the final phases of the illness before passing away.

The controversial question of human euthanasia is closely linked to terminal illness. While some people would prefer to end their own lives rather than endure the pain, debilitation, and indignity of terminal illnesses, voluntary active euthanasia (VAE), in which the doctor takes an active role in carrying out the patient’s wish, and medical aid in dying (MAID; formerly known as physician-assisted suicide, or PAS), in which the doctor makes the means of ending life available to the patient, remain illegal in some countries. Some form of euthanasia or medical aid in dying is legally available to patients with the capacity to make healthcare decisions in Belgium (both VAE and MAID), Canada (MAID), Colombia (VAE), Germany (MAID), Japan (passive euthanasia), Luxembourg (both), the Netherlands (both), and Switzerland (MAID). However, strict country-specific due care criteria must be met to ensure the process is ethical and legal, with many countries requiring mandatory reviews to verify that all protocols were followed. Several US states and the District of Columbia allow MAID; active euthanasia is illegal throughout the country.


Bibliography

Annadurai, Kalaivani, et al. “Euthanasia: Right to Die with Dignity.” Journal of Family Medicine and Primary Care, vol. 3, no. 4, Oct. 2014, p. 477. National Library Of Medicine, www.ncbi.nlm.nih.gov/pmc/articles/PMC4311376/, doi:10.4103/2249-4863.148161. Accessed 3 Mar. 2026.

Bates, Alan T., and Julia A. Kearney. “Understanding Death with Limited Experience in Life: Dying Children’s and Adolescents’ Understanding of Their Own Terminal Illness and Death.” Current Opinion in Supportive and Palliative Care, vol. 9, no. 1, Mar. 2015, pp. 40–45.

“End of Life Care.” NHS, Crown copyright, www.nhs.uk/conditions/end-of-life-care/. Accessed 3 Mar. 2026.

Granger, Kate. “Terminal Cancer: How to Live with Dying.” The Guardian, 19 Sept. 2012, www.theguardian.com/lifeandstyle/2012/sep/19/terminal-cancer-how-to-live-with-dying. Accessed 3 Mar. 2026.

“In Your State.” Death with Dignity, 11 Mar. 2025, deathwithdignity.org/states/. Accessed 3 Mar. 2026.

Kübler-Ross, Elisabeth. On Death and Dying. Macmillan Publishers, 1969.

“Medical Aid in Dying Is Not Assisted Suicide, Suicide or Euthanasia.” Compassion and Choices, 2026, compassionandchoices.org/resource/not-assisted-suicide/. Accessed 10 Mar. 2026.

McHugh, Neil, et al. “Extending Life for People with a Terminal Illness: A Moral Right and an Expensive Death? Exploring Societal Perspectives.” BMC Medical Ethics, vol. 16, no. 14, 2015, doi:10.1186/s12910-015-0008-x. Accessed 3 Mar. 2026.

Patel, Paragi. “Research Roundup: Psychological Interventions for Individuals Coping with a Terminal Illness.” American Psychological Association Services, Inc., APA, 10 May 2024, www.apaservices.org/practice/ce/expert/psychological-interventions-terminal-illness. Accessed 3 Mar. 2026.

Saenz, Jessica. “Achieving Quality of Life for People with Advanced Cancer through Individualized Care.” Mayo Clinic Comprehensive Cancer Center Blog, 29 June 2022, cancerblog.mayoclinic.org/2022/06/29/achieving-quality-of-life-for-people-with-advanced-cancer-through-individualized-care/. Accessed 3 Mar. 2026.

“Terminal Illness.” Cleveland Clinic, 15 Oct. 2024, my.clevelandclinic.org/health/articles/terminal-illness. Accessed 3 Mar. 2026.

Treem, Jonathan. “Medical Aid in Dying: Ethical and Practical Issues.” J Adv Pract Oncol, vol. 14, no. 3, pp. 207-211, doi:10.6004/jadpro.2023.14.3.5. Accessed 10 Mar. 2026.

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