ABSTRACT
It can often be difficult for all concerned to acknowledge that "enough is enough." It is an essential and completely appropriate role of the counselor to encourage the client to explore his or her feelings about whether to cease treatments or to continue fighting for extra time. It is not the worker's role to give permission for one choice or another. Dying can be a quality time for the terminally ill person as well as for the loved ones. The worker should ask the client questions that wil l offer him or her options and some control over the process. Rabkin, Remien, and Wilson (1994) correctly note that it is far easier to believe in the right to choose the timing of one's death when the person is actively dying and when the remaining time is likely to be hours or days. The strength of this conviction is tested when the person is not acutely and severely i l l , but untreatable, and may have weeks or months before an inevitable death. Such a person may be able to survive physically but with such chronic discomfort and restricted horizons that he or she sees no reason to remain alive. Is this person entitled to say "enough is enough"? Many health care providers who work with terminally ill people believe so. IV morphine is often started once the client has decided to discontinue medical procedures or drugs, with the double purpose of alleviating pain and possibly accelerating the impending death.
