title: The end-of-life experiences of 9/11 civilians: death and dying in the World Trade Center.
abstract: This bioethics analysis of trapped civilians in the World Trade Center (WTC) on September 11, 2001, is based on a review of materials in the public domain. Death and dying experiences are divided into three major groups: sudden death, of which there was virtually no suffering or foreknowledge; deaths in which there was a maximum of 102 minutes of suffering; and death by falling or jumping, in which an autonomous decision may have been exercised as a palliative approach. A content analysis of publicly available records of this event reveals many types of end-of-life decisions were being made within the 102-minute time frame from aircraft impact to collapse. Many WTC occupants experienced intensified suffering directly consequent to unprepared emergency dispatchers and inaccurate instructions. Truthtelling and appropriate end-of-life dialogues could have reduced loss of life, suffering, and led to qualitatively improved dying experiences.
authors.affiliation: Department of Internal Medicine, Pediatrics and Behavioral Science, University of Kentucky Program for Bioethics, Lexington, KY 40536, USA. m.sararosenthal@uky.edu
authors.forename: M Sara
authors.initials: MS
authors.lastname: Rosenthal
mesh_terms: D001293:Attitude to Death; D001364:Awareness; D003643:Death; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D009519:New York City; D047851:September 11 Terrorist Attacks; D029181:Spirituality; D013405:Suicide