John L. Shuster, Jr, MD

Miriam Friedlander, YanaBrayman, and WilliamBreitbart have produced anexcellent review of delirium in thepalliative care setting. Their paper isthorough, readable, and thoughtful,and will be helpful to oncologists caringfor patients with advanced illness.I particularly like the fact that theauthors make it clear that delirium isnot only a very common complicationof advanced cancer, but that it isalso a major source of suffering anddistress for both patients and families.In view of the problems deliriumpresents and the frequency with whichdelirium arises as death approaches,this complication of advanced and terminalillness has received inadequateattention. My thanks and congratulationsgo to the authors for providingsuch a clear and helpful review of thischallenging clinical problem.