Three years ago Dr. Irwin Nash of New Haven, Conn., visited his 73-year-old uncle, a childless widower with terminal cancer, in a major medical center's intensive care unit.

"Hooked up to a respirator, with numerous abdominal drains communicating with postoperative abscesses and invaded by multiple intravenous lines and a {chest} catheter, he was an all too familiar hospital figure, but almost unrecognizable as the thoughtful and gentle brother-in-law of my father," Nash wrote the New England Journal of Medicine.

"Despite the fact that he was reasonably alert, communicating with him was extremely difficult. The endotracheal tube {a tube from the respirator into his throat} precluded his speaking. Multiple lines, wrist restraints and his obvious discomfort prevented him from feeling the warmth of efforts to touch him."

". . . He wanted {the tube blocking his throat} out and would have pulled it out but for the wrist restraints . . . He could not be sedated and made more comfortable, because if he had been they could not have determined whether or not he could 'tolerate' being off the respirator . . .

"He died four days later.

"He was fixed to his bed and his suffering as if by a Gordian knot. What he needed was an Alexander, or at least a physician general who could put the problem in a new perspective, cut through the knot, change the therapeutic direction from cure to palliation and order adequate analgesia . . .

"Unfortunately, though there were a few kind and harried nurse foot soldiers, the general and his lieutenants were on another field." Last June Dr. Ronald Cranford, a Minneapolis neurologist and consultant to national panels on death and dying, confronted the fact that his mother-in-law was dying in Winter Park, Fla.

"She had lung cancer," Cranford said last week. "Her husband had died of lung cancer in 1981, and when he was dying his doctors refused to give medication for air hunger," a relentless difficulty in breathing for lack of oxygen. "My wife vowed that that would never happen to her mother, and we had assured her mother that she would not suffer needlessly."

His wife's mother -- Betty -- was in Florida, however, and the ordeal stretched out for six weeks.

"But I called several times a day," he said. "I talked to the physicians and suggested appropriate doses of medication -- enough to minimize pain -- down to specific amounts. They followed my suggestions. And she did not suffer needlessly.

"What might have happened otherwise? I don't know.

"Did we hasten Betty's death by the administration of adequate morphine and the withdrawal of other medications? Yes.

"Did we commit euthanasia? No."