Patient-Directed Dying: A Call for Legalized Aid in Dying for the Terminally Ill

This is the most compassionate, knowledgeable, and thorough discussion of the topic of aid in dying I have ever read. Since most deaths in our technologically advanced society are medically managed, most of us will face a series of decisions and interventions, for ourselves and our loved ones, at the end of life. This book will help readers make thoughtful, informed decisions consistent with their own values that are based on knowledge about end of life choices. Dr. Preston addresses all the key issues involved in patient choices at the end of life. He helps distinguish between a terminally ill person's readiness to die and a suicidal wish of an individual who is not ill. She shows how aid in dying is different from euthanasia. He explains the difference between depression that is a normal reaction to the losses associated with dying, and clinical depression and other mental illnesses that are separate from the physical illness. He discusses the importance of families talking openly about end of life decisions that may lead to death. He summarizes the biomedical, ethical, and spiritual debates in this area. Dr. Preston is also very pragmatic and describes the range of treatment decisions that people can make at the end of life. He presents the stories of several patients he has worked with to illustrate the issues, making the book highly readable and down to earth. This book does a fantastic job of educating the reader about myths and realities regarding decisions at the end of life. It is an eloquent plea for reducing suffering at the end of life and respecting the sanctity of death. I highly recommend it to everyone wishing to make thoughtful decisions about dying! Judith R. Gordon, Ph.D. Chair, Washington State Psychological Association End of Life Task Force

Dr. Preston's clear account of how some terminally ill face the hard decisions related to the end of life is an inspiration. We learn that the truly professional and empathic role of a physician is to inform the patient of choices such as hospice as well asthe realities and semantic evasions which obscure the fact that many doctors assist terminal patients wishing to avoid unnecessary pain and indignity. Patients, medical providers and all of us as citizens will benefit from his experience.

This is must reading for anyone who wants to be in control of their life right up to the end. It is not a paean to suicide or an individual's rights, but rather a call for personal dignity and comfort. It is well written and delivers its message and insights through personal stories and anecdotes that the author draws from his own professional and personal experiences. I am sure that everyone, like myself, will strongly identify with one or more of the people and families we meet in this book--these are good stories and good lessons. It is an easy and important read. I highly recommend it.