Final Acts

Book excerpt: Today most people die gradually, from incremental illnesses, rather than from the heart attacks or fast-moving diseases that killed earlier generations. Given this new reality, the essays in Final Acts explore how we can make informed and caring end-of-life choices for ourselves and for those we loveùand what can happen without such planning. Contributors include patients, caretakers, physicians, journalists, lawyers, social workers, educators, hospital administrators, academics, psychologists, and a poet, and among them are ethicists, religious believers, and nonbelievers. Some write moving, personal accounts of "good" or 'bad" deaths; others examine the ethical, social, and political implications of slow dying. Essays consider death from natural causes, suicide, and aid-in-dying (assisted suicide). Writing in a style free of technical jargon, the contributors discuss documents that should be prepared (health proxy, do-not-resuscitate order, living will, power of attorney); decision-making (over medical interventions, life support, hospice and palliative care, aid-in-dying, treatment location, speaking for those who can no longer express their will); and the roles played by religion, custom, family, friends, caretakers, money, the medical establishment, and the government. For those who yearn for some measure of control over death, the essayists in Final Acts, from very different backgrounds and with different personal and professional experiences around death and dying, offer insight and hope.