A Midwife Through the Dying Process

This work explores the doctor/patient partnership and the end of life issues that surround physician-assisted death. Here are the stories of nine individuals and their different endings, common only in each person's struggle to confront issues of law and ethics and to realize a "good" death.

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Approximately two-thirds of deaths in the United States involve a doctor's partnership with an individual, whether it be for the administration of very high doses of pain relief or sedation, or for the act of discontinuing - or not beginning - life sustaining treatment. This work explores that partnership and the complex end of life issues that surround physician-assisted death. Here are the stories of nine individuals and their very different endings, common only in each person's struggle to confront issues of law and ethics and to realize a "good" death. Each story illustrates different aspects of the myriad dilemmmas commonly faced by dying patients, their families and physicians. Each involves a series of painful decisions that should help the reader understand how an individual's specific medical condition and unique history - personal values, and concepts of self, spirit and community - blend to suggest clinical choices that might otherwise seem difficult to understand.
At the end of each narrative, the author explores the themes illustrated, highlighting the salient questions for physicians, and exposing readers to a coherent way of thinking about issues such as hospice care, withdrawal of life-sustaining therapy, terminal sedation and physician-assisted death. This text demonstrates the tension inherent between the fight for life and the mandate to relieve suffering.