Selected and reviewed by James Park,
existential philosopher and advocate of the right-to-die.
Organized in the order of quality, beginning with the best.
Comments in red are the views of this reviewer.

A note to authors of books supporting the right-to-die:
Please avoid the following four misleading words:
euthanasia, suicide, hasten, medication.

(New York: Putnam, 1975)

     The best book on the right-to-die: comprehensive, with good examples,
well-documented, readable, insightful, forthright, well-argued.
Deals with: merciful death (for adults and defective infants),
refusing treatment, voluntary death, definitions of death,
organ transplants, & hospices.

2. Derek Humphry & Mary Clement 
Freedom to Die:
People, Politics, and the Right to Die Movement

(New York: St. Martin's Press, 1998)       388 pages
(ISBN: 0-312-19415-3; hardback)
(Library of Congress call number: R726.H844 1998)

     No single individual is more central to the right-to-die movement
than Derek Humphry, who founded the Hemlock Society in 1980
and who has written several book on the subject. 
(In 2003 the Hemlock Society renamed itself End-of-Life Choices.
And in 2004 it merged with Compassion in Dying,
taking the new name Compassion & Choices.)
This book is a summary of the history
of the right-to-die movement up to 1998.
The right-to-die emerged in response to modern medical technology,
which can keep bodies 'alive' longer than ever before imagined.
Humphry and Clement summarize the most famous right-to-die cases:
Quinlan, Cruzan, Kevorkian, Quill.
They summarize the current policies in the Netherlands,
which allow a physician to assist a patient to die
when specified safeguards are fulfilled.

     Detailed accounts are given to the efforts to win the right-to-die
on the West coast of the United States: California, Washington, Oregon.
These states have referendum laws,
allowing the people to create laws directly by a popular vote
—when the elected lawmakers are too timid to enact a particular law.
One drawback of this means of changing the laws
is that the debates tend to be reduced to 30-second television ads.
Oregon was the first state to allow physicians to aid a voluntary death
—by prescribing lethal drugs after careful safeguards were fulfilled.
(The complete text of the Oregon law is included as an appendix.
The Oregon law with annual reports is also available on the Internet:
http://www.oregon.gov/DHS/ph/pas )

     The US Supreme Court found no right-to-die in the Constitution,
but the justices left the door open for states to write new laws.

    Humphry and Clement even include a chapter on
the high cost of medical care at the end of life,
—an argument for the right-to-die that is open to easy attack by opponents,
who will suggest that some people will be put to death to save money.
Voluntarily-created 'living wills' or Advance Directives for Medical Care
can accomplish the same goal, but few people have written them.
And sometimes doctors do not know about 'living wills' or ignore them.

     This book is an excellent place to begin reading
about the right-to-die movement.  
It is based on Derek Humphry's personal experiences and all published sources.

Seduced by Death 
moved to Books Opposing the Right-to-Die

3. James M. Hoefler 
Managing Death

(Boulder, CO: Westview Press, 1997)       206 pages
(ISBN: 0-8133-2816-0; hardcover)
(Library of Congress call number: R726.H564 1997)

     Hoefler documents a broad consensus among almost all groups
(doctors, nurses, hospitals, religious organizations)
that have taken official positions
concerning how to manage the process of dying:

1. Forgoing medical treatment and life-supports is not suicide.
2. Withholding and withdrawing life-supports are ethically the same.
3. Family members can decide for incapacitated patients.
4. Terminal illness is not required
    as a precondition for making life-ending decisions.
5. Food and water need not always be provided.

7. Severe dementia is a condition in which the patient is no longer able
to make any meaningful decisions about life or death.
The number of such patients is measured in the millions at any given time.
But common sense and public opinion is slowly moving in the direction
of a consensus that the severely demented need not be kept alive by artificial means.
In other advanced countries, they are not routinely put on life-supports
—as is quite common in the United States.
But America as a society does not yet have a consensus
about how to treat former persons who have permanently lost
such capacities as consciousness, memory, language, & autonomy.

     Hoefler discusses artificial nutrition and hydration
as end-of-life treatments.
Dying from lack of water is much quicker and easier than starvation.
Two months is a typical time to die from lack of food
—if there are no other physical diseases or problems.
A week or 10 days is all it takes to die
if all water and other fluids are given up.
According to all objective reports, this is a quick and easy death,
often without the need for pain medication.

    The following points about voluntary death by dehydration (VDD)
come from this reviewer rather than from James Hoefler:

     Giving up water and other fluids has some additional advantages
over other methods of bringing life to an end:

1. The patient can always change his or her mind.
Since it takes at least a week to die using this method,
the patient might see life quite differently
after a few days without food and water.
People tempted to commit irrational suicide
will probably recover from their suicidal urge before they die.
Then they will decide to begin eating and drinking again
—and continue to live indefinitely.
Other people will probably know about this decision to die
—which gives them ample opportunity to intervene
if they do not believe that death at this time is the best option.

2. Doctors do not need to be involved in the dying process at all.
Thus, there are no moral or legal questions
about doctors aiding in the process of dying.
Death by dehydration can be conducted completely at home,
without the need for any special equipment or drugs,
and without the involvement of any health-care institutions.

3. Giving up food and water is completely legal.
There are no laws against choosing this means of death.
This eliminates all the secrecy involved in underground means of death.

4. Families can be informed ahead of time about the planned death,
so they can gather for the last days of their loved one if they please.

     Death by dehydration might become
a preferred method for voluntary death
in the first few decades of the 21st century,
because it does not involve the state
or health-care institutions or personnel.
Patient autonomy is certainly preserved
because the decision to die must be affirmed over and over again
during the last week or 10 days of life.
And when the patient slips into unconsciousness,
the proxies and medical personnel can continue the decision to withhold fluids.

     No new legislation is required to permit this method of choosing death.
We already have the power to end our lives in this way.
The danger of irrational suicide is sharply diminished.
(Irrational suicide is a danger in all methods that bring death suddenly.)
The patient will go to sleep at night and wake up again in the morning
several times during the period of dying from dehydration
which will give new perspectives on problems
that might otherwise lead to an irrational suicide.
If this plan for achieving a voluntary death is announced to others,
they might decide to provide new support or better medical care,
which might make postponing death a little longer
a more desirable option for all.  

    (This reviewer has written a cyber-sermon on this subject:
Voluntary Death by Dehydration .)

     Hoefler hopes that death will be better managed in the future.
He suggests that the following ways to improve the process of dying:

1. New standards of care will be developed for mortally-ill patients.
Then they will no longer suffer the default decision,
which is always to provide maximum aggressive medical care:
Because it can be done, it will be done
—until someone decides otherwise.

2. We will make better use of hospice care.
Now it is often used just for the last week of life—or last few hours.
Taking advantage of hospice services
for several weeks or months 
can greatly improve the process of dying.

3. We will develop a clearer concept of medical futility.
Research will show more clearly than ever before
which medical treatments are useful and which are useless
in the various situations in which such treatments might be used.
Not only the medical profession but also the general public
will reach a more reasonable consensus
about when to omit or withdraw
high-tech medical care at the end of life.

4. End-of-life decision-making will become more open and rational.
Both health-care professionals and the general public
will be better educated in order to make wiser end-of-life decisions.
Death can be better managed rather than fought every step of the way.

5. We will reject the slippery-slope arguments
of those who oppose making any life-ending decisions.
By paying close attention to the particulars of each case
rather than trying to enforce rigid rules of morality,
wise decisions will emerge that can be embraced by everyone involved.

6. Advance Directives will be used more fully and wisely,
so that we can choose our own pathways toward death,
rather than being handled according to the standard operating procedures
of the hospital or the medical profession.

     Managing Death is a basic and moderate book about process of dying.
Hoefler does not attempt to break new ground.
Rather he clarifies the consensus that we already have achieved
—and projects the elements of a new consensus
that is now beginning to emerge in our collective thinking.

    Everyone concerned about the process of dying
should read Managing Death.

4. Michael Schiavo with Michael Hirsh
Terri: The Truth

(New York: Dutton, 2006)       360 pages
(ISBN-10: 0-525-94946-1; hardback)
(ISBN-13: 978-0-525-94946-6; hardback)
(Library of Congress call number: R726.S35 2006)

    Terri Schiavo, the author's wife,
became a major name in the right-to-die debate
as she reached the end of her life in 2005,
after 15 years in a persistent vegetative state.

    This book is a personal account in which Michael Schiavo
tells the story of her life and death as known to him,
the person who was closest to her
and to the events that led to her collapse in 1990
and to her being disconnected from life-supports in 2005.

    Michael Schiavo is well aware
that there are other accounts of the same events,
which is the reason he has sub-titled his book The Truth.

    This reviewer also read the book by the Schindler family
in parallel with reading this book,
following the two accounts of the events year-by-year in both books.
It is quite remarkable that a family that was originally very close
could be so dramatically split by this right-to-die controversy.
The same events are often given diametrically-opposite interpretations
by the two sides of this family dispute
about what should be done for Terri Schiavo.
The Schindlers' book—called A Life that Matters—is reviewed in
the bibliography of Books Opposing the Right-to-Die.

    Immediately after her collapse,
Michael was completely devoted to helping his wife recover.
He spent many days by her bedside
watching for the slightest sign that she was conscious again.
But after several months and many failed attempts to rehabilitate her,
Michael had to agree with the doctors
that his wife would never recover.

    The jury in the 1992 malpractice trial determined that Terri herself
was 70% responsible for her own collapse,
which was most likely due to an eating disorder,
which ultimately caused her heart to go into fibrillation,
which deprived her brain of oxygen,
causing a persistent vegetative state that lasted for 15 years,
until she was ultimately disconnected from her life-supports.
The other 30% responsibility was assigned to her doctors,
who failed to diagnose her eating disorder,
which could have been treated, preventing her death.

    The long, complex legal wrangling
over Terri's guardianship and fate
is discussed in full in both books,
but will not be reviewed here.

    In the year 2000, Michael was first empowered by the court
to remove Terri's feeding-tube.
It took 5 more years of appeals,
intervention by the Florida legislature and governor,
and ultimately the US Congress and the President
before the court cases were ultimately settled
—ordering the removal of Terri's feeding tube.

    A secret video-tape was made by the Schlinder family,
which was widely shown on television.
It was convincing enough to many viewers
that most public opinion favored keeping Terri 'alive'.
A number of neurologists diagnosed Terri from this tape
as being in a "minimally conscious state"
rather than being in a persistent vegetative state.

    But when the court ordered 5 experts to examine Terri,
the majority determined that she was in PVS,
which was confirmed by autopsy after her final death.
(The two experts selected by the Schindler family did not agree.)
The autopsy showed that her brain had shrunk to half normal size,
that she could not see, and that there was never any hope of recovery.
Terri's brain was even more gone than most patients in PVS.
The apparent 'responses' seen on the video-tape
were random events originating in Terri's brain-stem,
not actual responses to anything in her environment.

    Even Pope John Paul II got involved indirectly.
He declared the tube-feeding of patients in PVS
is not medical treatment but a normal means of caring for the sick.

    Actually, Roman Catholic priests
were lined up on both side of the Schiavo case,
some saying that she should be kept on life-supports
and others saying that she should be allowed to die.
Such religious opinions affected the public's responses to the case,
but they did not affect the legal rulings,
which ultimately led to removing Terri's feeding-tube in 2005.

    Michael reminds us at the end of his book
that Terri Schiavo would not have become a 'household name'
if she had had an advance directive for medical care,
which would have been immediate "clear and convincing" proof
that Terri did not want to be kept 'alive' by a feeding tube
if she was never going to recover.

    Whatever we want, if ever we are in a condition similar to Terri Schiavo,
we should state our wishes clearly and unambiguously
in our advance directives for medical care.

    If you would like to see suggested language to put into your 'living will'
so that you will not be kept 'alive' indefinitely on life-supports,
go to the following website created specifically
to help others avoid Terri Schiavo's fate:
http://www.tc.umn.edu/~parkx032/TERRI.html

    Michael Schiavo has established a political action committee
to insure that end-of-life choices
are not taken away from the duly-authorized persons:
http://www.TerriPAC.com.

(New York: iUniverse: www.iuniverse.com, 2006)     180 pages 
(ISBN-10: 0-595-38144-8; paperback)
(ISBN-13: 978-0-595-38144-9; paperback)
Library of Congress call number: not given in book)

8. Samuel Greenberg, MD
Euthanasia and Assisted Suicide:
Psychosocial Issues

(Springfield, IL: Charles C. Thomas, 1997)       164 pages 
(ISBN: 0-398-06785-6; hardcover)
(Library of Congress call number: R726.G74 1997)

    This is an open-minded book on the right-to-die
written by a psychiatrist.  
He does not break any new ground.  
But he does not prejudge any of the difficult cases he discusses.  

    The following summary of the contents shows the wide-range of this book:
Ch. 1  a good summary of the issues and the sides taken.
Ch. 2  a good summary of the high-profile cases of the previous 20 years.
Ch. 3  experiences in other countries: Netherlands, Great Britain, Germany.
Ch. 4  learning from the practices of veterinarians.
Ch. 5  physicians' attitudes are divided,
            but moving in the direction of the right-to-die.
Ch. 6  legal aspects: definitions.
Ch. 7  religion, morals, & bioethics.
Ch. 8  the hospice movement.
Ch. 9  the right-to-die societies.
Ch. 10  a case of a severely defective newborn.
Ch. 11  looking toward the future.

9. Derek Humphry  
Lawful Exit:
The Limits of Freedom for Help in Dying

(Junction City, OR: Norris Lane Press, 1993)       166 pages
(Library of Congress call number: R726.H847 1993)

    Derek Humphry—champion of the right-to-die—
explores several legal details in the process of winning the right-to-die.  
Many provisions have been proposed for various right-to-die laws. 
Some are more workable than others.
Some deal with very unlikely possibilities.
Humphry presents his own Model Death with Dignity Act
as an appendix to this book. 

    History has moved on in the years since this book was published.
But some of the same issues are still discussed.
And reading this book could provide a background
for the debate about the right-to-die
that will continue in the 21st century. 

    Here are some of the legal issues discussed: 

1. How shall we define and use our technical terms?
2. How can we make tacit 'decisions' more open and honest?
3. Should doctors be involved in the process of ending life? 
4. When doctors are involved, should they be especially qualified
        in the disease or other condition of the patient? 
5. How can be make sure that a second professional opinion
        is really independent?
6. Must patients choosing death be competent?
7. Must patients choosing death be terminal?
8. How should we decide for infants and children?
9. Must patients choosing death have a physical illness
        or could mental suffering ever by a sufficient reason? 
10. Should a psychological evaluation of the patient be required? 
11. Should a medical trial of pain-control be required?
12. Should we have special protections for disabled people?
13. What documentation of voluntary deaths
        or merciful deaths should be required?
14. Should judges be required to certify
        a voluntary death or a merciful death?
15. Residency requirements:
        Should only local people be granted the right-to-die?
16. How can be avoid the right-to-die becoming the duty-to-die? 
17. Should we prohibit or regulate 'suicide clinics'?
18. How should we protect health-care personnel
        from criminal, civil, & administrative sanctions if they follow the guidelines?
19. How should we handle people with Alzheimer's disease? 
20. Should there be special safeguards for residents of nursing homes?
21. What sense does it make to report the fulfilling of safeguards
        after the death has already occurred?
22. Should the laws be changed by a direct vote of the people?
23. Are legislators usually too timid to vote for the right-to-die?
24. What about patients who wish to choose death
        who lack the physical capacity to kill themselves? 
25. How long should the patient have to wait
        between a request for death and when relief is finally granted?
26. How do we prevent coerced death?  
27. What kind of documentation or witnesses
        for a request for death should be required?
28. Must all family members be notified of a request for death?

    One chapter in Lawful Exit
reviews the efforts in three states to change the law:
Washington, California, & Oregon.
Much of the opposition focused around lack of safeguards.

    This book offers a good opportunity to review and re-consider
many of the details of any proposed laws concerning the right-to-die.

10. Quill, Timothy E., MD & Margaret P. Battin, PhD., editors.
Physician-Assisted Suicide:
The Case for Palliative Care and Patient Choice

(Baltimore, MD: Johns Hopkins University Press: www.press.jhu.edu, 2004)       342 pages
(ISBN: 0-8018-8069-9; hardcover)
(ISBN: 0-8018-8070-X; paperback)
(Library of Congress call number: R726.P485 2004)
(Medical call number: W50P5781 2004)

    This book is a collection of articles written by various people
in support of the right-to-die generally
and more specifically in support of
life-ending drugs prescribed by a physician
as a means of voluntarily ending one's life under careful safeguards.
The Oregon Death with Dignity Act is the background model
for so-called "physician-assisted suicide".

    Doctors should not abandon their patients as they near death.
Each patient needs special caring,
even when such services cannot be billed as medical care.
Patient autonomy should be respected.

    The authors from the Netherlands defend their practice
of assisting dying under their current safeguards.
And they offer telling criticisms of the critics
who claim wide-spread abuse within the Dutch system.
These chapters contain some first-person accounts of doctors' feelings
as they help their patients to end their lives.

    In the opinion of this reviewer,
the Dutch system spends too much time and energy
reviewing cases of voluntary death after the death has already been achieved.
If abuses and mistakes are to be avoided,
such reviews should take place before death.

    Some chapters address political strategy for changing laws to permit the right-to-die.
Advocates of the right-to-die need to be aware of who the opposition is
and how they are likely to manipulate legislators and the public
to prevent any changes in the laws of the various states.

    From this reviewer's perspective, this book seems to have been put together
in a hurry by people who are very busy with other things.
The usual authors were asked to contribute.
And they form a united front in favor of life-ending drugs
as the means of voluntary death.
We might even say that these authors
are the establishment of the right-to-die movement.
They have not taken great care to consider the impact of their code words
on readers from the general public who do not deal with right-to-die issues every day.
The outstanding example of this oversight is embodied in the title
and several of the articles: "physician-assisted suicide".
We are not really recommending
that people commit irrational suicide with the help of a doctor.
Was the expression "physician-assisted suicide" invented by the opposition?

    (Instead of "suicide", we should say "voluntary death".
The present reviewer has created a cyber-sermon on this theme:
Four Differences between Irrational Suicide & Voluntary Death .)

    The authors of the articles collected here represent various professional perspectives
rather than the perspective of people facing their own deaths.
But it is nevertheless useful to know what doctors and lawyers
think about the process of choosing a wise path toward death.
No authors share their own plans for achieving an ideal death.

    In general this is a good book, 
but unfortunately it does not break any new ground.  
Nevertheless this book will stand as a broad-based representation
of the state of right-to-die thinking at the beginning of the 21st century.
What will such books say 50 or 100 years from now?

11. Loretta M. Kopelman & Kenneth A. DeVille, editors
Physician-Assisted Suicide:
What Are the Issues?

(Dordrecht, Netherlands: Kluwer Academic Publishers, 2001)       235 pages
(ISBN: 0-7923-7142-9; hardcover)
(Medical call number: W50P578 2001)

    Collected papers from a conference in March 1998. 
The doctors and professors invited to speak were already well-known
for their views on the question of physician participation
in the decision to bring life to an end.  
Most favor allowing physicians to assist a voluntary death.

    The issues are explored deeply
as they were understood at the end of the 20th century.
But no new ground was broken by these contributors.

12. Lisa Yount, editor  
Euthanasia

(San Diego, CA: Greenhaven Press, 2002)       174 pages
(ISBN: 0-7377-0828-X; paperback)
(Library of Congress call number: R726.E782 2002)

     This is a collection of short articles from a wide variety of view-points,
dealing with many end-of-life issues:
right-to-die, euthanasia, physician-assisted suicide, personhood,
public opinion, medical ethics, doctors' role, Oregon and Netherlands,
terminal illness as a safeguard, religious perspectives,
& active and passive help in dying.

    One major benefit of this book is that it collects in one short volume
articles that would take many hours to locate in their original sources.
And the editor has selected only the best articles.
They are short and to the point.
These are not offered as extremes on any issue—pro & con.
But they do offer very different perspectives on the same issues.  

    The only extreme views seem to be the right-wing religious views
—authors who fear that terrible things will happen
if euthanasia is even considered.
Somehow at least the most rational of these fears need to be addressed.

    I found this a good collection, but no article breaks new ground.
I wonder when and how new thinking will enter the debate. 

13. Lisa Yount
Physician-Assisted Suicide and Euthanasia

(New York: Facts On File: www.factsonfile.com, 2000)
(ISBN: 0-8160-4021-4; hardcover)
(Library of Congress call number: R726.Y673 2000)

    This is a reference book focusing on
the most important court cases related to the right-to-die.
Chronology of important events; 
glossary of terms used in the debate;
important persons;
annotated bibliography;
listing of organizations.

    This book is a research tool rather than opening new ideas.
But it could be a good place to begin reading
about the past efforts to win the right to die.

14. Sue Woodman
Last Rights:
The Struggle over the Right to Die

(New York: Plenum, 1998)       293 pages
(ISBN: 0-306-45995-7; hardcover)
(Library of Congress call number: R726.W655 1998)

    Sue Woodman is a journalist,
who has read deeply in the history of the right-to-die movement.
She summarizes the well-known cases that attracted media attention.
And she illustrates the need for the right-to-die
in the lives of several people who were forced to live too long.  

    When this book was written, Dr. Jack Kevorkian
was the most famous person in the right-to-die movement.
Serious doubts were raised about some of the deaths he assisted.

    Should physicians help their patients to die?  
Doctors come down on both sides of this question.

    Disabled people usually reject any talk of the right-to-die
because they fear that they will be forced into death
because able-bodied people think their lives are not worth living.

    Opponents of the right-to-die can cite many cases in which people died before their time.
Mistakes and abuses can and do occur under the name of the right-to-die.

    The Roman Catholic Church is one of the best-organized
and best-funded opponents of the right-to-die.  
And yet, even Roman Catholic morality allows withdrawal of life-supports.

    This book is mostly of historical interest now,
since there have been several important developments since the middle 1990s.
But Sue Woodman tells us the stories and introduces us to some of the people
from the early years of the right-to-die movement.

15. Ian Dowbiggin
A Merciful End:
The Euthanasia Movement in Modern America

(New York: Oxford University Press: www.oup.com, 2003)       250 pages
(ISBN: 0-19-515443-6; hardcover)
(Library of Congress call number: R726.D69 2002)

    The author is an historian who has read deeply in the documents
of the right-to-die movement, mainly in 20th century America.
He reviews the most important organizations and personalities,
including these best-known characters:
Joseph Fletcher, Derek Humphry, Robert Ingersoll, Jack Kevorkian,
Donald McKinney, Ralph Mero, Hugh Moore, Charles Francis Potter,
Timothy Quill, Sidney Rosoff, Olive Ruth Russell, & Ruth Proskauer Smith.

(New York: Human Sciences Press, 1975) 

     The author makes no new arguments
but masterfully summarizes the arguments advanced thru the years.
Also contains a good historical survey of the right-to-die movement up to 1975.

17. A.B. Downing, editor 
Euthanasia and the Right to Die

(London: Peter Owen, 1969)
(Los Angeles: Nast, 1970)
(New York: Humanities Press, 1971)

     A very well-written collection of essays
on merciful death and voluntary death as debated in England.
Summarizes in a small volume all the major issues.
A Basic source.

18. Louis Shattuck Baer, MD 
Let the Patient Decide:
A Doctor's Advice to Older Patients

(Philadelphia: Westminster Press, 1978)

     An excellent short book illustrating the many hazards
and complications created by the ordinary application of medical science.
Dr. Baer, a family doctor in his 60s when he wrote this book,
explains his own decision to refuse resuscitation and
life-prolonging drugs if he has been brain-damaged or becomes senile.
He presents the documents he has executed to prevent
the routine 'life-saving' treatments he does not want.

19. Jo Roman 
Exit House:
Suicide as an Alternative

(New York: Seaview Press, 1980)

     One woman, suffering from terminal cancer,
explains her reasons and plans for a "rational suicide".
This very personal book encourages readers to think deeply
about what they would do in similar circumstances.
A very forthright and outspoken book by someone who actually
carried out her careful practical and interpersonal plans
to die at the right time and by the best means.

20.  Doris Portwood 
Common Sense Suicide:
The Final Right

(New York: Dodd, Mead & Co., 1978)

     This is a courageous argument favoring voluntary death for the elderly.
A peaceful, orderly death is much preferred
over the common distasteful death in hospital or nursing home.
Mrs. Portwood's photograph suggests
that she was over 70 when she published this book.
And she has probably at least tried to die according to her plan by now.
We can only hope that she found a peaceful and meaningful end
—and was not prevented by well-meaning 'helpers'.

21. Ernan McMullen, editor 
Death and Decision

(Boulder, CO: Westview Press, 1978)

     A symposium sponsored by
the American Association for the Advancement of Science.
The two best contribution:

    (1) "Definitions of Death" by H. Tristram Engelhardt, Jr.
He argues for the death of the person
rather than the death of the biological organism
or the death of the whole brain
(which is now almost universally accepted as a definition of death).
Human death should be defined by neo-cortical or cerebral death
because once the higher parts of our brains are dead,
we will never functions as persons again.

    (2) "What is the Function of Medicine?" by Eric J. Cassell argues
that medicine should work to preserve the autonomy and independence
of patients—not merely to preserve their biological lives.
Sometimes allowing patients to refuse treatment
and hence shorten the process of dying
helps them to preserve their dignity as human persons.

    The other 6 contributors deal with
familiar themes in the right-to-die debate.

22. Jonathan D. Moreno, PhD, editor 
Arguing Euthanasia:
The Controversy over Mercy Killing, Assisted Suicide,
and the "Right to Die"

(New York: Simon & Schuster, 1995)       251 pages

     A collection of 19 articles by well-known authors such as Timothy Quill,
Nat Hentoff, Betty Rollin, Ronald Dworkin, Sidney Hook, Daniel Callahan,
H. Tristram Engelhardt, Jr., Margaret Pabst Battin, Dan Brock, & Leon Kass.
Both sides of the debate are well represented.
And this format—presenting complete articles—
gives more space to each thinker than other 'both-sides' collections,
which usually give each author only 2 or 3 pages.
This book could be a good introduction to the issues,
but it does not break any new ground.

23. Robert L. Risley  
Death with Dignity:
A New Law Permitting Physician Aid-in-Dying

(Eugene, OR: Hemlock Society, 1989)    109 pages

     A presentation and explanation of a law
to allow physicians to assist a voluntary death.
Basically the law calls for the patient
to make a written request for death.
After the doctor has made sure that it is a valid request
and that all the other options have been considered,
the doctor may assist the patient in dying.

     The basic safeguard of this law is the doctor's participation,
following the patients fully-informed, repeated request.
The doctor may grant a merciful death to someone who has previously requested death
—while fully capable of making medical decisions.
Only doctors may assist with a voluntary death.
Anyone else who helps commits a crime—and should be punished.

     This book lists all the objections to such a law—and gives good replies:

     1. Doctors will use this new right to cover their mistakes.
They can already do this by withdrawing further treatments and life-supports.

     2. Doctors will murder their patients under the guise of "physician aid-in-dying".
Doctors who kill without proper requests will be guilty of murder.
And proper safeguards will make this kind of murder easy to detect.

     3. Mistakes in diagnosis will lead to premature death.
A second, independent medical opinion is required.
Both doctors must certify in writing that the patient is terminal.

     4. The right to die would become the duty to die.
The physician is there to counter-balance any undue influence
from greedy relatives who want to usher someone prematurely into death.

     5. Physician-aid-in-dying would harm the doctor-patient relationship.
Doctors have the best interests of their patients at heart.
And knowing the full range of help available (including aid-in-dying)
should help some doctor-patient relationships.

     6. Doctors will be feared as "executioners".
The rhetoric is inflammatory.
Real executioners kill only condemned criminals,
who are being punished by society following due process with many safeguards
for capital crimes they have committed.
Usually such criminals do not want to die.
And they are not terminally ill.

     7. Better pain control will eliminate the wish to die.
Not all pain can be controlled.
And sometimes the pain-medication causes such a low level of consciousness
that such a life becomes meaningless to all concerned.

     8. Holland--see notes
(this means that I must have the original notes on this book somewhere. 
I did not see them 2-4-97)





     9. Oath of Hipocrates prohibits physician aid-in-dying.
It has been changed before (eg abortion, surgery for kidney stones).
And it can be changed again if there are good reasons.

     10. Physician-aid-in-dying would be used to kill the useless and elderly.
The safeguards proposed would never permit this.
And if some mistakes were made, the safeguards should be improved.

     11. The Nazis used physicians to kill "useless eaters".
Good safeguards would prevent any such abuses.

     This book is an excellent example of a good-faith attempt
to write a law permitting physician-aid-in-dying.
Everyone else who is trying to change the law to permit the right-to-die
should read this book.
But because this approach has been turned down by voters twice
and has been resisted by the courts,
perhaps a new approach is needed.

24. James Rachels  
The End of Life: Euthanasia and Morality

(Oxford, UK: Oxford University Press, 1986)       204 pages
(ISBN: 0-19-217746-X; hardcover)
(ISBN: 0-19-286070-4; paperback)
(Library of Congress call number: R726.R32 1986)

    Please suggest additional books that should be included
in this bibliography on the right-to-die.
Send your suggestions to James Park: e-mail: PARKx032@TC.UMN.EDU

    See related bibliographies:

Books on the Right-to-Die

Books Opposing the Right-to-Die