BOOKS ON TERMINAL CARE

Copyright © 2009 by James Park

Reviewed by James Park,
existential philosopher and medical ethicist.
The comments in red are the evaluations of this reviewer.
The books are organized by quality, beginning with the best.


1. David Kuhl, MD
What Dying People Want:
Practical Wisdom for the End of Life

(New York: Public Affairs, 2002)       317 pages
(ISBN: 1-58648-119-2; hardcover)
(Library of Congress call number: BF789.D4.K84 2002)

    This book is based on interviews with dying people.  
Usually they want more than standard medical care at the end of their lives.
They want their lives to be meaningful.
This often involves personal connections with other people.  
   
    The author is a physician who has worked with dying patients
in a hospice program over a period of 15 years.
He has participated in the dying process with hundreds of people.

    When we are told that we have a life-threatening disease,
time suddenly becomes much shorter:
We are looking at the definite end of our lives.
Before we probably thought of our futures as indefinitely long.
But when we learn that we have a terminal illness,
we want to know "How long do I have?"
We want to prepare well for whatever time remains.

    Learning the bad news of our approaching deaths
is often the most traumatic part.
Some were told in ways that seemed worse than death itself.
Some had to take a peek at their medical records
when the doctor was not looking.
Another patient was told in a drive-by manner:
The doctor told her from the doorway without entering her room.
Some doctors are very bad at communicating the fact of terminal illness.
Some patients want to know only a little piece of information at a time.
But knowing the truth is almost always better than being kept in the dark.
We do not want to be 'kept hopeful' by not knowing that we are dying.

    The pain of dying is almost always a combination
of physical pain and psychological suffering.
Everyone wants their physical pain treated.
If physical pain is the overwhelming fact of one's life,
then most people prefer death.
But physical pain can almost always be managed.

    Once the physical pain has come under control,
we can begin to focus on our emotional and spiritual suffering.
When we are dying, we need time to work thru our interpersonal dynamics.
   
    When we are dying, we do not want to be isolated and alone.
We want to be physically touched.
We want to have meaningful communication
with the people who have been important to us during our lives.
   
    When we are dying, we want to review our lives
to see what meanings we have achieved.

    We want the whole truth about our condition
and the likely course of events from now until the end.
We do not want lies and secrets.

    We want to be part of a family or other meaningful group.
When we are suffering thru the process of dying,
this is not the time to be cut off from other people.

    We want to ask "Who am I?" more deeply than before.
Trivial problems disappear when we are facing death.

    We often want some spiritual or religious comfort.  

    At the end, Dr. Kuhl tells of participating in the death of his sister,
which was more intense than the hundreds of other deaths he attended.
But this personal experience has made it possible for him
to offer others some means of coping with the process
of caring for dying people at the end of their lives.

    This book is based on the thoughts and feelings of actual people.
It should be helpful for all readers who will face the deaths of loved ones
and ultimately their own deaths.
There are no philosophical points to be made.
The wisdom surrounding the approach of death is simple and plain-spoken.
And this book is filled with compassion for those who are dying.


2. Ira Byock, MD 
Dying Well:

The Prospect for Growth at the End of Life

(New York: Riverhead Books, 1997)     299 pages
(ISBN: 1-57322-051-5; hardcover)
(Library of Congress call number: HQ1073.B96 1997)

    A hospice doctor tells in detail of the deaths 12 patients,
all very different, who met their deaths in different ways.
The dying persons are old and young, male and female,
happy as they approach their deaths and having serious problems.
But each death has some important lessons for the reader.

    This book is more about the psychological processes
of preparing for death than the medical or biological processes involved.
Even tho each story is told by the doctor,
the perspectives of the patients and their families are foremost.

    This is not a technical book.
Every page can be understood by anyone
who will eventually approach his or her own death.

    The hospice team of nurses, social workers, volunteers, doctors, etc.
is there to help everyone handle this death as well as possible.
Because they have met most situations before,
they know how to cope with problems
that most people are facing for the very first time.


3. Jerome Groopman, MD
The Measure of Our Days:
New Beginnings at Life's End

(New York: Viking, 1997)       242 pages
(ISBN: 0-670-87570-8; hardcover)
(Library of Congress call number: R726.8.G77 1997)

    The biographies of the last years of ten patients,
including both parents of the author.
Each chapter deals with a different person.
These well-written accounts follow each step
of the process of discovering the illness that ultimately causes death,
including in many cases years of remission after successful medical treatment.
Specific medical details are included,
but each disease and each treatment
is explained in terms that can be understood by laypeople.

    This reviewer did not learn
any new facts about dying from reading this book.
But it helped me to face my own coming death.

    If you start reading this book,
you will want to finish reading it.
Each story is real and compelling.


4. L. L. Basta, MD
Life and Death on Your Own Terms

(Amherst, NY: Prometheus Books: www.PROMETHEUSBOOKS.COM, 2001)       364 pages
(ISBN: 1-57392-918-2; hardcover)
(Library of Congress call number: R725.5.B27 2001)

    A heart specialist (and cancer survivor) presents most of the issues
that will have to be faced at the end of any human life:
definitions of death; medical technology; CPR; assisted dying;
the high cost of dying; cut-off age for medical care?;
doctor-patient relationships; advance directives; medical futility; palliative care.

    Dr. Basta recommends that everyone have an advance directive.
He presents his own check-list format,
which covers 4 possible conditions at the end of life
and 4 procedures that might be selected or omitted.

    This is a big-hearted book by a heart doctor.
But it does not break any new ground.
It could be a starting place for someone who has not yet faced
most of the end-of-life issues.


5. Martin Shepard, MD
Dying: A Guide for Helping and Coping

(Sag Harbor, NY: Permanent Press, 2000)       208 pages
(ISBN: 0-933256-92-2; hardcover)
(Library of Congress call number: BF789.D4S48 1999)

     A doctor who has cared for many dying patients of all ages
tells of his experiences—and theirs.
Many of the chapters are extensive interviews with dying patients,
who have a whole range of different feelings about dying.
This book offers no brilliant new insights,
but it offers close-up experiences of the deaths of a variety of people.
At the end, there is a chapter exploring death as experienced by
the family members who continued to live after their loved ones died.
Another opportunity to confront the reality of modern dying.


6. David Kessler
The Rights of the Dying:

A Companion for Life's Final Moments

(New York: HarperCollins, 1997)       204 pages
(ISBN: 0-06-018753-0; hardcover)
(Library of Congress call number: BF789.D4K47 1997)

     The owner of an in-your-home hospice care service
shares his philosophy and experiences of caring for the dying.
Dying persons should always be regarded as persons
—with all the rights of persons:
The right to keep hoping, to decide for themselves,
to be free of pain, to express their emotions;
the right to die, to peace, to dignity;
the right to have someone present when they die;
and the right to a decent burial.

     Families should be allowed to participate in the death
as fully as they wish, including children.
There should be no rigid rules about how people must die.

     This book provides another opportunity
for ordinary people to think about death
—one's own death and the deaths of others who are close to us.
It provides no new information, but it is a common-sense account
of the situations we will all face sooner or later.


7. Timothy E. Quill, MD
A Midwife Through the Dying Process:
Stories of Healing and Hard Choices at the End of Life

(Baltimore, MD: Johns Hopkins UP, 1996)       239 pages
(ISBN:
(Library of Congress call number: R726.Q55x 1996)

    The last years of nine of Dr. Quill's patients.
Terminal sedation is the closest Dr. Quill
is now willing to go toward helping patients to die.
He became famous by admitting in print that he helped one patient to die.
But here we have more mundane dying-processes.
There are many useful insights as seen thru the eyes of the doctor.


8. Lois Snyder, JD & Timothy E. Quill, MD, editors
Physician's Guide to End-of-Life Care

(Philadelphia, PA: American College of Physicians: www.acponline,org, 2001)       267 pages
(ISBN: 1-930513-28-3; paperback)
(Library of Congress call number: R726.8.A46 2001)
(Medical call number: WB310A512p 2001)

    This is a collection of articles by 27 doctors, professors, & lawyers
exploring various aspects of terminal care.
They break no new ground, but they do present a good analysis
of the problems facing doctors who care for the dying:
How to communicate better with patients and families?
Dealing with pain, depression, dementia, & grief.
Withdrawing life-supports and other life-ending decisions.
Advance directives and hospice care.
Legal and financial problems in end-of-life care.

    This guide should be especially helpful to physicians
who are just beginning their practice
or who are only beginning to think about how to deal with dying patients.


revised 4-3-2009

    
See related bibliographies:

Best Books on Voluntary Death


Best Books on Preparing for Death


Books on Terminal Care


Books on Helping People to Die


Best Books on the Right-to-Die

Books Opposing the Right-to-Die


Go to the Book Review Index
to discover 400 other reviews
organized into more than 40 bibliographies.


Return to the DEATH page.


Return to the beginning of this home page:
An Existential Philosopher's Museum





The views and opinions expressed in this page are strictly those of the page author.
The contents of this page have not been reviewed or approved by the University of Minnesota.