Final Acts of Love: Families, Friends, and Assisted Dying
(New York: Putnam, 1995) 279 pages
should be read by everyone who plans a
or who plans to help someone else in a voluntary death—doctors included.
It is a very careful guide for exploring all the dynamics associated
with choosing to die and helping others to end their lives.
Final Acts of Love is based on interviews with 140 different people,
who assisted in 160 voluntary deaths.
Only 10% of these were reported as suicides.
The rest were attributed to natural causes.
The helpers were usually not doctors, but family members and friends.
several of the cautions raised in this comprehensive
1. Is the medical diagnosis and prognosis clear to all?
2. Have all the medical options been explored, tried, and then rejected?
3. Has a specialist in the disease given a second opinion?
4. Is the patient asking for better treatment
or for loving attention rather than death?
5. Is the patient's judgment impaired by the disease or the treatment?
6. Is the patient irrationally depressed or suicidal?
7. Is the decision to die caused by a medical crisis?
8. Is the patient being pressured or manipulated by others
for personal or financial reasons?
9. Is the patient manipulating others into helping
when he or she could achieve a voluntary death without help?
10. Does the patient have an irrational fear of nursing homes?
11. How many people have been involved in discussing the proposed death?
12. How many independent people agree that death is the best option?
13. What impacts will this death have on other people?
14. Has the patient's wish to die persisted over time?
15. How long a waiting period would ensure that death is a wise decision?
16. What special measures will be needed to make the death
appear to be "from natural causes" or a "private suicide"?
17. How will the death be reported and registered?
18. What people will be present for this voluntary death?
19. What roles will each person take in the life-ending process?
20. Is one helper too enthusiastic about causing death?
21. What will the helpers do if the first method of death fails?
22. Has concern for secrecy and the details of dying
obscured the possible meanings that might be realized from this death?
23. If I plan to help some other person to die,
what are my own personal, ethical, philosophical, or religious views
about assisting a voluntary death?
24. What safeguards and limits would I put on my participation?
25. What will be the impacts on those who help with a voluntary death:
psychological, moral, professional, political, & legal?
2. Barbara Coombs
Compassion in Dying:
Stories of Dignity and Choice
www.newsagepress.com, 2003) 137
(ISBN: 0-939165-49-X; paperback)
(Library of Congress call number: not given in book)
Barbara Coombs Lee (when she
put this book together)
was President of the Compassion in Dying Federation.
Later this organization was merged with End-of-Life Choices
to form Compassion & Choices, which she now serves as President.
This book consists mostly of several stories of patients in Oregon
who chose to shorten the process of their dying
using the Oregon Death with Dignity Act.
Usually a picture of the person or whole family begins each story.
And often family members give their own accounts
of the complex processes that ultimately led to a decision for voluntary death.
All of the statements written by others support the decision for death.
Oregon was the first state that
to prescribe drugs for patients to take
to bring their lives to a peaceful and painless end.
This book is probably the only book so far to tell their stories.
(In 2009, Washington state also authorized the use of life-ending
When many of these deaths took place,
Oregon was in the national news
because of its controversial right-to-die law.
Thus, some of the patients were given considerable news coverage
for their decisions to shorten the process of their dying
—to choose a timely death.
But all of these deaths seem to have been wisely decided,
based on the information provided in this book.
The patients were all in the process of dying from well-known diseases.
And their doctors agreed to write prescriptions for life-ending chemicals
so that they would not have to suffer longer than necessary.
Some of the people profiled in this book
had the lethal chemicals on hand in case they were needed
but decided to let nature take its course.
They died from natural causes
without taking the chemicals prescribed for voluntary death.
This book also contains interesting contributions
provided by Compassion-in-Dying volunteers and staff members.
And there is a time-line describing the many steps
in the complicated process of winning the right-to-die in Oregon.
Since this book's publication in 2003, many more Oregonians
have taken advantage of Oregon's Death with Dignity Act.
And there are more steps to add to the chronicle of securing the right-to-die.
Thus we can hope for a new and expanded version of this book in the future.
We want more stories of people who rationally chose voluntary death.
Since we must all die our own deaths,
we can learn from others who have already faced death
and made wise life-ending decisions.
3. James L Werth,
Contemporary Perspectives on Rational Suicide
(ISBN: 0-87630-936-8; hardcover)
(ISBN: 0-87630-937-6; paperback)
(Library of Congress call number: RC569.C66 1999)
Thirty paired articles (pro
& con) from various perspectives
such as law, medicine, psychology, sociology, philosophy, & religion
deal with the question of 'rational suicide'.
This collection is a good snap-shot
of the state of the debate
about the right-to-die in the last decade of the 20th century.
The contributors were carefully selected
to represent the points of view of people in each profession.
What this book lacks is any
No genuinely-new views or arguments appear.
But the book now represents the background discussion,
which could be the foundation for better thinking in the 21st century.
4. Jo Roman
Exit House: Suicide as an Alternative
(New York: Seaview Books, 1980)
Jo Roman was an
artist and writer who decided on
instead of waiting for cancer to take her.
She involved a large number of friends and relatives
in her plans for death and wrote this book to explain her plan
and to argue that others should have the same right,
in organized places called Exit Houses.
5. Judy Brown
The Choice: Seasons of Loss and Renewal
after a Father's Decision to Die
6. 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'.
created February 3, 2002; revised
11-30-2007; 3-6-2009; 5-29-2010; 9-16-2010; 9-13-2011; 2-9-2012
books are welcome for this bibliography
Best Books on Voluntary Death.
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