Addressing the subject of euthanasia, medical ethicist Dr. Linda Emanuel assembles testimony from leading experts to provide not only a clear account of the arguments for and against physician-assisted suicide and euthanasia--but also historical, empirical, and legal perspectives on this complex and often heart-rending issue.

“A remarkably nuanced, empathetic, and well-crafted work of journalism, [The Inevitable] explores what might be called the right-to-die underground, a world of people who wonder why a medical system that can do so much to try to extend their lives can do so little to help them end those lives in a peaceful and painless way.”—Brooke Jarvis, The New Yorker More states and countries are passing right-to-die laws that allow the sick and suffering to end their lives at pre-planned moments, with the help of physicians. But even where these laws exist, they leave many people behind. The Inevitable moves beyond margins of the law to the people who are meticulously planning their final hours—far from medical offices, legislative chambers, hospital ethics committees, and polite conversation. It also shines a light on the people who help them: loved ones and, sometimes, clandestine groups on the Internet that together form the “euthanasia underground.” Katie Engelhart, a veteran journalist, focuses on six people representing different aspects of the right to die debate. Two are doctors: a California physician who runs a boutique assisted death clinic and has written more lethal prescriptions than anyone else in the U.S.; an Australian named Philip Nitschke who lost his medical license for teaching people how to end their lives painlessly and peacefully at “DIY Death” workshops. The other four chapters belong to people who said they wanted to die because they were suffering unbearably—of old age, chronic illness, dementia, and mental anguish—and saw suicide as their only option. Spanning North America, Europe, and Australia, The Inevitable offers a deeply reported and fearless look at a morally tangled subject. It introduces readers to ordinary people who are fighting to find dignity and authenticity in the final hours of their lives.

When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Physician-Assisted Death is the eleventh volume of Biomedical Ethics Reviews. We, the editors, are pleased with the response to the series over the years and, as a result, are happy to continue into a second decade with the same general purpose and zeal. As in the past, contributors to projected volumes have been asked to summarize the nature of the literature, the prevailing attitudes and arguments, and then to advance the discussion in some way by staking out and arguing forcefully for some basic position on the topic targeted for discussion. For the present volume on Physician-Assisted Death, we felt it wise to enlist the services of a guest editor, Dr. Gregg A. Kasting, a practicing physician with extensive clinical knowledge of the various problems and issues encountered in discussing physician assisted death. Dr. Kasting is also our student and just completing a graduate degree in philosophy with a specialty in biomedical ethics here at Georgia State University. Apart from a keen interest in the topic, Dr. Kasting has published good work in the area and has, in our opinion, done an excellent job in taking on the lion's share of editing this well-balanced and probing set of essays. We hope you will agree that this volume significantly advances the level of discussion on physician-assisted euthanasia. Incidentally, we wish to note that the essays in this volume were all finished and committed to press by January 1993.

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

Emanual (oncology and medical ethics, Harvard) rejects the argument that recent issues of medical ethics are the result of new technologies, and contends that they are an inevitable consequence of liberal political values. He proposes a communitarian solution. Annotation copyrighted by Book News, Inc., Portland, OR

Encourages patients to become active participants in the process of fighting disease, and includes guidelines for medically-assisted suicide.