Final Acts: Death, Dying, and the Choices We Make

Final Acts: Death, Dying, and the Choices We Make

Final Acts: Death, Dying, and the Choices We Make

Final Acts: Death, Dying, and the Choices We Make

Synopsis

Today most people die gradually, from incremental illnesses, rather than from the heart attacks or fast-moving diseases that killed earlier generations. Given this new reality, the essays in Final Acts explore how we can make informed and caring end-of-life choices for ourselves and for those we love- and what can happen without such planning.

Contributors include patients, caretakers, physicians, journalists, lawyers, social workers, educators, hospital administrators, academics, psychologists, and a poet, and among them are ethicists, religious believers, and nonbelievers. Some write moving, personal accounts of "good" or 'bad" deaths; others examine the ethical, social, and political implications of slow dying. Essays consider death from natural causes, suicide, and aid-in-dying (assisted suicide).

Writing in a style free of technical jargon, the contributors discuss documents that should be prepared (health proxy, do-not-resuscitate order, living will, power of attorney); decision-making (over medical interventions, life support, hospice and palliative care, aid-in-dying, treatment location, speaking for those who can no longer express their will); and the roles played by religion, custom, family, friends, caretakers, money, the medical establishment, and the government.

For those who yearn for some measure of control over death, the essayists in Final Acts, from very different backgrounds and with different personal and professional experiences around death and dying, offer insight and hope.

Excerpt

When we issued a call for contributions to a book on death and choice, we hoped for strong, convincing essays: personal stories, professional analysis, some historical background, political and social contexts. We wanted essays that would explore how complicated it is to put death and choice in the same sentence, particularly when one is talking about terminal illness. Given a death sentence, what kind of choice or agency does one have?

With that common purpose, we also came to the project for different reasons and out of different life circumstances.

Nan

I have been interested in the subject of death and choice for some time—way before I turned sixty-five. I have taken care to do the “normal” things like write out an extensive living will, draw up a power of attorney and do-notresuscitate instructions; before I travel on an airplane I tend to look at my living will and update it with yet another procedure or mechanical device I do not want inflicted on me. Before almost every departure, I write a note to my daughter (there are years of them sitting in sealed envelopes waiting for her to read after I have died) and now I have decided to write an ethical will for my grandchildren.

I have always been a strong defender of death by choice, of self-suicide and assisted suicide, telling my friends and relatives that I plan to take my own life at some point if and when I am incapacitated or no longer feel I am able to have the quality of life I want for myself. I have even advocated for suicide when you are not incapacitated—before you get to that point—and I have argued against those who say that people who do that are depressed. Like so many people, I watched my mother spend her last years lying, unaware, unable to communicate, and maybe in pain, in a nursing home. While my concern about dying . . .

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