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

    Learning the bad news of approaching death
is often the most traumatic part.
Some were told in ways that seemed worse than death itself.
Some had to 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.
How should the doctor tell the patient that he or she is dying?
Some patients want to know only a little piece of information at a time.
But knowing the truth is usually 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.
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 today until the end of our lives.
We do not want lies and secrets.

    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 of this book,
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 dealing with 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. David F. Kelly

Medical Care at the End of Life:
A Catholic Perspective

(Washington, DC: Georgetown University Press: www.press.georgetown.edu, 2006)       180 pages
(ISBN: 978-1-58901-112-0; paperback)
(Library of Congress call number: R725.56.K46 2006)
(Medical call number: WB310K295m 2006)

    This medical ethicist reviews difficult questions for terminal medical care:
Who makes decisions: patients, family, doctors?
How do we separate standard medical care
(which must always be provided or at least offered)
from unusual, prolonged, questionable, & perhaps futile care
(which can always be challenged)?
How should we apply advance medical directives?
When are hydration and nutrition required
and when may they be withdrawn or withheld?
Are physician-assisted suicide and euthanasia ever wise?
When does treatment become medically futile?

    Unfortunately, this book limited its audience
by including the word "Catholic" in the sub-title.
It is a wide-ranging and thoughtful book
that should be read by everyone concerned with medical ethics.
As a matter of historical accident, the Roman Catholic Church
has created the longest tradition
of thinking about medical ethics at the end of life.
But this tradition does not limit what the author offers.
He does not hesitate to declare that the Pope himself
departed from wise Catholic thinking when he spoke about
providing food and water to patients in persistent vegetative state.

    There is nothing backward or conventional about this book.
David F. Kelly deserves to be much more widely read.
And his writing is good enough to warrant reading aloud.
In the opinion of this reviewer, this book is the best of its kind.

(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 of 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.
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 these helpers have met most situations before,
they know how to cope with problems
that most dying people are facing for the very first time.

4. 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.

5.  Fiona Randall & R. S. Downie

End of Life Choices:
Consensus and Controversy

(Oxford, UK: Oxford University Press: www.oup.com, 2010)       220 pages
(ISBN: 978-0-19-954733-3; paperback)
(Library of Congress call number: not in book)
(Medical call number: WB310R188e 2010)

    These authors take a basically conservative approach
to all questions concerning end-of-life decisions.
For example, they are very concerned to avoid "hastening death".
Keeping the patient alive seems to be the default 'decision'. 
When discussing terminal sedation,
they want carefully to avoid slipping toward 'euthanasia'.
The purpose of the sedative drugs should be the relief of pain
even if the doctor can foresee
that the drugs will probably result in an earlier death.

    These are concerns mainly for the medical professionals:
Which pathway towards death is most ethical for the doctors?
The patients will probably have rather different questions:
Will I ever return to my home?
Or will I be in medical institutions until I die?
If I am definitely on some pathway towards death,
why choose a longer pathway rather than a shorter one?
If I am ready to die now,
why not shorten the process of dying?

    The authors seem to assume that every patient
wants to live as long as technically possible.
But at least a significant minority of patients
would prefer life-ending decisions
that will result in dying now rather than dying later.

6.  James L. Werth, Jr., editor

Counseling Clients Near the End of Life  

(New York: Springer: www.springerpub.com, 2013)       238 pages 
(ISBN: 978-0-8261-0849-4; paperback)
(Library of Congress call number:                    )
(Medical call number: WB310C855 2013)

    Psychological experts, mainly from the academic world,
explore many aspects of caring for dying patients.
Case histories of real patients illustrate end-of-life problems,
including how they were actually resolved in these cases. 

    This book is written from the perspective of psychological helpers
rather than the patients who are facing their own deaths.
But the case-histories are still the most important contribution.
Almost no attention is given to making life-ending decisions.
Rather, death is allowed to come in its own time. 

9. 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 we will have to face at the end of our lives:
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.

10. 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 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.

11. 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.

12. 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 process of dying for 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.

13. 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)

    
See related bibliographies:

Terminal Medical Care from the Consumer's Point of View

Best Books on Voluntary Death


Best Books on Preparing for Death

Books on Helping Patients to Die

Best Books on the Right-to-Die

Books Opposing the Right-to-Die