Each year, more than one million people and their loved-ones arrive at a decision to cease attempts at curative medical treatments and shift to hospice care, while one-in-five Americans now live in in geographical regions that have established lawful protocols allowing medical aid in dying-also known as assisted suicide. In this powerful new work, Lew Cohen, a psychiatrist and palliative medicine researcher, reveals a self-determination movement that empowers people to shape the timing and circumstances of their deaths, decriminalizes laws threatening those who help them, and passes assisted dying legislature. He offers a vivid tapestry woven from the candid, inspirational, and graphic stories of individuals who sought to choreograph how they would die. There is nothing simple about these decisions, and A Dignified Ending tackles the intricacies of timing, the presence of dementia and other dire but not terminal conditions, the legal risks, as well as the mixed reactions of the disability community. Cohen illuminates the evolution of right-to-die organizations in the United States, and the impact of activists like Jack Kevorkian, Derek Humphrey, Faye Girsh, Cody Curtis, and Brittany Maynard. The decision to conclude one's life with a planned death is an emotionally polarizing subject. Nonetheless, the public increasingly wants to control how they die. This requires that people formulate their end-of-life preferences and not wait until the last moment to communicate these with physicians and families. A Dignified Ending conveys truthful and nuanced accounts of men and women who chose to die, and stories of the activists-proponents and opponents- who promote this growing right-to-die movement.
Lew Cohen is a professor of psychiatry at the University of Massachusetts-Baystate School of Medicine, and an adjunct professor of psychiatry at the Tufts University School of Medicine. He is the recipient of a Guggenheim Fellowship for Medicine and Health, two Rockefeller Foundation Bellagio Residency awards, and a Bogliasco Fellowship for the Arts and Humanity, as well as the Eleanor and Thomas Hackett Award from the Academy of Consultation-Liaison Psychiatry. He is author or co-editor of several books, including No Good Deed.
Part I. Foreword Chapter 1. The Admiral and His Wife Chapter 2. The Geriatric Romeo and Juliet Chapter 3. It's Not Like She's Suffering Chapter 4. Sigmund Freud's Cancer Chapter 5.You Don't Want Custer Chapter 6. How Life Turned Out Chapter 7. Putting the 'Mensch' in Dementia Chapter 8. You Won't Let Me Suffer? Chapter 9. My Way Chapter 10. Fate Worse Than Death Chapter 11. Nothing But Torture Part II Chapter 12. Goodbye, My Love Chapter 13 .Dr. Death Chapter 14. Hemlock Chapter 15. A Well-Worn Sweater Chapter 16. Bring Out Yer Dead Chapter 17. The Federation Chapter 18. Caring Friends Chapter 19. The Metamorphosis of Caring Friends Chapter 20. The New Dr. Death Chapter 21. The Final Two Cases Part III Chapter 22. Four Boxes of Chocolate Chapter 23. On Her Own Terms Chapter 24. Golden Summer Chapter 25. Don't Sugarcoat It Chapter 26. Enough is Enough Chapter 27. What She Wanted Chapter 28. Cowboys, Mormons, and Sundance Part IV Chapter 29. We Have Choices Chapter 30. Last Thoughts Author's Notes, Acknowledgments
Cohen uses case studies of a number of people, some famous and others less well known, to examine the controversial subject of medically assisted suicide. From profiles of people like Jack Kevorkian, the late doctor who became one of the more noted champions of euthanasia, to other activists and opponents of assisted suicide, Cohen looks at the timing of such decisions, the legal risks and the mixed reaction of the disability community. * Daily Hampshire Gazette * "The wave of aging baby boomers and people with terminal or dire conditions are asking profound questions: After a well-lived life, how will I die? How will I maintain my dignity without being a burden on others? They are examining and wanting to plan and control their own end of life. Dr. Lewis M. Cohen's insightful and fascinating book candidly and high-mindedly tackles the timely issues surrounding planned death, a topic more and more likely to touch us all." -- Ken Dychtwald, CEO of Age Wave and bestselling author of "BodyMind" and "Age Wave" "In A Dignified Ending, palliative care psychiatrist and end-of-life choice champion Lewis Cohen opens our eyes and touches our hearts once again with a wide range of deeply moving stories about life-ending choices as told to him by dying patients and their caregivers, and then analyzed by a wide range of advocates and opponents. Those personally struggling with these questions, and those on all sides of this societal debate would do well to learn from this thoughtful, provocative exploration." -- Timothy E. Quill, MD, MACP, FAAHPM In "A Dignified Ending," Lewis Cohen illuminates the realities of assisted dying. Rather than rehearse familiar arguments, Cohen's vivid prose tells the stories of leaders in the right-to-die movement and of opponents without shying away from their missteps and conflicts. The most striking stories are of persons who chose to end their lives with the help of family, friends, and volunteers. His sympathies are clear, but Cohen has tried to listen attentively to and represent fairly a full range of voices in this most divisive debate. -- Tom Murray, President Emeritus, The Hastings Center Seven states and the District of Columbia have already legalized aid-in-dying. Dr. Lewis Cohen poignantly shows us the pitfalls of what can so easily happen at the end of life in those other states. Both a psychiatrist and an author, he gives special attention to the problems of dementia, addressing issues not covered in depth before. It is both a wake-up call and a helpful salve for taking better care of ourselves and those we love as we near the end of life's great journey. I have written extensively on this subject but I learned a lot by reading this engaging book. -- Marilyn Webb, Author of "The Good Death: The New American Search to Reshape the End of Life" A Dignified Ending by Dr. Lewis M. Cohen is a brilliant exposition laying out the case for dying with dignity. Having just lost a brother-in-law to metastatic cancer, who begged to be released from his great pain, I can only thank Dr. Cohen for this important and extremely well written book. -- Alan Chartock, WAMC President and CEO I kept thinking of Anton Chekhov, the most humane of our physician writers, as I read this caring, careful and compassionate book of endings, which takes up matters of life and death. -- Edward Hirsch, author of "Gabriel: A Poem" Recommended:Cohen (Univ. of Massachusetts) provides detailed stories of persons who have determined for themselves the circumstances in which they would die. He also discusses death-hastening methods and describes the experience of selected friends and family. Also included are interviews with notable activists, for example Jack Kevorkian, Derek Humphrey (Hemlock Society), Larry Egbert (Final Exit Network), and Brittany Maynard (a terminally ill 29-year-old who moved from California to Oregon to die on her own terms). Most narratives represent US persons and organizations, but Cohen also covers a biennial conference of the World Federation of Right To Die Societies, among others, and discusses end-of-life laws in Argentina, the Netherlands, Canada, and elsewhere. Although the text is organized into four parts and thirty chapters, the purpose of this organization is unclear because the book's multiple stories are woven through its multiple chapters. The author is a strong advocate of assisted dying (with the exception of persons with psychiatric disorders), but here he presents dissenting viewpoints including that of the AMA, currently restudying the issue. Chapter notes, bibliography, and index are useful, and the book is recommended especially for its numerous compelling examples. * Choice Reviews *
