77 of 77 people found the following review helpful:
5.0 out of 5 stars
Many views of dying in America, July 8, 2000
Offering no soft, simple answers, this book gives a troubling look at many different views of dying in America. A necessary read for anyone interested in not just the spiritual side of dying, but the practical, political, difficult aspects of dying.
When I started reading books on dying (Final Gifts by Maggie Callanan, Patricia Kelley; The Grace in Dying by Kathleen Singh), I read books that gave me hope and comfort in dealing with my own mortality. This book made the hair on my neck rise up.
It begins by shattering illusions (the ones I'd built up) about having a pain-free, easy death. There are insurance companies, personal opinions, differing agendas of a variety of institutions that come into play.
In short, some people have an easier death than others. Webb writes in an easy to read, article style. She begins with a chapter called "Dying Easy", about the nearly beautiful, fairly comfortable death of Judith Hardin, who at 36 dies at home with her husband and children.
"Dying Hard," is based on Webb's personal interviews and experiences with the death of Peter Cicione. Cicione died a death more painful than it needed to be, largely due to medical staff's fears that this dying man was misusing morphine, might overdose or use so much medication that the drugs would no longer be effective (not true).
In "The Sorcerer's Apprenctice" and "When Death Becomes a Blessing," Webb focuses on the history of medical control of pain, the prolonging of life with new medical techniques and modern pain control through the works of Dr. Kathleen Foley, director of neurology pain service at Memorial Sloan-Kettering Cancer Center. Foley estimated that 5% of the patients she was seeing were "in unassuageable pain." Webb's conservative estimate offers that "109,500 people a year die with unrelieved suffering." Much of this is due to outdated information, old rules, and misunderstandings about how much medication a dying person in severe pain can and should get. She offers the possibility that terminally ill patients who want to commit suicide or look for assistance in dying might not do this, if their pain could be properly handled.
She has chapters about the legal conflicts for families who want comatose relatives off of life-support systems, with detailed information about Karen Quinlan and Nancy Cruzan's cases and the affects on their families long after these women died.
"Bearing the Burden" focuses on what happens to the lives of families with a terminally ill member - "The sad secret that many don't want to admit is that care at home, wonderful as it can be in helping a patient to a good death, is hard on families. Home care may allow for those close, intimate, late-night times with the dying family member...but there are also the difficult times: changing diapers, losing sleep or feeling intense anxiety because the patient is in pain or can't breath..."
This first half of the book is tough reading, but necessary - for there is still a lot of work to be done to make dying easier. The second half of the book deals with hospice; assisted dying (suicides); spirituality in dying.
She closes with 10 common factors 'good deaths' have - 1) open, ongoing communication with doctors, patients, families 2) preservation of the patient's decision-making powers for as long as possible 3) sophisticated pain control 4) limits on excessive treatment (medical interventions, per the patient) 5) focus on preserving the patient's quality of life 6) emotional support 7) financial support 8) family support 9) spiritual support 10) patient isn't abandoned by the medical staff even when curative treatment is no longer required.
She also has 10 changes, which she believes need to be made to change the culture of dying from a cold, hospital-set detachment to a family affair. These encompass everything from expanding health insurance to cover needs currently not met, to legalization of assisted suicide.
If you have given little thought to some of the darker sides of dying, focusing as I have on the spiritual and more uplifting side, this book offers a lot of food for thought. Well-written, easy to read, disturbing.
Even if you have different opinions than Webb has (about assisted suicide, for example), this book is a good read to investigate the other side's information and arguments.
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14 of 15 people found the following review helpful:
5.0 out of 5 stars
Important information everyone should know!, February 19, 1999
This review is from: The Good Death: The New American Search to Reshape the End of Life (Paperback)
The Good Death provided me with information that everyone should know! If you have a loved one facing a trminal illness this is the book that you should read. I was especially grateful for the information about pain management, about what to expect, and to learn why we fail so often in this country to make people comfortable in their final days, how our "war on drugs" has tied the hands of doctors and resulted in dying patients being under medicated, often times grossly under medicated even hospices, and what you can do to insure that your loved on will not suffer.
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