Last Rights: Rescuing the End of Life from the Medical System [Hardcover]

Stephen P. Kiernan (Author)

Book Description

ISBN-10: 0312342241 | ISBN-13: 978-0312342241 | Publication Date: November 14, 2006 | Edition: First Edition

"This country is fairly crowded with doctors, families, and patients--all possessed of good intentions--failing to achieve the simple goal of allowing people to die with dignity and grace."
In the 1970s, most Americans died swiftly and brutally: of heart attacks, strokes, cancer, or in accidents. But in the past three decades, medical advances have extended our lives and changed the way we die. In Last Rights, Stephen Kiernan reveals the disconnect between how patients want to live the end of life--pain free, functioning mentally and physically, surrounded by family and friends--and how the medical system continues to treat the dying--with extreme interventions, at immense cost, and with little regard to pain, human comforts, or even the stated wishes of patients and families.

Backed with surveys, interviews, and intimate portraits of people from all walks of life, from the dying and their families to the doctors and nurses who care for them, this book will be for our time what Elizabeth Kubler-Ross's books were for a previous generation.

Editorial Reviews

From Booklist

*Starred Review* Anyone who has stood helplessly by as physicians insisted that a battery of tests and interventions could prolong the life of a loved one, only to see those expensive efforts fail, is certain to be moved by Kiernan's presentation. While his assertion that the American way of dying has changed only during the last 30 years may be debatable, there is no question that the process of dying has undergone a radical makeover. It has become, too often, a parade of last-ditch, state-of-the-art medical interventions, to the direct detriment of the dying person and his or her family and friends. Those who have a terminal illness, Kiernan says, deserve to die quietly, in their own homes, surrounded by loved ones and as pain-free as possible. He makes it sound simple enough, and a lot cheaper than the currently popular, if futile, pricey hospital heroics that prolong little more than misery. The problem is that American medical schools devote more time to teaching students about diseases not even found in the U.S. than to preparing them to work with terminal patients. Doctors, therefore, are ill equipped in every way to accompany a patient down the path to a serene death. A nice polemic, even without practical advice on assuring one's own peaceful demise. Donna Chavez
Copyright © American Library Association. All rights reserved

Review

"Damn, I wish I'd had this book before my own father died. Part a guide to thinking through the policy questions surrounding the end of life, and part an informal handbook for helping with the deaths of your own loved ones, it also offers a final and supreme gift: the chance to begin thinking about what your own life means in the context of its inevitable end."---Bill McKibben author of The End of Nature
 
"With an uncommon mix of stories and scholarship, Stephen Kiernan has described the challenges that remain at life's end, despite efforts to reform care over the past few decades. With candor, clarity, and an advocate's sense of urgency, he seeks to understand why our acute-care system has been so resistant to change and how we can infuse
greater humanity to life's final chapter."---Joseph J. Fins, M.D., F.A.C.P., Chief of the Division of Medical Ethics, Weill Medical College of Cornell University, and author of A Palliative Ethic of Care: Clinical Wisdom at Life's End
 
"Last Rites paints a frightening picture of the disorganized, deficient, and disastrous ways many people are cared for and die. Thankfully, Kiernan goes beyond exposé to uncover hopeful progress and practical ways to protect and nurture the people we love. Kiernan's Last Rites is to end-of-life care today what Nader's Unsafe at Any Speed was to car safety in the 1960s. This is one book that America must read!"---Ira Byock, M.D., Professor of Palliative Medicine, Dartmouth Medical School, and author of Dying Well and The Four Things That Matter Most

See all Editorial Reviews

Product Details

• Hardcover: 320 pages
• Publisher: St. Martin's Press; First Edition edition (November 14, 2006)
• Language: English
• ISBN-10: 0312342241
• ISBN-13: 978-0312342241
• Product Dimensions: 9.3 x 6.2 x 1.3 inches
• Shipping Weight: 1.2 pounds
• Average Customer Review: 4.8 out of 5 stars  See all reviews (24 customer reviews)
• Amazon Best Sellers Rank: #679,683 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

18 of 18 people found the following review helpful:

5.0 out of 5 stars About What We All Know Is Going to Happen, February 15, 2007

By 

John Matlock "Gunny" (Winnemucca, NV) - See all my reviews
(REAL NAME)   

This review is from: Last Rights: Rescuing the End of Life from the Medical System (Hardcover)

When asked, the overwhelming percentage of people thinking about their own deaths say that they want to die at home, either alone or with family around and without pain.

About 1200 people a day make it this way. The other 5300 who die on an average day die in a hospital, surrounded by machines and strangers, and often in pain because the doctors are afraid to give to many drugs to patients where the government might come down on them.

My own father reached a point where he was given six months to a year to live. Or he could have an operation. He had the operation. Only afterward were we told that now he had perhaps one to five years. He lived a year and a half, and was in pain every day. The medical profession did not do him a favor.

For me this book can be summed up by four sentences on the last page, they reflect my exact hopes for myself when the time comes:

'Dozens of people taught me that same lesson during my research. They did not fear death, but they feared dying badly. They did not want to live forever, but they wanted to live well for as long as possible. They did not want to die one moment too soon, but they did not want to suffer one moment too long.'

14 of 14 people found the following review helpful:

5.0 out of 5 stars Hospice Doc gives a thumbs up, February 9, 2007

By 

Leslie A. Foote "hospice doc" (Monterey CA) - See all my reviews
(REAL NAME)   

This review is from: Last Rights: Rescuing the End of Life from the Medical System (Hardcover)

As a hospice medical director I have been greatly moved by this book. All the palliative texts I own cannot compare to the perspective of this book. I am buying copies for my hospice team, nursing home and any wayward physicians who create "problems" for our hospice clients. A must read for everyone, especially medical students in line to deal with this.

6 of 6 people found the following review helpful:

5.0 out of 5 stars Last Rights, October 17, 2007

By 

Barbara A. Lyons - See all my reviews
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Amazon Verified Purchase

This review is from: Last Rights: Rescuing the End of Life from the Medical System (Hardcover)

This is a "Must Read" for everyone! As an R.N with 32 years experience (12 yrs critical care & 7 yrs In-Patient Hospice) it is my privilege to endorse this book. Mr. Kiernan has clearly and accurately documented what is a reality that will ultimately affect every single one of us. In both scope and depth Mr. Kiernan has spoken the truth. He has not embellished, exaggerated or dramatized any detail of his book. Every human being deserves to die in peace (spiritual and emotional) and free from pain. This is a goal which is attainable but I can assure you that your chances of experiencing this are not good in any of today's modern acute care hospitals or nursing homes. (There are always exceptions). Hospice care is the only option and that is primarily because hospice is not a place but a philosophy of care. All physicians can manage the care of an acutely ill person but only a few physicians are qualified to manage your care if you are dying because the vast majority of physicians do not recognize or they refuse to accept that there is a difference. Please read this book. It could be one of the most important things you ever do both for yourself and for those whom you love.

Barb Lyons, R.N.