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The Best Way to Say Goodbye: A Legal Peaceful Choice At the End of Life Paperback – November 28, 2007

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Editorial Reviews


A comprehensive, insightful, and surprisingly entertaining guide through the maze of end-of-life decisions. It calms our greatest fear: that complete strangers can intrude on our most intimate decisions, and worse make decisions that we would not make for ourselves. Dr. Terman offers a close to ironclad strategy to preserve control at the end of life, even for those individuals who may ultimately suffer from severe brain damage or dementia. Every pitfall has been considered and solved! It also guides families through the chaos that results from inadequate advance care planning. This book is so good that our organization keeps copies at every office. It is a mainstay of the recommendations we provide our clients. --Barbara Coombs Lee, PA, FNP, JD; CEO of Compassion & Choices; Chief Petitioner for Oregon s Death with Dignity Act

Dr. Stanley Terman has provided a very insightful analysis of the President's Council on Bioethics' report, Taking Care: Ethical Caregiving In Our Aging Society. His detailed suggestions for wording Advance Directives are very important. While it may be Utopian to hope, as Dr. Terman proposes, that governmental agencies (such as motor vehicle departments) might require individuals to complete Advance Directives, it would be a major improvement over our present laissez faire policy of ignoring this issue. I am very supportive of responsible strategies to encourage individuals to complete such documents. The book's final story, She Revised her Advance Directives from 16 to 86, clearly illustrates how our views can change as we age and mature, and as our situation changes. Clearly, we need to update our Advance Directives on a regular basis. --Janet D. Rowley, MD, DSc; President s Council on Bioethics member; Albert Lasker Clinical Medicine Research Prize recipient

People think if they do not die instantaneously in a car accident or from a heart attack, they are going to be caught between two undesirable options--either to be attached to machines for a very long time, often in a state of unconsciousness with no reasonable hope for recovery, or, at the other extreme, to commit suicide or get someone to murder you so that you can end it all more quickly. In a wise, medically well-grounded, and even witty book, Dr. Terman explores the middle course: refusing tube feeding and hydration --Elliot N. Dorff, Rabbi, PhD; Distinguished Professor of Philosophy, University of Judaism; author of Matters of Life and Death

From the Author

This book is about choices. It also offers you choices in reading:

Start at the beginning and read everything, or if you prefer. . .

A) Read the book-within-a-book. Page 4 explains how to skip flagged portions to reduce the number of pages to just over 300.

B) Focus on Patient Stories and Legal Cases for discussion, Humorous Stories for fun, or Guidelines and FORMS for personal planning. The Table of Contents list all these Titles on pages xxv through xxx.

C) For a quick overview, read ten pages: "She revised her Advance Directives from age 16 to 86," and "Which documents do I need when?" on pages 383-389; and The Seven Principles of Good End-of-Life Decision-Making on 427-429. View thirst-reducing products on 104.

D) Delve into such general topics as the medical, legal, religious, or family aspects of end-of-life planning. The Table of Contents can guide your choice of chapters.

E) Implement a legal alternative to Physician-Assisted Suicide. You can avoid prolonged unbearable pain and suffering at the end of life as long as you are mentally competent. Read the answers to questions D, & numbers 1-9, 16, 19, 20, 32, 34, 36, 38, & 40.

F) Prevent years of indignity & dependency from Alzheimer's disease, vegetative states, or persistent unconsciousness. Learn how to set the stage now so others will honor your wishes in the future, if you no longer can speak for yourself. Read Chapter 3 and the answers to questions numbers 20-22, 25-31, 40, 41, and 43-45.

G) Expand your knowledge.


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Product Details

  • Paperback: 489 pages
  • Publisher: Life Transitions Publications; 1st edition (November 28, 2007)
  • Language: English
  • ISBN-10: 1933418036
  • ISBN-13: 978-1933418032
  • Product Dimensions: 9.9 x 7 x 1.2 inches
  • Shipping Weight: 2 pounds (View shipping rates and policies)
  • Average Customer Review: 4.4 out of 5 stars  See all reviews (18 customer reviews)
  • Amazon Best Sellers Rank: #666,641 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

45 of 47 people found the following review helpful By STEPHEN PLETKO on December 9, 2007
Format: Paperback

"Death is not something any one need be afraid of. It is peaceful. What I fear is suffering a long time before I die."

The above is found in this extremely well researched, well-written, and empowering book authored by psychiatrist Dr. Stanley Terman. (It was Terman's mother who said the above quoted statements to her then young son.) Clinical professor & medical ethicist Dr. Ronald Miller and attorney & social worker Michael Evans "provided professional oversight" during the creation of this book by being "critical readers and contributors" to it.

Thus, any potential reader of this book can be assured that the information on its pages is completely accurate especially from legal, clinical-medical, psychological-sociological, ethical-philosophical, and religious perspectives.

This book deals only with the process of dying, not death. It specifically has two goals:

(1) To provide a description of a legal and peaceful choice or method of dying for most of those who are suffering from devastating, terminal conditions (such as permanent brain damage or incurable, progressive dementia). Two things should be mentioned about this method:

First, it gives the suffering patient sufficient time to reconsider his/her decision with no residual effects if the patient does reconsider. Therefore, there is some control.

Second, the author tested the method out on himself!!

(2) To maximize the probability that others will honor your Last Wishes especially if you cannot speak for yourself. Thus, Terman explains why we must create precise, non-ambiguous, strategic, written documents or forms that correspond to our Last Wishes and he shows us how to do that.
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23 of 25 people found the following review helpful By C. Campbell on December 28, 2007
Format: Paperback
After my Grandpa's massive stroke he could not speak. Some family members argued he'd want 'to join' his recently deceased wife of 70 years and would not want to live so inactive. Yet others interpreted statements in his Living Will as wanting to live. I dreaded that a conflict was about to begin. We'd never go to court, like Terri Schiavo's family, but old feelings and different perspectives on what it means to provide care and reduce suffering could have divided our family. A crisis was impending. Then, we all read a story in this book, A Time To Be Sure, and discussed using its series of questions. On three occasions, Grandpa was consistent as he shook or nodded his head to indicate what he wanted: To my surprise, he wanted to continue tube feeding. All of us felt relief. We could be sure that we knew what he wanted, and we were all united to provide that. My Grandfather passed in August of 2007. This time he looked at his caregiver and she told him its okay to go if he is ready and he died then. Peacefully and the way he wanted. This is an amazing book that helps us when making decisions about death. I recommend everyone read it!
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20 of 22 people found the following review helpful By Jacqueline Marcell on December 14, 2007
Format: Paperback
Dr. Terman offers many suggestions on how to make the process of dying peaceful... for patients, for physicians, and for family members--all of which makes this book both comprehensive and useful. He presents a compelling case for a legal and peaceful alternative to Physician-Assisted Suicide, which he terms: 'Physician-Aided, Patient-Hastened Dying.' He also provides a step-by-step guide for those who want to avoid lingering in a state of total dependency and indignity that can result from illness, including Alzheimer's and other dementias.

We learn that voluntary refusal of food and fluid is legal and has significant advantages for terminally ill patients: They have opportunities to change their mind, and precious days to make amends and say goodbye to loved ones. This was particularly meaningful for me, as I had a dear friend who was dying from a brain tumor recently who ended her life this way. Now I more fully understand her difficult decision and that of the late Mrs. Billy Graham who also refused tube-feeding.

The book gains depth from the contributing editors: a medical ethicist and an end-of-life attorney. Psychiatrist Terman strengthens his argument by sharing captivating and poignant memoirs by recognized authors (a favorite 'An October Morning'), as well as many from his patients. One, 'A Time To Be Sure,' so intrigued the attorneys for Terri Schiavo's parents that they included it in Dr. Terman's declaration to the Florida court, after asking him to help determine if Terri really wanted to continue tube-feeding.
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55 of 68 people found the following review helpful By Kay Paggi on January 11, 2008
Format: Paperback
The Best Way to Say Goodbye: a Legal Peaceful Choice at the End of Life has some excellent information. However, the book is so redundant that its information is not useful. As a counselor and a professional geriatric care manager, it is not a book I would recommend.

Basically the book is an extensive exhortation to use starving and dehydrating as a way of ending your life. The author, a psychiatrist, actually tried the method himself for 4 days. Oddly, he was not bothered by hunger pangs or thirst. He spends most of the 450 pages justifying this method of dying, which he calls Voluntary Refusal of Food and Fluid. Whenever this method is mentioned in the book, it is typed in bold face, which gets annoying.

Refusing food and fluids may not be experienced as an easy death by patients to whom taste is a primary source of pleasure, other pleasures having been removed by the effects of their disease. The initial deprivation before onset of a coma could be psychologically painful. The author neglects to mention that Azotemia, a normal and comfortable biological reaction to lack of food and water, is well known by hospice workers for the sedating side effect on dying persons.

The book is poorly organized. The same topics come up in almost every chapter, and the author says the same thing over and over again. It would be more useful if there were 1/10 of the words and a comprehensive index, plus addendums on thirst-reducing aids, medications that can be taken other than with fluid, and possible legal complications. A short chapter on the various religious views would be helpful.

The book needs statistical data to support the statement that "Medicare will most likely be bankrupt years before Social Security.
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