Final choices: to live or to die in an age of medical technology

Abstract

The staggering advances in medical technology over the past few decades have enormously increased the number of treatment techniques available at the concluding stages of life. For countless patients and families, this situation is challenging and confusing, especially if an unexpected crisis occurs in a hospital or hospice, or at home. Final Choices is an extraordinary presentation of the issues, options, and obstacles concerning the right and ability of a dying person to control his or her future. George M. Burnell, M.D., a psychiatrist with direct experience in grief and bereavement counseling, emphasizes the development of open communication within the family and with members of the treatment staff. He sensitively discusses many important concerns so as to facilitate such dialogue, for example: the questions to ask a doctor at the onset of illness; the fear of pain or physical deterioration (e.g., from AIDS or chemotherapy); the spiritual, legal, and financial counsel available to patient and family; the medical choices a patient may have in pursuit of a dignified death; the official documents to prepare (e.g., a living will, a power of attorney, a healthcare proxy) for the patient's last wishes; the possible merits of hospice care for the medical and spiritual benefits of patient and family. Featuring poignant case histories, Dr. Burnell describes in clear, nontechnical language the painful ethical and legal complications that surface when patients and families not pursue the possibility of do not resuscitate (DNR) orders in lieu of life-prolonging measures. Unlike other books in the field, Final Choices does not underplay the dilemmas posed by modern medical technology.Featuring a fascinating breakdown of landmark cases, the author weighs the opinions posed by the medical and legal communities, and the increasingly important role of a bioethics committee in its capacity as a family-hospital mediator. An extensive list of sample forms, charts, a he