Rowman and Littlefield International

The Dying Experience

Expanding Options for Dying and Suffering Patients

By (author) Samuel H. LiPuma, Joseph P. DeMarco

Publication date:

28 March 2019

Length of book:

266 pages


Rowman & Littlefield International

ISBN-13: 9781786608574

This vitally important book attempts to move beyond the current death-denying culture. The use of euphemistic and defiant phrases when dealing with terminal disease such as “She lost her battle with cancer” was more appropriate when medical doctors could do little to prolong life. But treatments and technologies have significantly changed. Now life prolonging interventions have outpaced our willingness to use medical intervention to secure patient control over death and dying. We now face a new question: When is it morally appropriate for medical intervention to hasten the dying process? LiPuma and DeMarco answer by endorsing expanded options for dying patients. Unwanted aggressive treatment regimens and protocols which reject hastening death should be replaced by a patient’s moral right, in carefully defined circumstances, to hasten death by means of medical intervention. Expanded options range from patient directed continuous sedation without hydration to physician assisted suicide for those with progressive degenerative disorders such as Alzheimer’s. The authors’ overriding goal is to humanize the dying process by expanding patient centered autonomous control.

LiPuma (Cuyahoga Community College) and DeMarco (Cleveland State Univ.)—both philosophers—offer an informed, well-argued, and boundary-pushing defense of expanded medical interventions at the end of life. Drawing on data indicating serious limitations in current pain management strategies, the authors argue that physician assistance in hastening death is a morally appropriate option that demonstrates compassionate concern for terminal patients facing unbearable suffering and loss of dignity. The authors argue that public policy should open options currently unavailable to those whose suffering exceeds the limits of pain relief through palliation. They present a strong case for the humaneness of assisted suicide even in cases of progressive dementia disorders. While protecting those suffering decision-making impairments, the authors center ethical concern at the end of life on the competent and autonomous patient making decisions grounded in informed consent, and they defend medical interventions to hasten death, including physician assisted suicide and euthanasia. This bold, thoughtful, and mature study revisits end-of-life issue with ethical sophistication, challenging six-month limits for defining "terminal" and questioning the usefulness of the double effect doctrine. Case studies demonstrate the end-of-life problems the authors are seeking to rectify.

Summing Up: Recommended. Advanced undergraduates through faculty and professionals.