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Describes the physician's role in the care of the dying, suggests criteria for physician-assisted suicide, and discusses living wills.

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Publishers Weekly Review

A University of Rochester professor of medicine and psychiatry and former medical director of a hospice, Quill contends that the care of people with terminal illnesses is among the ``highest callings'' of physicians. But, he argues, medical institutions as well as the legal system wrongly limit the choices available to such patients. Unsentimentally relating stories from his own practice and those of colleagues, Quill explains the various options afforded by living wills, health care proxies and ``comfort care'' (treatment limited to alleviating patient suffering). While he avers that ``I would be willing to fight substantial medical battles to continue living,'' Quill defines certain circumstances under which a rational patient should have the right to choose death and to enlist the aid of a physician to ensure ``death with dignity.'' Quill's perceptive, empathetic exploration will help readers to make informed decisions in tragic situations. (Mar.) (c) Copyright PWxyz, LLC. All rights reserved

Booklist Review

Quill, Diane's physician for several years, diagnosed her problem as acute leukemia. His description of her taking control of her illness, her final months with her husband and son, and her suicide from barbiturates he had given her originally appeared in the New England Journal of Medicine. This book is, in part, Quill's response to the 1,500 letters he received after journal publication, but it is even more the result of his being the humane and thoughtful physician he is. In it, he describes his experiences with the deaths of relatives and patients and his growing feeling that medicine was not taking the proper attitude toward death. He writes about comfort care, hospice care, assisted suicide, and euthanasia, and throughout he makes it clear that the major element in them is the physician-patient relationship. He also argues the need for change in medical education, hospital policies, insurance regulations, legal requirements, and social attitudes regarding death in a cogent and sympathetic manner, personalizing his theses with case histories. The great need served by all the changes he advances is the need for honesty; the sought-for goal is "prolonging a meaningful life and humanizing the process of dying." ~--William Beatty