Abstract

An interdisciplinary exploration of some of the key issues surrounding end-of-life decisions, this work is aimed at helping individuals sort out how to approach questions about death and what it is appropriate to expect from one's physician in the way of assistance when death is near. ;Following a look at whether "Hospice" and "Hemlock" are sociological "movements" is a brief history of the modern Hospice Movement and of the Right-to-Die Movement in the United States. The central chapter is a philosophical discussion of the kinds of rights we have, using Judith Jarvis Thomson's Realm of Rights , and an application of that analysis to the putative right to die. ;Contemporary public discourse about death and dying is shown to center on three kinds of theoretically available help: "do-it-yourself" help, legalized physician assistance, and medical help that is part of a continuum of care. The status of euthanasia in the Netherlands is briefly explained. ;The differences between Hospice and Hemlock become most manifest in the chapter where principles are used to evaluate the two movements, and what are here called "the pain arguments" and "the dignity of life arguments." The work ends with an effort to show how the trajectory of one's life and improved doctor-patient dialogue can help one make rational decisions about the dying process. The conclusion is reached that true compassion requires both the kind of comfort care that Hospice has made its signature and the kind of freedom to make one's own choices on which right-to-die advocates insist. ;A unique feature of the work are profiles of persons who have played critical roles in debates over death and dying: Cicely Saunders and Derek Humphry, founders of the modern Hospice Movement and the Hemlock Society USA, respectively; Jack Kevorkian, who publicly assisted more than 130 persons to die before being convicted of murder; Herbert Cohen, a leading proponent of the practice of euthanasia in the Netherlands; Timothy Quill, who published an account of how he helped a long-time patient die; and Joanne Lynn, director of the Center to Improve Care of the Dying at Georgetown University