THE INEVITABLE

A survey of the history and current state of affairs of the right-to-die movement.

When the laws fall short or are subject to powerful economically or ideologically vested interests, people have always found a way to end the suffering of their lives. Working from the concept of a peaceful death being a basic human right, physician-assisted, rational suicide has usually been available, covertly if necessary. In this searching, compassionate narrative, journalist Engelhart explores “the push to wrest bodily control, at the end of natural life, from the behemoth powers of Big Medicine and the state,” an effort that “has been defined by individual stories”—in this case, doctors and individuals and their immediate, personal encounters with the administration of life-ending drugs and the paths that led them to that point. As the author recounts, the reasons for this increasingly public debate involve concepts of autonomy and the even more practical desire to avoid suffering and indignity. For many of the author’s interviewees, “planning death was often about avoiding indignity, something they imagined would be humiliating, degrading, futile, constraining, selfish, ugly, physically immodest, financially ruinous, burdensome, unreasonable, or untrue.” The author also examines instances in which patients were “treated and treated and overtreated,” which often prolonged agony and drained resources, whether individual or societal, and she digs into the even more complicated issues involved with patients suffering from dementia or other forms of mental illness. Evenhandedly and without undue criticism, Engelhart brings forth the counterarguments—e.g., the slippery path to eugenics and social Darwinism or that “maybe rational suicide was just a symptom of social and financial neglect, dressed up as a moral choice”—but she offers enough convincing evidence about the efficacy and ethical standing of the right-to-die movement that many readers will be persuaded of its value to society.

A meticulous and frank collection of end-of-life stories, conversations, and ideas.