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.
