Our supporters often join the Death with Dignity movement because of a heartbreaking personal experience. Ann Neumann began her exploration of dying in our country after witnessing her father’s death. The result of Neumann’s work is her new book, The Good Death: An Exploration of Dying in America, out today from Beacon Press, which graciously sent us a free review copy.
How We Die
Neumann spent six years volunteering at a hospice, researching history, law, religion, and the healthcare industry, and traveling around the country’s hospitals, clinics, prisons, grief centers, nursing and funeral homes, and beyond to understand the way we die today.
Where a hundred years ago, Americans tended to die at home, today most, about 80 percent, die in institutional settings where medications and machines can prolong life beyond its natural lifespan and, more importantly, the dying people’s wishes. This is a major reason we champion physician-assisted dying legislation, which allows people to die in the comfort of their homes (around 90% of people taking medications under Death with Dignity laws die at home).
Neumann deals with our issue primarily in the chapter titled “Double Effect.” She travels to Montana to investigate the landmark State Supreme Court ruling in Baxter v. Montana, which in 2008 allowed physicians in the state to prescribe death-hastening medications. Neumann traces the history and growing momentum of our movement, reviews some of the main arguments for and against Death with Dignity legislation, and speaks with advocates from all walks of life, including our friends like Robb Miller, formerly of End of Life Washington.
Neumann spends some time discussing religious influence on health care in faith-based organizations. While Death with Dignity laws allow physicians and their employers to opt out of participating in them for any reason, those in religious hospitals or clinics cannot even discuss it with patients or refer them elsewhere. In other words, moral values and religious dogma override individual freedom and personal choice.
“What [is] legal [is] not necessarily accessible to patients in those institutions. Corporations and religious institutions…interject their own beliefs into the privacy of the patient-doctor relationship.”
The Church and Death
Neumann discusses religious influence on health care in several other sections of the book, and what she finds is discouraging for anyone who wants to have their final, end-of-life wishes respected.
“The entire public conversation about our social role in protecting rights and patient privacy is shaped by the power that the Catholic Church has over how care is given to bodies, our collective body.
The hard power of the church, which retains its ability to decide the types of care millions of patients receive daily—even to decide what medical options patients can be informed of—has combined with the soft power of public influence and coercion. These deliberate efforts work in conjunction with our collective fear of talking about death, with our lack of knowledge about how it comes, and with our institutionalization of the dying….But the role that the Catholic Church and its allies play in how health care is delivered and legislated further limits everyone’s claim to choice.”
No Good Death
Neumann’s The Good Death is not to be confused with Marilynn Webb’s 1997 book The Good Death: The New American Search to Reshape the End of Life. If anything, the former constitutes an update of the latter. Though nearly 20 years passed between the respective works, the two authors paint a similar picture: few people die a good death in America.
Neumann, however, transcends that simple conclusion to say
There is no good death, I know now. It always hurts, both the dying and the left behind. But there is a good enough death…each specific to the person dying. As they wish, as best they can.