Death and taxes may be two of the inevitabilities of life, but for some there are options when it comes to how and when to die. In Politics of Death, William Kirtley analyzes how Oregon’s 1997 Death with Dignity Act came into existence, how it overcame challenges at the state and federal levels, and how it resulted in contentious debates on physician-assisted suicide throughout the United States.
Kirtley succinctly recounts the major facts and tactics of the ballot measures, legislative and administrative maneuverings, legal cases, and the public campaigns. He delves into the mixed results in seven other states that also seriously considered the right to permit hastened deaths. In the closing chapter of the book, he reviews studies and reports about the use of Oregon’s Death with Dignity Act and its lasting impact.
With over five hundred citations, Kirtley has written a well-documented introduction to the controversy. He presents the breadth of important issues involved in the right-to-die movement with careful consideration of the multiple perspectives. The dilemma between patient decision making and medical ethics, the role of organized religion in political debate, the influence of political consultants and mass advertising, and the boundaries of states’ rights and federal power are addressed without becoming tangents.
Kirtley presents a balanced view of the issue throughout the text. Rather than declaring that one position is right, Kirtley gives the reader the opportunity to ponder the topic independently. To be sure, Kirtley believes that “much good has come” from Oregon’s law. He explains that the benefits include the increased availability throughout the country of palliative care, hospice, pain management, and end-of-life directives. While a biographical sketch of the author is missing, Kirtley mentions teaching and holding a doctorate.
Thankfully, amidst the debate, Kirtley does not allow the reader to lose sight of what is truly at stake: the life and dignity of each person. This human aspect of the legal battle is presented through numerous quotations from advocates on all sides and, most movingly, from terminally ill patients and their family members. By including such statements—from Catholic archbishops to newspaper editors, medical associations to hospice nurses, and judges to patients—Kirtley compellingly outlines the web of competing personal interests engaged in this debate. His ability to present the various religious, ethical, and personal rights arguments alongside the legal and political issues is to be commended.
The debate over the right to hasten death with physician-prescribed medications is likely to grow in intensity. Kirtley’s Politics of Death is a timely primer for those on both sides of the issue and in between
C. William Gee
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