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Book Review: At Peace

Choosing a Good Death after a Long Life

by Samuel Harrington MDGrand Central Life & Style
reviewed by Damon Orion
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At Peace book cover

“How do you want to die?” asks Samuel Harrington MD. “Do you want to suffer? Do you want your last conscious sensations to be the chest compressions of an emergency medical technician (EMT) separating your sternum from your ribs?” 

Harrington, a graduate of Harvard College and the University of Wisconsin Medical School, served as Sibley Memorial Hospital’s patient safety officer representative to the Johns Hopkins Medicine Board of Trustees. His experiences as a gastroenterologist gave him a firsthand understanding of the limitations and hazards of “assembly-line care.” As such, he advises readers of At Peace to be wary of a health care system “designed to treat excessively.” Using his father’s story as an example of a good death, Harrington outlines steps that can be taken to avoid a medicalized death, characterized by what he calls “the state of a semi-conscious patient in an ICU or nursing home who is subjected to medical treatments beyond their direct wishes or beyond common sense.” 

At Peace takes a realistic look at the difficulties one is likely to encounter after age 75, presenting an overview of diseases commonly responsible for death in one’s later years. For those who have come to the conclusion that an earlier death in relative comfort is preferable to a protracted one in a medical facility, Harrington discusses how to have “The Conversation” with a loved one about end-of-life wishes; explores the ethics and legalities of the voluntary refusal of fluid and food; offers advice on the preparation of advance directives; and encourages readers to create a vision of their own death. It is the author’s hope that this information will “maximize the possibility that one can pass away surrounded by friends and family, with minimal suffering, uninterrupted by ineffective medical interventions, at home (if desired or possible) and at peace.”


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