Still dying after all these years: a classical library for contemporary controversies.

A review and discussion of Death, Dying and the Ending of Life, edited by Margaret P. Battin, Leslie P. Francis, and Bruce M. Landesman. Ashgate Publishing, 2007. The many philosophical, ethical, legal, and social aspects of death and the dying process remain deeply controversial despite substantial and continuous public discussion and debate about them. Springing from an in-depth review of a newly-published compilation of some of the most seminal writings in this area, the author in this essay reflects on and systematically analyzes how the classical literature of the past millennium has set the intellectual stage and in many respects established the rules of engagement for modern discourse on end-of-life decisions and decision-making. Keywords: ethics; law; dying; palliation; medicine Shortly before his 100th birthday, the comedian George Burns was reported to have remarked, "I don't believe in dying. It's been done. I'm working on a new exit. Besides, I can't die now-I'm booked." 1 This amusing line notwithstanding, death has always been an inevitable, undeniable part of the human condition. One would think that, by now, people would have a reasonably firm conceptual handle on the topic of death and the process of dying. But judging by an enormous and growing contemporary literature documenting and fomenting continuing controversies surrounding many aspects of this fundamental subject, we still are not quite sure why, how, and with what impact we are all one day supposed to die. Public discussion and debate about various facets of dying and its consequences have been taking place in the United States since at least colonial times (Dowbiggin, 2003; Filene, 1998; Lavi, 2005). Yet this subject continues to inspire an enormous volume of new books and articles in the academic and popular press (both secular and sectarian) as well as an avalanche of formal presentations and informal conversations. The oral and written discussion is both descriptive, reporting on empirical research and surveys of relevant populations, and normative, analyzing the ethical and legal principles of right and wrong implicated by the reality of death and dying. This discussion additionally encompasses consideration of the appropriate methods or instruments for deciding on and implementing the proper normative precepts. The discourse is richly colored by the secular, religious, cultural, and ethnic (Braun, Pietsch, & Blanchette, 2000) backgrounds and beliefs of the participants. The ways we frame and debate questions associated with death and the dying process in America today no doubt are strongly influenced by our remarkable recent advances in medical treatment capabilities (Greif & Merz, 2007) and the profoundly changing demography (i.e., the aging of the population; President's Council on Bioethics, 2005) and hence overall disease picture in this nation and internationally. Despite the importance of these relatively recent influences, the modern discussions of death and dying repeat in many fundamental respects ideas and disputes that are not brand new. As we reflect on and add our own contributions to contemporary social, philosophical, ethical, and legal controversies in death and dying, it is useful to step back and remember some of the classical literature of the past millennium that set the intellectual stage and in any many ways established the rules of engagement for today's debates. In this regard, Battin, Francis, and Landesman (2007) have performed an outstanding service by compiling and organizing in two meaty volumes many of the foundational articles on death and dying published in the philosophical, religious, medical, and legal literature during the last quarter of the 20th century. These editors are all well-respected philosophers at the University of Utah; Professor Francis also is affiliated with the university's law school. In each volume of this hardback two-volume collection, which is part of Ashgate's "International Library of Medicine, Ethics and Law" and retails for $475, Battin and her colleagues reprint directly from the original sources 27 classic selections. …