Dying with Ease- a book review

Dr. Spiess doesn’t suggest that confronted with terminal illness we refuse treatment and give up. He advocates thinking about and planning for the dying process long before we develop an illness that might be fatal.

This is at least the fouth book about death I have reviewed. I didn’t plan to, but it just happened. Maybe because of what Dr. Atul Gawande wrote in his book Being Mortal, another book I reviewed.

Death may be the enemy, but it is also the natural order of things.

Atul Gawande, M.D.

In this instance, I was approached by the publisher , FSB Associates, asking if I would review the book, and offered a complimentary copy. Otherwise, I was not compensated for my review. The book links in this post are affiliate links which may help support this blog financially.

Dying with Ease by Jeff Spiess, M.D.

A Compassionate Guide for Making Wiser End-of-Life Decisions
Dying with East-a book

In the introduction, author Dr. Jeff Spiess explains his purpose for writing this book.

my primary hope is for you, dear reader, to become more informed and at peace regarding your own dying.

Jeff Spiess, M.D.

Dr. Spiess doesn’t suggest that confronted with terminal illness we refuse treatment and give up. He advocates thinking about and planning for the dying process long before we develop an illness that might be fatal.

His book reviews the challenges of the dying process, and guides us in making choices that make it smoother and with ease.

Let’s review the titles of each chapter with a brief description of what each contains.

1. Dying in America

Here he proposes a definition for what is a “good death”; it’s one that matches the wishes of the dying person and their family.

2. I’m Going to Die? What Can I Do?

In this chapter he explains Advance Care Planning

  • Advanced Directives
  • Durable power of attorney for healthcare
  • Do Not Resuscitate-DNR
  • Physician Orders for Life Sustaining Treatment
  • Artificial Nutrition and Hydration

3. Hospice

In this chapter he reviews the history of hospice care care and explains the basics of palliative (rather than curative) care

4. Suffering

Most dying persons want to minimize suffering so Dr. Spiess lists ways to do so, some of which are controversial and even illegal in some states.

  • Palliative sedation
  • Voluntary stopping eating / drinking
  • medical aid in dying
  • voluntary euthanasia

5. It’s My Life, Isn’t It?

Here he discussed autonomy , bioethics, and the legal system using past high profile cases as illustrations, those being

  • Karen Ann Quinlan
  • Brittnany Maynard
  • Theresa Schiavo
"To every thing there is a season" Bible verse with fall color leaves
from Ecclesiastes 3

the time of peril, what St. John of the Cross called the “dark night of the soul,” … both tests the validity of one’s faith and initiates that essential process of incarnation

page 109

6. What’s God Got to Do With It?

Here he talks about “Religion, Spirituality, and the End of Life. He finds many people turn to religion when faced with death and sometimes that is not an altogether positive experience. However, he denies being anti-religion saying,

many find religious traditions to be sources of profound comfort and meaning. …it has been so for many friends, relatives, and patients, and also because it is true for me.

page 109

He finds it essential to differentiate religion as primarily a matter of intellectual assent to doctrines and beliefs, or whether the essense of a person’s faith has become understood and embodied in their being.

photo by DJ Thomas, Lightstock.com

7. What Does It Feel Like to Die?

In this chapter he invites the reader to do a guided exercise to encounter the inner experience of dying. Putting pen to paper you will answer a series of questions about your life. Then you review it as you finish reading the chapter. I did the exercise and found it enlightening and sobering.

8. Envisioning Your Own Death

Here he expands on the idea of Advanced Care Planning introduced in chapter 2. He adds such steps as

  • Know the rules (insurance coverage)
  • Disposition of your body
  • Disposition of “stuff”, making a will
woman sitting in a cemetery
photo from the Lightstock.com collection, an affiliate link

9. What’s It All About, Anyway?

Dr. Spiess concludes with a true story about a wife’s journey to finding meaning after her young husband’s unexpected death.

living well increases the likelihood of dying well

page 161

Conclusion

After the obligatory Acknowledgments this book has

  • Discussion Questions which seem most appropriate for personal reflection . There is one question based on each chapter.
  • Notes, which are chapter specific
  • An extensive Bibliography
  • An Index
  • Brief Author bio

Jeff Spiess, M.D.

Dr. Jeff Spiess

Dr. Spiess started in medicine as an oncologist, cancer specialist, then transitioned into palliative and end-of-life care as director of a hospice. His website, https://drjeffspiess.com/, offers a complete bio, audio interviews, his blog posts, social media links, and form to join his email list.

exploring the HEART of life and death

Thanks for following this blog. If you’re visiting, I would love for you to start following Watercress Words : use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me. I also want you to find and follow me on Facebook, Pinterest , Instagram, and LinkedIn .

Dr. Aletha

cheesy-free faith-focused stock photos

Photos and graphics in this post are from Lightstock-quality photos and graphics site- start free trial and get 4 free credits here. 

(This is an affiliate link)

How do you want to die?

If, like me, you don’t listen to rap often, you may need to watch this video more than once to get the message. Dr. Zubin Damania, aka ZDoggMD, is a “physician, off-white rapper, and purveyor of the finest medical satire.” In this video and others he uses unconventional means to educate and inform about important health issues. This video caught my attention and I hope it does yours also.

We, meaning doctors and patients, care much about how we live, but often give little attention to how we die. But death, after birth, is the single thing we all share as humans. Still, we live like it’s not going to happen, or act surprised when it does.

 

Fewer than 10% of persons with sudden cardiac arrest survive.
Fewer than 10% of persons with sudden cardiac arrest survive.
Death should never be welcome, and it will never be easy, but sometimes it is more horrible than it has to be because no one planned for it. No one asked the hard questions-

“What if you are diagnosed with a terminal illness?”

“What if you can no longer swallow or eat on your own?”

“What if you cannot breath unassisted?”

“What if you are no longer competent to make your own medical decisions?”

 

End of life planning is not synonymous with ending care or euthanasia. It is about providing comfort, controlling pain and other symptoms and supporting family. It’s about deciding ahead of time how you want to spend the last few months, weeks, days or hours of your life.

End of life care is often provided through hospice services. 

No matter how young or old you are ,it is important to consider these things, because unexpected illness and injury can happen to anyone. There are two things to do-

 

Talk- to your family about what you want. If you  already have a life threatening condition, talk to your doctors.

Write- down what you want. This is usually in the form of an advanced directive, living will or medical power of attorney. You can learn how to do this here.

 

Advance directives are discussions or written statements which convey a person’s wishes to his or her family and physician in the event that he or she becomes unable to discuss such matters. They may

1. explain the individual’s values about health, life and death;

2. give directions to family and physician about treatment goals or the use or non-use of specific treatment modalities; or

3.  designate a surrogate to make decisions on behalf of the individual.

After completing an advance directive, the individual should discuss its content and meaning with his or her family, surrogate, and physician. Individuals should review their advance directives periodically to assure that they accurately reflect their current values and wishes.”(CMDA Ethics Statement)

My husband and I  have advance directives,and we discuss our wishes with each other periodically to confirm what our current  plans are. We both prefer to forgo aggressive treatments which are likely to be futile, but you may feel differently; it is important for your family to know.

 

 

 

It is also important to understand what your physician thinks and believes about end of life care, and how those beliefs affect one’s medical practice. Ideally, you and your doctor will agree on expectations and if not, it may be best to seek care elsewhere.

 

“Clinicians should examine carefully the verbal and written wishes expressed by their patients. They should be willing to follow these wishes provided they do not conflict with the clinician’s personal moral or religious values. If such a conflict exists, the clinician should discuss it with the patient and transfer care if the conflict cannot be resolved. ” (CMDA Ethics Statement)

 

 

“It always seems too soon until it’s too late. Talk about your end of life wishes now with those you love.” ZDoggMD

 

For further reading-

 How Doctors Die

Advance Directives and Do Not Resuscitate Orders.

 

“The End-of-Life Handbook” A Compassionate Guide to Connecting with and Caring for a Dying Loved One

(an affiliate link which pays this blog a commission for your purchase; thanks)

“This book address both the emotional and psychological issues associated with death and dying and the practical and medical realities typically dealt with at this time-unusual among titles in this subject area.

The authors, a psychologist and medical doctor, are passionate advocates for quality end-of-life care. Author Feldman’s background in positive psychology brings an emphasis on hope, inspiration, meaning, and human connection at the end of life to the book.

As medical technology progresses and life expectancies edge upward, families are being faced with ever-more-complicated choices as loved ones approach their final hours. This book offers readers much-needed guidance and support for making these often difficult decisions.”