Cover image for Final victory : taking charge of the last stages of life, facing death on your own terms
Final victory : taking charge of the last stages of life, facing death on your own terms
Preston, Thomas A., 1933-
Personal Author:
Publication Information:
Roseville, CA : Forum, [2000]

Physical Description:
xx, 252 pages ; 23 cm
Format :


Call Number
Material Type
Home Location
Item Holds
R726.8 .P73 2000 Adult Non-Fiction Non-Fiction Area

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Let's face it, we're all going to die eventually. Dying, after all, is a part of natural life. Unfortunately, modern medicine has turned this natural process into an experience that is often traumatic and painful not only to patients, but also to their loved ones. According to Thomas A. Preston, M.D., a nationally respected patients' rights advocate, it doesn't have to be this way. "Read this book. Make use of what you learn. Pass it on." -- Robert Fulghum, author ofAll I Really Need to Know I Learned in Kindergarten InFinal Victory,Dr. Preston shows how you can take charge of life's end and set the stage for a peaceful, dignified death. He gives you invaluable information on the dying process, the limits of modern medicine, and what living wills can and cannot accomplish. He describes which treatments reduce suffering, which extend it, and how far doctors can legally go to reduce pain. You will discover how to accept a serious diagnosis, how to understand life-expectancy statistics, how to decide among treatment options, how to talk with your doctors and your loved ones, and how to take charge of the medical decisions that will profoundly affect you and those you will leave behind. Final Victorymay be the most important book you or a loved one will ever read.

Author Notes

Thomas A. Preston, M.D., was for more than 20 years a professor of medicine at the University of Washington. He has appeared as a medical expert on numerous national television programs, including Nova, 60 Minutes, and a PBS special on health. His articles about medicine have appeared in publications such as the New York Times, Atlantic Monthly, Washington Post, and the Readers' Digest, among others. Dr. Preston lives in Seattle, Washington.

Reviews 1

Choice Review

Preston, a physician with decades of experience, outlines, in easy-to-read chapters, information helpful to understanding the need for early planning for end-of-life decisions. He provides helpful information to answer the question he raises: "What is the antidote for patients adrift in extended suffering after technology has run its course?" Beginning with discussions on how medical technology has affected the way we die and of the differences between living wills and durable powers of attorney for health care, Preston guides the reader through the need to discuss individual preferences related to dying with both health care providers and family members. He outlines physical and psychological changes associated with dying and provides suggestions and alternatives to prepare for and manage them. Complementing the text are chapter summaries, a sample living will and durable power of attorney for health care, a bibliography, and Web addresses for sites related to death, grief, pain control, and hospice. General readers; undergraduates. N. I. Whitman Lynchburg College

Table of Contents

Prefacep. xi
Epigraphp. xvii
Acknowledgmentsp. xix
Part 1 Taking Charge from the Startp. 1
1. Setting Your Coursep. 3
New Ways of Dyingp. 4
Preparing for Dyingp. 6
Begin Planning While You're Still Healthyp. 8
Setting Your Course in Advancep. 11
Summaryp. 12
2. Medically Managed Dyingp. 14
Changing Our Dying Processesp. 15
Dying Unnaturallyp. 18
Non-Resuscitationp. 20
Withdrawing Life-Sustaining Therapyp. 25
Aggressive Comfort Carep. 27
Terminal Sedationp. 31
Summaryp. 34
3. Advance Directives: Living Wills and Durable Powers of Attorneyp. 36
The Living Willp. 37
The Durable Power of Attorney for Health Carep. 48
Summaryp. 56
4. Talking to Important Peoplep. 58
Talking to Your Doctorp. 58
Talking to Your Family and Friendsp. 63
If You Are a Family Member or Friendp. 66
Summaryp. 68
Part 2 Taking Charge After the Diagnosisp. 71
5. Learning the Diagnosisp. 73
Why You Need to Knowp. 73
The Diagnosisp. 75
Summaryp. 80
6. Talking to Your Doctor After the Diagnosisp. 81
Absorbing the Diagnosisp. 81
Learning About Your Diseasep. 85
Discussing Options for Treatmentp. 92
Choosing Your Treatment(s)p. 94
Summaryp. 102
7. Planning in the World of Curative Therapyp. 104
How Physicians Treat Patients: A Cascading Application of Technologiesp. 105
Choosing Your Primary Decision-Making Doctorp. 108
Expectations and Hard Realityp. 109
Summaryp. 113
8. The Options of Assisted Dyingp. 114
Legal Methods of Assisted Dyingp. 115
Physician-Assisted Suicidep. 126
Summaryp. 135
9. Getting Foundp. 137
Expanding Your Familyp. 138
For Family and Friendsp. 140
Summaryp. 144
Part 3 Taking Charge When the End Is Nearp. 147
10. Understanding the Last Stages of Lifep. 149
Defining the Terminal Phasep. 150
Facing the Probabilities of the Terminal Phasep. 151
Using "Long-Shot" and Alternative Treatmentsp. 153
Planning for Terminally Ill Childrenp. 156
Summaryp. 157
11. Strategies for Peaceful Dyingp. 158
The Components of Peaceful Dyingp. 158
Medical Strategies for Peaceful Dyingp. 161
Selecting the Best Place for Dyingp. 168
Summaryp. 178
12. Talking to Important People After You're Illp. 180
Choosing a Trusted Doctor or Nurse to Direct Your Carep. 180
Talking with Your Doctorsp. 182
Talking with Your Familyp. 186
Summaryp. 193
13. Dealing with Symptoms During the Terminal Phasep. 195
Dealing with Physical Distressp. 196
Getting Good Pain Reliefp. 198
Other Methods of Pain Controlp. 203
Dealing with Mental or Emotional Distressp. 204
Summaryp. 207
14. Arriving at the Endp. 209
Symptoms at the Endp. 209
Dealing with Intractable or Prolonged Sufferingp. 211
If You Are a Friend or Family Member: Caring at the Endp. 213
Summaryp. 218
Appendix 1 Sample Living Will and Durable Power of Attorney Formsp. 219
Appendix 2 Organizations and Internet Sitesp. 225
Suggested Readingsp. 231
Indexp. 237