Document Type


Publication Date



Political Science


Many Americans, before they die, will go through a stage where they are unable to make competent decisions about their own life-sustaining medical treatment. More and more, family members and care givers are facing these difficult decisions in their stead, becoming engulfed in questions about personal wishes, medical ethics, state and federal law, and quality of life.

Drawing on provocative case studies, personal interviews, and detailed research, James Hoefler examines the medical, legal, ethical, and clinical aspects of such right-to-die issues. Beginning with the legal struggle of a woman whose son existed in a persistent vegetative states (PVS) for seventeen years, the author moves into a broader look at consensus among professional organizations, from the AMA to the President's Commission to the National Center for State Courts; beliefs of mainstream religious groups; public opinion; issues surrounding end-stage Alzheimer's and other organic brain disorders that can slowly lead to PVS; and the role of artificial nutrition and hydration in these cases.

Hoefler concludes with recommendations on how to improve the quality of right-to-die decisionmaking. An absorbing read with a minimum of technical jargon, this book is a valuable guide to care givers, public policy students, medical ethicists, family members, and anyone facing questions about an individual's right to die.

Hoefler_Cover.pdf (3337 kB)

Hoefler_Gift-Note.pdf (588 kB)
Gift Note

Hoefler_TitlePage.pdf (477 kB)
Title Page

Hoefler_Copyright.pdf (606 kB)

Hoefler_Dedication.pdf (455 kB)

Hoefler_Contents.pdf (1290 kB)

Hoefler_Tabes,Figures,Boxes.pdf (1176 kB)
Tables, Figures, and Boxes

Hoefler_Preface.pdf (1453 kB)

Hoefler_Acknowledgments.pdf (805 kB)

Hoefler_Introduction.pdf (3924 kB)

Hoefler_Ch1.pdf (21719 kB)
1. The Case of Joey Fiori

Hoefler_Ch2.pdf (25760 kB)
2. The Emergence of Consensus

Hoefler_Ch3.pdf (21770 kB)
3. A Broader Consensus

Hoefler_Ch4.pdf (19285 kB)
4. Beyond the PVS: Severe Dementia

Hoefler_Ch5.pdf (19290 kB)
5. Artificial Nutrition and Hydration

Hoefler_Ch6.pdf (22858 kB)
6. Conclusion and Recommendations

Hoefler_Notes.pdf (14479 kB)

Hoefler_References.pdf (12443 kB)

Hoefler_About-Book-and-Author.pdf (638 kB)
About the Book and Author

Hoefler_Index.pdf (4052 kB)