Dying Declarations: Notes From a Hospice Volunteer

The book Dying Declarations is a small tome that defies easy description. Most simply put, it can be called a nonthreatening invitation to explore the field of hospice care. The author, who is a bioethicist, employs an almost folksy, conversational style as he discusses both the philosophical perspectives of hospice and palliative care and also practical considerations faced by caretakers of the dying and hospice volunteers. His stated intent in writing the book is to try to bridge the gap he perceives between moral theory and moral practice.

Unabashedly candid in nature, the book is an amalgam of case vignettes, the author's poetry, lessons taught by the dying, and philosophical asides concerning the state of health care in the United States. It really is best seen as a primer or introduction to the field, because it does not attempt to explore, with any academic rigor or depth, core issues in hospice medicine and care. In very cursory fashion, the book touches upon subjects such as euthanasia, do-not-resuscitate orders, withdrawal of life support, and more practical concerns, such as effective pain management, caretaker fatigue, grief, and bereavement.

The book has two chief goals, both of which it achieves quite successfully. The first is to portray hospice care as an attractive, dignity-enhancing option for people who are confronted with a terminal diagnosis and for their families. The second goal is to describe the varied and pivotal roles a volunteer plays on the hospice treatment team.

The author shares his own initial fears as he contemplates becoming a hospice volunteer and quickly debunks the perception that it is likely a dreary, depressing undertaking. Through the use of very touching, almost confessional reminiscences of people and families he has encountered as a hospice volunteer, the author puts forth the gentle encouragement, "If I can do this, so can you!"

The book is an easily accessible read for anyone interested in the field of hospice, regardless of their training or education.