Mr. Filene takes the reader into the lives and feelings of people who have struggled with the predicament of modern dying. By personalizing this social and cultural issue, he illuminates the difficult and often harsh decisions involved.

Beginning with the nineteenth-century background and the rise of medical technology, Mr. Filene moves quickly to the landmark case of Karen Ann Quinlan, who became in the 1970s the macabre protagonist of a melodrama that crystallized the nation's consciousness and produced a legal benchmark. In navigating the maze of bioethical arguments surrounding this and succeeding cases, the author guides readers through complex questions with remarkable lucidity.

Ultimately, Mr. Filene argues, we must acknowledge that traditional American self-determination is not sufficient to resolve terrible questions of life and death. He suggests, first, that terminal patients must have greater access to "reassurance or morphine": and second, that we can finally exercise our autonomy only with the help of others.