Allow Natural Death


Remember Reading Rainbow? It was a PBS show hosted by  LaVar Burton that introduced kids to a featured book for each episode. At the end of each show LeVar would urge kids to do more reading on the topics introduced in that week’s show. He would say….”Don’t take my word for it.”  I urge you to do the same by reading my sources for your self to see what conclusions you may come to.

Oh my. So clearly outlining the dilemmas faced by those who are dying(badly) in the world of medicine. I love the use of the term “unwanted care”. Exactly.

The Dartmouth Atlas is a wealth of information. Data is presented re: Medicare spending.
Hours can be sent here seeing the different ways we care for patients in all areas of the country….and how much it costs.

The Roberts Woods Johnson Foundation website keep presents the most recent research in end of life care.

This article from Atul Gawande, is to me, one of the very best at summing up the complexities of end of life care in the American health care system.

This is an excellent and comprehensive source of clinical information regarding end of life care.


Byock, Ira (1997) Dying Well: Peace and Possibilities at the End of Life. New York: Riverhead Books

Callahan, Daniel (1995) Setting Limits: Medical Goals in an Aging Society. Washington: Simon & Schuster

Gladwell, Malcolm (2000) The Tipping Point: How Little Things Can Make a Big Difference. New York : Hachette Book Group USA

Kiernan, Stephen (1996) Last Rights: Rescuing the end of life from the Medical System: New York: St. Martin’s Press

Martensen, Robert: (2008) A Life Worth Living: A Doctor’s Reflections on Illness in a High-Tech Era. New York: Farrar, Straus and Giroux

McCollough, Dennis (2008) New York: My Mother, Your Mothe: Embracing Slow Medicine. New York: Harper Collins

Nearing, Helen. (1992) Loving and Leaving the Good Life: Post Mills, VT,: Chelsea Green Publishing Company

Nuland, Sherwin B. (1993) How We Die. New York: Alfred A. Knopf

Stone, Douglas, et al. (1999) Difficult Conversations: How to Discuss What Matters Most. New York: Penguin Books

Wheatley, Margaret J., Myron Kellner-Rogers. a simpler way. San Francisco: Berrett-Koehler Publishers

Wheatley, Margaret (2002) turning to one another: simple conversations to restore hope to the future: San Francisco: Barrette-Koehler Publishers


Callahan, Daniel, Death and the Research Imperative, The New England Journal of Medicine, Vol. 342 (9) 654-656

Garrard, E.& Wilkinson, S., (2005) Passive Euthanasia, Journal of Medical Ethics,Vol 31, p 64-68

Koch, Kathryn A., Allow Natural Death: “Do Not Resuscitate” Orders, Northeast Florida Medical Supplement, January 14, 2008, 14-17

Moss, Alvin H., 2001, Shared Decision Making in Dialysis: A New Clinical Practice Guideline to Assist with Dialysis-Related Ethics Consultations, The Journal of Clinical Ethics, Vol. 12 (4) 406-414

Price, Christy A., (2003) Resources for Planning Palliative and End of Life Care for Patients with Kidney Disease, Nephrology Nursing Journal, Vol.30 (6), 649-665.

On-line Sources

Meyer, Chuck, Hospice Patients Alliance, New Designation for Allowing Natural Death(“A.N.D.”) would Eliminate Confusion and Suffering When Patients are Resuscitated Against Their Wishes

Kellum, John A.& Dacey, Michael J., Ethics in the intensive care unit: Informed Consent;
Withholding and withdrawal of life support; and requests for futile therapies

Luce, John M. &White, Douglas B., A History of Ethics and Law in the Intensive Care Unit, MD Consult

The Natural Death Handbook: Training for Dying

Venneman, P., Nanrner-Harris, P.,Perish, M., & Hamiliton, M., “Allow Natural Death:
versus “do not resuscitate”: Three words that can change a life

Other Sources

An Agenda for Change – Improving Quality and Curbing Health Care Spending: Opportunities for the Congress and the Obama Administration – A Dartmouth Atlas White Paper

Golodetz, Arnold, The Patient’s Learning Curve – For Medical Care at the End of Life,
Self published 8/31/05 National Kidney and Urologic Diseases Information Clearinghouse.

Satel, Sally, The God Committee, June 17, 2008,

Steinman, Theodore, “Ending Dialysis: New perspectives on end-of-life considerations, The Medical Ethics Forum-Harvard Medical School, Spring 2004, 58.

Xue, Jay L., Forecast of the number of patients with ESRD in the US to the year 2010, Journal of American Society of Nephrology, Vol. 12, 2753-2758.