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University of California Press

About the Book

How the legalization of assisted dying is changing our lives.

Over the past five years, medical aid-in-dying (also known as assisted suicide) has expanded rapidly in the United States and is now legally available to one in five Americans. This growing social and political movement heralds the possibility of a new era of choice in dying. Yet very little is publicly known about how medical aid-in-dying laws affect ordinary citizens once they are put into practice. Sociological studies of new health policies have repeatedly demonstrated that the realities often fall short of advocacy visions, raising questions about how much choice and control aid-in-dying actually affords.
 
Scripting Death chronicles two years of ethnographic research documenting the implementation of Vermont’s 2013 Patient Choice and Control at End of Life Act. Author Mara Buchbinder weaves together stories collected from patients, caregivers, health care providers, activists, and legislators to illustrate how they navigate aid-in-dying as a new medical frontier in the aftermath of legalization. Scripting Death explains how medical aid-in-dying works, what motivates people to pursue it, and ultimately, why upholding the “right to die” is very different from ensuring access to this life-ending procedure. This unprecedented, in-depth account uses the case of assisted death as an entry point into ongoing cultural conversations about the changing landscape of death and dying in the United States.

About the Author

Mara Buchbinder is Associate Professor of Social Medicine and Adjunct Associate Professor of Anthropology at the University of North Carolina at Chapel Hill. She is author of All in Your Head: Making Sense of Pediatric Pain and coauthor of Saving Babies? The Consequences of Newborn Genetic Screening.
 

Table of Contents

Introduction
1. Scripting Choice into Law
2. Making Death
3. Starting the Conversation
4. Reconciling Assistance with the Physician's Professional Role
5. Access and the Power to Choose
6. Choreographing Death
Conclusion 

Coda
Acknowledgments
Appendix: About the Research
Notes
References
Index

Reviews

"A beautifully written, thought-provoking ethnography that traces how patients, family caregivers, health care providers, activists, and legislators navigate this new world in which MAID is a legal option. . . . This book is essential reading for courses on death and dying, health care, and bioethics and will be eye-opening for those caring for terminally ill loved ones or grappling with their own life-or-death decisions. . . . Highly recommended."
CHOICE

“Buchbinder offers a compelling introduction to the complexity and inconsistency of ethical stances around life and death decision-making. In addition, she calls attention to the danger of reducing the forms of personhood and sociality produced through impending death to individual autonomy. And she  shows the heart-wrenching consequences of unequal access to information and care in the United States. Scripting Death is a wonderful introduction to a pressing social issue.”

Medical Anthropology Quarterly
“?"Buchbinder’s work is the latest of several highly accessible health related ethnographies that represent a resurgence of anthropology in which real people talk rather than ‘discourse,’  questions are asked rather than ‘interrogated,’ and the term ‘reinscribe’ does not appear. A welcome development."
The Hastings Center Report
"Scripting Death provides a rich collection of Vermont stories about the challenges of organizing medical aid in dying, which serve as a microcosm of the broader problems faced by Americans in gaining access to health care."
Journal of Health Politics, Policy and Law
"As a work in public anthropology, the text is readable and accessible, taking up what people say about assisted dying as a contemporary cultural form, and as a normatively charged endeavor."
Journal of the Royal Anthropological Institute
"Mara Buchbinder's rich description of the law, bureaucracy, and the hurdles to scripting physician aid-in-dying provides an eye-opening, sometimes disturbing answer to the question of how we can foster health care justice when it comes to assisted dying. Costs, access, community, the burden of time, and the pragmatics of choice loom large here. A provocative, necessary book."––Sharon R. Kaufman, author of Ordinary Medicine: Extraordinary Treatments, Longer Lives, and Where to Draw the Line

"This marvelous, unsettling book documents how a new law on assisted dying gets translated into practice. With sensitivity and nuance, Buchbinder describes the new forms of exclusion as well as sociality that this 'aspirational death' has created, and the dilemmas for physicians, pharmacists, nurses, and others involved."––Janelle S. Taylor, Professor of Anthropology, University of Toronto

"The trained eye of an ethnographer sees things ordinary observers don't, and the trained eye of an ethnographer committed to careful neutrality is particularly valuable. Partisans on both sides of the debate over medical aid-in-dying should read this perceptive and informative book: it will enhance the vision of all."––Margaret Pabst Battin, author of The Least Worst Death: Essays in Bioethics on the End of Life