The main purpose of this book is to shed light on many previously unexplored aspects of the euthanasia debate, specifically the subtle acquisition of Alzheimer's disease by pro-euthanasia activists, proposing euthanasia not just as a bona fide medical option at end of life but as a desirable and even responsible choice when living with dementia. Johnstone offers a comprehensive insight into how the debate on euthanasia/physician-assisted suicide has been framed in policy, literature and the public domain. She focuses on the powerful influence of the media in this process, arguing that public opinion is not just swayed by the media but also ‘created and held together by it’ (Louw Reference Louw2010: 25).

Johnstone provides a clear and detailed account of how social movement entrepreneurs have legitimised and mobilised support for euthanasia. The book gradually reveals the factors behind the public story from a fascinating insight to the Alzheimer's metaphor and how the media represent this (Chapter 3) to the use of Alzheimer's disease and euthanasia as a symbolic system of control (Chapter 9). The book has a sound theoretical base, with comprehensive statistical information where appropriate but consistently supported by case studies potentially making the book accessible to a wider audience. Johnstone uses all of these to expose the subscript to the current public and policy position on euthanasia. Her analyses are detailed and clear, and while the book weaves many threads through its exploration of this subject, they are perfectly woven providing clarity and insight. Johnstone takes the time to explore background factors such as risk construction and social movement theory, making the book more accessible to student or indeed lay readers. Each chapter is succinctly summarised and leads the reader into the ideas to be explored in the next chapter.

The first two chapters set the scene, covering the origins of the book and providing detail of trajectory, prevalence, characteristics and costs of dementia. In Chapter 1, some quite shocking examples of euthanasia and people with dementia introduce the reader to the Alzheimerisation of the euthanasia debate. Chapter 3 is one of the most compelling, exploring media representations, metaphors and the stigmatisation of Alzheimer's disease. Johnstone sheds light on the metaphorical representation of Alzheimer's in all its forms and the sometimes unintended impact on public consciousness and discourse. Chapter 4 reveals how the issue of limited resources and health care has moved from being one of economics to morality linked to ethical issues of paternalism versus autonomy and the reduction of suffering. Chapter 5 discusses the different forms of assisted human death with associated legal, ethical and philosophical perspectives. In Chapter 6, Johnstone considers the highly successful cultural change affected by euthanasia activists, while in Chapter 7 she exposes the tools they use, from hasty generalisations to fallacies and character attacks on opponents. In the final chapters of the book, the author exposes how marketing has been used to sell death (Hendin Reference Hendin1995) and normalise euthanasia, and the effect of media priming on the construction of this debate and other social issues. Chapter 9 explores euthanasia as a symbolic way to regain the control symbolised as lost in Alzheimer's, demonstrating how euthanasia is framed as a defence in the battle with the metaphorical ‘living death’ of Alzheimer's. In the final chapter, the author considers the intersection between euthanasia politics and public opinion, reminding the reader that the proposal to include euthanasia as ‘a morally warranted option in the treatment of Alzheimer's disease and other dementias is neither simple, medically objective, nor evidence-based. Rather it is complex, highly emotive and ideology based’ (p. 188).

The author succeeds in uncovering the influences of differing discourses on this debate from the theoretical and philosophical perspectives on personhood to medical debates on end of life and medical futility. She considers media representations and the influence of public figures on public consciousness and how these have contributed in subtle and not so subtle ways to a climate that increasingly considers euthanasia as a viable, reasonable and even necessary option for people living with dementia. She challenges the reader to go beyond the rhetoric on both sides of the euthanasia debate and provides the tools and information to do just that. Johnstone's expressed aim for this work was ‘that it infuse the euthanasia debate with a level of intellectual honesty, transparency and accountability that up until now has largely been missing’ (p. xviii). Having now read this book, I am sceptical that this will happen but absolutely convinced that it must.