This is a timely publication. Belgium's parliament recently voted in favour of lifting age restrictions on euthanasia (McDonald-Gibson Reference McDonald-Gibson2014). The new legislation means that children can be lawfully euthanised in certain circumstances. A few weeks before the Belgian king signed this controversial Bill into law, the Supreme Court of Canada ruled that the prohibition of assisted dying condemns some people to a life of severe and intolerable suffering and may prevent patients waiving their right to life (Austen Reference Austen2015). It is not clear how the Canadian government will respond, but profound legislative changes are probably afoot. In England, meanwhile, Lord Falconer's Assisted Dying Bill continues to meander its way through the House of Lords (Perraudin Reference Perraudin2015).
Death Talk does not directly address these specific cases. However, Margaret Somerville's tome does provide an analysis of the ethical context within which these legislative earthquakes are taking place and she also sheds much light on the Canadian legal framework in particular. Somerville is deeply opposed to euthanasia and physician-assisted suicide and Death Talk reads as a no-holds-barred exposition of the reasons why euthanasia and physician-assisted dying is beyond the moral pale. Many of the arguments in favour of euthanasia and physician-assisted dying are also discussed at length. However, this is not intended to be a balanced work and readers who are seeking a more ‘neutral’ discussion of end-of-life ethico-legal issues might be better off reading another recent publication by Richard Huxtable (Reference Huxtable2013).
Death Talk is divided into six parts. Some chapters focus heavily on legal questions while others offer more in the way of ethical or moral analysis. There is also much scrutiny of the importance of narrative and the socio-cultural ambience that underpins discussions of ‘death talk’. Sometimes this analysis ventures into some strange territory. Talk of the ‘science spirit position’ will leave some readers cold – and confused. However, Somerville's claim that we have forgotten how to talk about death and that a failure to grapple with the metaphysics of our mortality ironically makes us more ready to accept euthanasia and physician-assisted suicide is interesting. Her ability to explore complex issues from an original angle is also not in question.
Death Talk is somewhat repetitive at times. Conceptual, ethical and semantic analysis of the use (and abuse) of terms like ‘passive euthanasia’ recurs again and again. The author is quite right to stress the importance of linguistic clarity when discussing end-of-life care. She is also right that people on both sides of the debate about euthanasia and physician-assisted suicide are sometimes guilty of playing hard and fast with terminology. However, endlessly returning to this issue over the course of a long book is neither necessary nor helpful. Some key legal cases and ethical arguments are also revisited a number of times – with similar rebuttals and counter-arguments offered each time. These editorial issues are probably the end-result of a decision to include previously published papers. Perhaps it would have been better to start afresh rather than try to pull together articles that were published over the span of two decades. That said, the voice of the author is ever present and there is sufficient thematic glue to hold the book together. The somewhat disjointed chapters and sections also allow the reader to read selectively certain sections of the book. Readers primarily interested in the impact of human rights on end-of-life debates can jump immediately to the chapter that deals with that particular issue. Readers who are keen to learn more about the nuances of Canadian law, meanwhile, will find what they are looking for in other chapters.
Whether Somerville's book is worth the time and dedication required to read and digest it is debatable. Death Talk is essential reading for scholars and students of end-of-life ethics and law. It will also be very illuminating to those who are instinctively in favour of euthanasia and physician-assisted suicide, but who have not given much thought to the opposing arguments. I would also recommend this book to clinicians who work in palliative care (or any other area of health care where end-of-life issues feature on a regular basis). But for those with more of a general interest in end-of-life issues and who do not have the time to delve deeply into the subject, there are pithier and more balanced works available.
