Final Exit: The Practicalities of Self Deliverance and Assisted Suicide for the Dying

Steven H. Miles, MD
JAMA. 1991;266(15):2150. doi:10.1001/jama.1991.03470150122044.
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Final Exit was the top-selling "selfhelp" book until a shortage stalled sales. It lent unusual prominence to a category of books normally occupied by titles about preparing tax returns, fixing sinks, or writing resumés. It provided a text to go with media coverage of the state of Washington's initiative to legalize voluntary active euthanasia. It led to dark humor about copies not being returned to the library. It struck a nerve, articulated a fear, and found a titillated market.

This is an odd book to review for these pages. It neither examines the practice of medicine nor proposes ways to improve end-of-life medical care beyond empowering physicians to supervise suicide. It contradicts the position of the American Medical Association against euthanasia. Nevertheless, this is a noteworthy work of popular culture about the health care system.

Final Exit reads like podium notes. It is a poorly edited mélange of anecdotes, first-person


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