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Reviewed by:
  • Time to Go: Three Plays on Death and Dying, with Commentary on End-of-Life Issues
  • Rhonda L. Soricelli (bio) and David H. Flood (bio)
Anne Hunsaker Hawkins and James O. Ballard, editors, Time to Go: Three Plays on Death and Dying, with Commentary on End-of-Life Issues. Philadelphia: Univ. of Pennsylvania Press, 1995. 118 pp. Paperback, $14.95.

In 1992, as part of an effort to fulfill the community education requirement of the Patient Self-Determination Act, the Medical Theater Program was established at Hershey Medical Center. Through a statewide competition, original “one-act plays on issues that patients, their families, and their physicians faced at the end of life” (p. 15) were solicited with the intent that the winning plays would be performed as staged readings followed by discussions between cast and audience. The result, a series of productions aimed at educating the community about advance directives, was both creative in approach and timely in goal.

Providing background and scripts for the three winning plays with commentary on each and suggested questions for discussion, Time to Go: Three Plays on Death and Dying, with Commentary on End-of-Life Issues is essentially the annotated record of this project in medical drama. As such, it is an especially helpful guide for those interested in setting up similar programs. Some readers, however, might be led by the title to expect a broad approach to end-of-life issues and will need to keep in mind the more delimited scope of the project and therefore of the book. With its introductory “Part I: Advance Directives: Starting the Dialogue” and appendices that include sample documents for a values history, living will, and durable power of attorney, others might anticipate a complete text on advance directives. The volume’s approach to this topic, however, is also limited. The introduction focuses primarily on medico-legal considerations without elaborating on the moral and ethical principles by which these directives are formulated and acted upon. For example, a thoughtful discussion of the inherent tension between patient autonomy and physician paternalism, the latter often driven by the principles of beneficence and nonmaleficence, would be imperative in such a text. Similarly, a text would present a broad sampling of representative documents suitable for patients of any class, race, or creed rather than the one example of each to which the appendix is confined. And, at a time when physicians, philosophers, and ethicists are appropriately calling for more empirical research on the formulation and implementation of advance directives, 1 a text on the topic would indicate that a written directive is not an imperative, that it is the process of engaging patient, family, and physician in a [End Page 268] dialogue that clarifies one’s values and leads to an expression of one’s wishes for advance care that has the greatest import.

Readers seeking a volume that illuminates death and dying and the breadth of issues at the end of life will also need to keep in mind the restrictions inherent in the original project. Frequently (perhaps inevitably), literature-and-medicine activities are characterized by a fundamental tension between medicine’s imperative to be practically focused and literature’s more open-ended approach to issues, and Time to Go is no exception. 2 In this collection, however, despite the editors’ intention to “situate the important but narrow topic of advance medical directives and health care proxies in the larger context of end-of-life issues” (p. 18), the tension has been clearly resolved in favor of the narrowly focused medical agenda of advance directives. By thus allowing the “pressure in the medical humanities to make the material practical to health professionals” 3 to dominate, the editors at times limit our view of the works themselves and the larger issues they contain.

“Part II: The Plays” leads off with Berry L. Barta’s first-prize-winning Journey Into That Good Night, a play occasioned by her father’s impending death and the questions for which he sought answers in life: “Had he done enough? Would he have a good death? What would he be remembered for?” (p. 23). These become the central issues for college-age...

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