End-of-Life Decision Making

From Basic Bioethics

End-of-Life Decision Making

A Cross-National Study

Edited by Robert H. Blank and Janna C. Merrick





This examination of end-of-life decision making offers a broader perspective than that found in the extensive existing literature on this topic by offering a cross-national comparison. Experts from twelve countries analyze death-related issues and policies in their respective nations, discussing such topics as health care costs, advance directives or wills, pain management, and cultural, social, and religious factors. The countries selected for study—Brazil, China, Germany, India, Israel, Japan, Kenya, the Netherlands, Taiwan, Turkey, the United Kingdom, and the United States—represent a mix of East and West, developed and developing nations seldom considered together in analyses of these issues. This is the first systematic attempt to analyze end-of-life issues in many of these countries; the chapters on China, Kenya (of special significance because of the HIV/AIDS epidemic in sub-Saharan Africa) and Turkey break new ground.

Each author reports on various factors in end-of-life decisions: estimated costs of dying, including health care costs; the proportion of deaths occurring in hospitals, in hospices, and at home; the prevalence and variety of advance directives; the mix of high technology and palliative care; the cut-off point for aggressive care and the legal definition of death; government policies on end-of-life decisions, assisted suicide, and euthanasia; and cultural, social, and religious influences. The findings show that there are great differences among countries even in the way these issues are framed. Scholars, policymakers, and medical practitioners can all benefit from the extensive information in these essays on how different nations are dealing with death-related issues.


$35.00 X | £7.99 ISBN: 9780262025744 280 pp. | 6 in x 9 in


$16.00 X | £12.99 ISBN: 9780262524735 280 pp. | 6 in x 9 in


Robert H. Blank

Robert H. Blank is Professor of Political Science at the University of Canterbury in New Zealand and Research Scholar at New College of Florida. His books include Brain Policy, Comparative Health Policy (with Viola Burau), and End of Life Decision-Making: A Cross-National Study (coedited with Janna Merrick; MIT Press, 2005).

Janna C. Merrick

Janna C. Merrick is Professor in the Department of Government and International Affairs at the University of South Florida.


  • End-of-Life Decision Making is a commendable work and a resource for identifying current data or lack thereof.

    Journal of the American Medical Association


  • An important work that contributes substantially to international research and understanding. It will be useful in many different countries, both in classrooms and in the boardrooms of various aid agencies and nongovernmental organizations. It is full of useful information and is of considerable importance to bioethicists as the field takes a turn toward much greater involvement with international issues.

    Margaret Battin

    Distinguished Professor, Department of Philosophy, University of Utah

  • End-of-life issues are certain to rise on every country's political agenda in the years to come. The cross-national landscape surveyed in this volume proves a fertile ground for identifying puzzles, highlighting inconsistencies, and generating new insights for scholars and policy makers.

    Mark Schlesinger

    Yale University