How does a conversation begin about a topic that we can't talk about--that no one really talks about? Where is the jumping off point to cut through the intellectual definitions and the sterile antiseptic medical terminology to reach a place in which real words, experiences and feelings can be used to speak about the unspeakable? Who has the capability, the depth of experience, the sensitivity, knowledge, or even more, the audacity to give themselves license to discuss our universally shared last act on the planet?

All of our respective cultures acknowledge the magnitude of death as the major event it is with structured behaviors and traditions. Afterlives, reincarnation, heaven and hell are all constructs that may help us deal with the consuming emotions of loss and humanly unanswerable questions surrounding the permanence of our souls. We would like to present for consideration, from a perspective of our own personal experience and that as healthcare workers, the idea that since death is inevitable, reasonable and appropriate we should embrace the concept and give ourselves and our loved ones the opportunity to die in a well-planned, dignified manner.

Without any pomp or ceremony, and with considerable humility, the authors of this volume attempt to advance the conversation that we've all never had about death--not someone else's death--not the stages of dealing with death--not the objective chemical reactions associated with death--and certainly not the legal definitions or issues of outside agencies' involvement in death--but of our own, not be denied, impending exit from this life.

We, who live with death each day of our professional careers, want to reach and speak out. Beyond our own individual indoctrinations, we, who have seen untold unnecessary suffering of patients and their families, want an opportunity to contribute to changing the conversation from life at all emotional, physical, spiritual and financial costs toward a release from fear and guilt and acceptance and celebration of life's natural conclusion. We offer: Permission to Die.

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