[O]ver a roughly 25-year span, my father, Phillip I. Lerner, acted as the primary doctor for his relatives several times.

All of the physicians agreed that the prognosis was grim, but that was not enough for my father. Pearl’s worst fear, which she had often stated, “was to have a stroke and have to live a limited existence, dependent on others for her basic necessities.” For my dad, every minute she lived in a coma was a betrayal, causing her to linger in a way she had vehemently rejected.

I never figured out exactly what happened in Pearl’s hospital room, but it seems pretty clear that my dad—either with the help of the nurses or not—somehow sped his mother’s death with intravenous morphine. In his journal, he vaguely wrote that he had been able “to help her achieve the peaceful end she sought.”

Not only did he understand the medical problems at hand and their potential treatments, but he also knew about the pitfalls of care: how patients fell through the cracks, could not reach their physicians, and suffered from inadequate pain management.

As Lerner’s son goes through his father’s medical papers, he discovers a history of his father choosing palliative care, discouraging invasive treatments, and even hastening the death of his comatose mother.

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