4-part series shares intimate journeys of patients,
their families and their caregivers as
they struggle to balance medical intervention with comfort
and compassion and to find meaning at the end of life

There is a great divide separating the kind of care Americans say they want at the end of life and what our culture currently provides. Surveys show that we want to die at home, free of pain, surrounded by the people we love. But the vast majority of us die in the hospital, alone, and experiencing unnecessary discomfort. While a rising chorus of patients, their families, and health care professionals say the time has come to change how we die in America, talking about dying has remained one of our most intractable taboos. Until now.

Bill Moyers goes from the bedsides of the dying to the front lines of a movement to improve end-of-life care in ON OUR OWN TERMS: Moyers on Dying. Two years in production, this four-part, 6-hour series crosses the country from hospitals to hospices to homes to capture some of the most intimate stories ever filmed and the most candid conversations ever shared with a television audience. "The stories of these generous people, who let us into their lives at an extraordinarily vulnerable time, help us to understand dying not as a failure of medicine, but as a natural part of life," Moyers said.

ON OUR OWN TERMS: Moyers on Dying premieres Sunday, September 10 and will air on consecutive nights through Wednesday, September 13 from 9:00 to 10:30 p.m. (ET) on PBS (check local listings). The series is produced by Public Affairs Television, Inc. and presented on PBS by Thirteen/WNET in New York. (Note: Many public television stations are airing additional programs and hosting events about end-of-life issues during this week. Check local listings.)

"In the last fifty years, in our love of technology, we've forgotten what it was like to have grandma (dying) in the other room," says hospice director Frank Ostaseski, in Living with Dying, the first program of the series. Today, dying is often a protracted battle against disease that can involve complex choices between length of life and quality of life. It is a battle fraught with profound physical, financial, emotional, psychological and spiritual consequences for both patients and families.

For pediatrician Bill Bartholome, a diagnosis of cancer of the esophagus included an expected prognosis of six months, but it took five years for the illness to end his life. From the beginning, he decided to spend his time living as well as possible, instead of attacking the incurable. In living with a terminal condition, he found a new sweetness and joy in life even as his health declined. "I think death transforms our living in ways that we in this culture do not understand," says Bartholome.

Families confronting the end of life of a loved one often have difficulty talking openly about what's to come, their fears, and their preferred choices for care. Under the most trying of circumstances, doctors must explain the treatment alternatives offered by medical technology and sophisticated pharmacology. "We as health care providers are constantly on the edge. We don't always have the answers and the questions can sometimes come fast and furious," says Dr. Pat Caralis, at Jackson Memorial Hospital in Miami, where her patient population includes Cubans, Haitians, Asians, African Americans, Jews and people of many other cultures. In America's plural society, different ethnic traditions, religious beliefs, and personal values shape what individuals consider the best kind of end-of-life care, and physicians must respect these expectations.

While terminal patients now live longer, for many that means living with pain. Improvements in pain medication and a growing understanding of the role of palliative care, or "comfort care," is changing that. In the second program, A Different Kind of Care, the palliative care center at Mount Sinai Medical Center in New York offers a different model for medical management. Dr. Diane Meier, who founded the palliative care program, says, "I think every doctor feels that somehow they've failed when a patient dies, and palliative medicine is an attempt to take a different perspective on that. We will all die, but how we die, the circumstances under which we die, what happens before we die is under our control." The program follows Dr. Sean Morrison as he attends to Joyce Kerr, a retired math teacher, at Mount Sinai. With his help to understand her choices for treatment and pain relief, Joyce decides she wants to die at home with hospice and family caregiving. Dr. Morrison's involvement doesn't stop at the hospital door. He continues to care for Joyce -- and her family -- until she takes her last breath.

The third program addresses choices such as the assisted-suicide debate that has narrowly framed public discussion of end-of-life issues. In A Death of One's Own, the critical issue is less the right to die, than the way to live when choices are circumscribed by practical realities. Jim Witcher is an independent-minded man. A veterinarian and horse breeder, he loves his north Louisiana farm and looked forward to a happy retirement with his wife Susie. Then he was diagnosed with ALS, a progressive illness that paralyzes the body while the mind remains alert. Jim wants to stay at home and Susie lovingly accepts the role of his sole caretaker, despite the extraordinary toll it takes on her physically and emotionally. "Every day is a new day, and before I get out of bed in the morning, I'm asking the Lord for strength physically to be able to care for him," she says. The Witchers are forced to sell off some of their land and their prized horses to meet the expenses of the illness.

Kitty Rayl battles cancer in Oregon, the only state to have legalized physician- assisted suicide. Kitty, her doctors and her daughters each have very different opinions of the option to control the moment of her death. With some opposed and some supporting her choice for assisted suicide, they work through the decision in an abiding spirit of cooperation and respect. Comforted by the peace of mind that she has the final control she believes is her right, Kitty ultimately dies without using life-ending medication.

The final program of the series, A Time To Change, offers a vision for what end-of-life care could be. At the Balm of Gilead project in Birmingham, Alabama, Dr. Amos Bailey and his colleague Edwina Taylor, R.N. are working to introduce hospice ideas into the mainstream of health care. Serving the working poor and the uninsured, the Balm of Gilead provides palliative care and helps terminal patients move from hospital care to home hospice care. Their goal is to treat the whole patient and the whole family, providing social services, counseling, and caregiver support. But their first priority is pain relief.

Obstacles in financing and training, as well as public policies that favor hospital-based care over hospice or home care, have put the brakes on the more rapid spread of this approach to caring for the terminally ill. "Can I get a patient a meal delivered on a weekend? Can I get a patient narcotics if they don't have the money to pay for it? No." says Dr. Joanne Lynn, a tireless crusader for public policy changes. "These are just gross nonfunctioning arrangements in our care system," she says. In Washington, D.C., Dr. Lynn lobbies hard for legislative change to establish a new paradigm for care of the dying.

An extensive companion Web site for ON OUR OWN TERMS: Moyers on Dying will be accessible at http://www.pbs.org/onourownterms and http://www.thirteen.org/onourownterms www.thirteen.org/onourownterms. Currently, the URL features a site oriented for community organizers, but it will be expanded and re-launched for the general public on August 28, 2000 (Separate Web release available). Tapping the potential of this unprecedented series to trigger a new conversation about end-of-life care, an outreach campaign involving more than 65 national medical, professional and consumer organizations has been gearing up since 1999. In more than 150 communities around the country, local steering committees are working with public television stations to plan discussion groups and town hall meetings, publish local resource directories, set up training programs for health care workers and employers, and form ongoing community coalitions to improve care for the dying and their caregivers. Over 200,000 printed viewer guides for the series have been distributed and the guide is available as a download on the Web.

Funding for ON OUR OWN TERMS: Moyers on Dying is provided by The Robert Wood Johnson Foundation, The Fetzer Institute, The Nathan Cummings Foundation, The Kohlberg Foundation, Inc., The John D. and Catherine T. MacArthur Foundation, and The Laurance S. Rockefeller Fund. Corporate funding is provided by Mutual of America Life Insurance Company.

ON OUR OWN TERMS: Moyers on Dying is produced by Public Affairs Television, Inc. and is presented on PBS by Thirteen/WNET New York. Executive editors: Judith Davidson Moyers, Bill Moyers; Executive producers: Judith Davidson Moyers and Judy Doctoroff O'Neill; Series producer: Elena Mannes; Producers: Elena Mannes, Gail Pellett; Editors: Alison Amron, Donna Marino, Nobuko Oganesoff, Sharon Sachs; Field producers: Gail Ablow, William Brangham, Paco de Onis; Associate producer: Valerie Linson; Director of production: Felice Firestone; Director of special projects: Deborah Rubenstein.


Press Contacts:

Rose Lynn Marra
Kelly & Salerno Communications
212-632-0207

Karen Salerno
Kelly & Salerno Communications
212-632-0175

June 27, 2000