Abstract
By Eric L. Weiner. Self-published, 2010, 92 pages, $20.00.
Terminally ill patients often want to leave a legacy for their loved ones, but palliative care clinicians don't always know how to help them do it. In his short book Words from the Heart: a Practical Guide to Writing an Ethical Will, Dr Eric Weiner introduces readers to a form of written legacy that can be a powerful tool for patients and clinicians. Especially for readers who are relatively unfamiliar with ethical wills, Dr Weiner's approach makes the idea of writing one both accessible and inviting.
Dr Weiner begins by introducing the concept of an ethical will. He notes that ethical wills are not a new approach to facing mortality but a traditional Jewish practice dating back 3,000 years to Jacob's spoken legacy to his 12 sons. Weiner describes the purpose: “Where a traditional will emphasizes passing on money, possessions, real estate, and valuables, an ethical will allows us to pass on values, life stories, and blessings” (p.1). He embraces ethical wills as a methodical way to leave a meaningful written legacy for loved ones, although he makes it clear that ethical wills do not need to be reserved for end of life but can be used at any life transition. The example of a mother writing one to her unborn child struck a particular chord for me.
Weiner recognizes that people wanting to write ethical wills might be daunted by the task. How does someone go about writing a document meant to convey his or her most important values and beliefs? Weiner's book addresses this need since it is, in fact, a workbook designed to help people through the process of writing their own ethical wills. He leads the reader through a series of “challenge questions” in order to stimulate reflection and provide a framework for thought and writing. He divides the challenge questions into five sections denoted by the mnemonic HEART, which refers to Hopes for the future; Experiences in life; Appreciation; Religion, spirituality, and core beliefs; and Treasures. Each section has a brief introduction and then a collection of quotes and questions to help the reader develop ideas to write down and gather into a document.
A real strength of this workbook is its approachability. Any layperson or clinician can follow the steps and arrive at the end of the process with a collection of written reflections that can form the backbone of an ethical will. The explanations and challenge questions are thought provoking and widely applicable. The quotations from writers, politicians, religious leaders, and other public figures provide varying perspectives that speak to the importance of self-definition and legacy leaving.
The book's approachability may also prove a limitation, however. Palliative care clinicians who are well versed in helping patients with life review and ethical will writing may find this workbook too basic for more complicated patient situations. I sometimes wished the writing exercises had more depth and nuance, for example. Overall, however, I found myself moved by the concepts and inspired to write an ethical will myself. For a short and simple workbook, Weiner's Words from the Heart is a compelling and helpful tool that most palliative care clinicians would find easy to use in their clinical practice to help patients leave a written legacy for loved ones.