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The American culture of death changed radically in the 1970s. For terminal illnesses, hidden decisions by physicians were rejected in favour of rational self-control by patients asserting their ""right to die"" - initially by refusing medical treatment and more recently by physician-assisted suicide. This new claim rested on two seemingly irrefutable propositions: first, that death can be a positive good for individuals whose suffering has become intolerable; and second, that death is an inevitable and therefore morally neutral biological event. This book suggests, however, that a contrary attitude persists in American culture - that death is inherently evil, not just in practical but also in moral terms. The new ethos of rational self-control cannot refute but can only unsuccessfully try to suppress this contrary attitude. The inevitable failure of this suppressive effort provokes ambivalence and clouds rational judgement in many people's minds and paradoxically leads to inflictions of terrible suffering on terminally ill people.;In this account of the psychological and social forces underlying American cultural attitudes toward death, Robert A. Burt maintains that unacknowledged ambivalence is likely to undermine the beneficent goals of post-1970s reforms and harm the very people these changes were intended to help.