FINAL DAYS: Japanese Culture and Choice at the End of Life, by Susan Orpett Long. Honolulu: University of Hawai'i Press, 2005, 288 pp., $45 (cloth).

This book asks how the final days might be different for Japanese patients and for those in the United States. Both Japanese and Americans state that they want to die peacefully at home surrounded by loved ones. Yet, in both countries, most people die in hospitals surrounded by medical equipment and the staff that run it.

In both Japan and the U.S., people speak of wanting to die with dignity, but there seems to be no single way to make this occur. One of the reasons is that we all want an individual death, one that recognizes that our life had a meaning. At the same time, defining such a self is inherently a social process, one quite beyond the individual.

In this very interesting book, the author, a professional anthropologist with an interest in the care of the elderly and in comparative medical systems, shows through both analysis and anecdotal example how people can have choices without denying this social embedment.