In a remarkably candid four-part series chronicling the struggles of people who are dying, journalist Bill Moyers moves to the forefront of America’s endeavor to improve end-of-life care. The PBS special "On Our Own Terms: Moyers on Dying" takes viewers into the homes, hospices, and hospitals of more than a dozen brave men and women who come to terms with their own deaths in different ways. What does it mean to die well in America?

The series will be broadcast initially in most markets from September 10 through 13, at 9 p.m. Eastern time. Each of the four programs will examine a major end-of-life issue. Part one, airing on September 10, is titled "Living With Dying." It will explore new ways in which to think about death, focusing on caregivers, family members, and patients who are able to overcome fear and denial about dying. The series also touches on a multitude of other issues, including pain management, spiritual care, and assisted suicide.

In one of the programs, Joyce Kerr, a woman with advanced-stage cancer, is shown leaving her hospital room at Mt. Sinai Hospital in New York City. She has stopped her chemotherapy treatments, and the care she will receive from this point on is focused on keeping her comfortable. She wants to die at home surrounded by her loved ones. Mother’s Day is soon upon the large family, and they share cards and affection with their mother. A week after Mother’s Day, Kerr’s health fails rapidly.

One of Kerr’s daughters, a resident physician at Mt. Sinai, has taken off work to be with her mother in her final days. She says, "When the nurse was with my mother the other day, we were with her trying to do some things, and my mother said ‘I don’t want to feel like I’m not dying, so don’t make me feel like I’m not dying.’"

Moyers, who stands vigil with some of the family members in the hallway, comments to the daughter that her mother was clear that she did not want to be a burden to the family.

"She is not a burden," remarks the daughter, becoming tearful. "You sit there in the rocking chair with her and you think: How many times did she sit here with me? It’s just nice to give some of that back."

Moyers and his wife, Judith, who is also a journalist, saw a need to address death and dying after realizing that there were so many new perspectives about these natural life events in America.

"Baby boomers are facing aging parents, as well as their own mortality," Moyers told Psychiatric News. "The AIDS epidemic has brought death close and has taught us many lessons about what needs to be done to provide compassionate care for the dying. There is also a growing movement to improve end-of-life care in America that we became aware of. This movement is gaining ground, like the natural childbirth movement that transformed how we enter the world. Now we need a better exit."

And Americans can definitely improve on how they exit this world. According to Moyers, Gallup polls from 1992 and 1996 showed that 90 percent of American men and women from diverse age groups and religious and ethnic backgrounds indicated that they did not wish to die in a hospital or nursing home. However, a 1997 study from the National Institute of Medicine found that less than 20 percent of all deaths occur at home. The study also showed that more than 40 percent of patients with cancer, AIDS, and other diseases had received inadequate treatment for their pain.

At New York City’s Sloan-Kettering’s palliative care program, physicians are trying to overcome these problems and help dying patients gain peace of mind. William Breitbart, M.D., a psychiatrist working on the palliative care service, told Moyers that there is currently a movement to recognize that psychological symptoms related to death and dying are an important area of focus. These symptoms, if left untreated, can worsen quality of life unnecessarily.

"He told us that there is a growing understanding that anxiety, depression, fatigue, and the existential concerns about being a burden are prevalent and debilitating to patients," Moyers commented. "He also says that very often the root cause of requests for physician-assisted suicide is unrecognized, untreated depression. When psychiatrists have treated this problem, the longing for death subsides."

Moyers launched a nationwide outreach campaign associated with his PBS special to engage the public in dialogue and action around end-of-life issues.

"We are fostering the development of local coalitions to stimulate dialogue and support improved care for the dying and their families," Moyers stated.

The outreach campaign involves medical, professional, and consumer organizations, all of which have been involved since last year. Local coalitions are expected to form in 100 communities across the country to plan screenings, town hall meetings, and training workshops for people who want to learn more about death and dying. They will discuss the many ethical, financial, spiritual, and medical issues surrounding end-of-life care.