This first novel, written by a young surgeon, moves swiftly toward its troubling conclusion. The pros and cons surrounding the euthanasia residency program are first among many other issues Snodgrass brings before readers.

These issues are: the anti-abortion movement's possible effects on other medical issues equally unpopular with conservatives; the media's ability to move the general public to action; the role of medical personnel other than physicians, personnel such as orderlies and nurses who are often ignored, overlooked, and under-appreciated; the difficulty of stopping certain actions that have been set in motion; the fact that decision-making can be just as difficult when dealing with the dying as it is when dealing with the living; the powerful effect religious belief can have on conditions in the secular world; and the inevitable presence of evil.

Whether the novel's last chapters are the result of Snodgrass's lack of experience in characterization and closure or are his very carefully planned challenge to those in medicine and to his readers is hard to tell. The ending is, however, both chilling and thought-provoking.