This book is not for everyone. My child had nightmares after reading chapter 19 which I would easily rate R for graphic detailed violence. For parents who take their responsibility of monitoring the material their children are exposed to, be sure ahead of time that your child will not be emotionally upset by the "how - to" description of the actions. In my opinion, there are no redeeming qualities to this book. My child could not evaluate anything to do with the book because she was obsessed with the murder of an innocent new-born baby. While other people may say that it's not real, the subject of euthanasia is real. I would never recommend this book, however, I would caution parents, and teachers alike to evaluate the person for whom the book is being selected and determine if he/she will be negatively affected by it ahead of time.