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229 Atul Gawande: Being Mortal

The importance of providing quality end-of-life care that focuses on patient preferences, values, and dignity.

Atul Gawande: Being Mortal

Summary

Being Mortal is a powerful reflection on the challenges and opportunities of aging and dying, and the role of medicine and healthcare in supporting patients and families during these critical times. Atul Gawande argues that contemporary medicine often fails to address the complex needs of elderly and terminally ill patients, emphasizing curative treatments and prolonging life at the expense of quality of life. Through a series of poignant stories and personal experiences, Gawande demonstrates the importance of providing compassionate and personalized care that respects patient preferences, values, and dignity, even in the face of difficult decisions and inevitable decline. He calls for a shift in our approach to end-of-life care, one that acknowledges the realities of aging and dying and values the worth and wisdom of every human life.

About

Title: Being Mortal: Medicine and What Matters in the End

Author: Atul Gawande

Publishing Year: 2014

Publisher: Metropolitan Books

Length in Hours: 9 hours and 3 minutes

5 main ideas

  1. Aging and dying are inevitable parts of the human experience, and require a nuanced and compassionate approach to care.
  2. Traditional medical interventions and technologies often fail to meet the complex needs of elderly and terminally ill patients, and can even undermine quality of life.
  3. A focus on patient preferences, values, and dignity is essential to providing quality end-of-life care, and should guide medical decision-making and treatment planning.
  4. Communication and collaboration between patients, families, and healthcare providers are crucial to ensuring that end-of-life care aligns with patient goals and values.
  5. A broader social and cultural shift is needed to promote a more holistic and respectful approach to aging and dying, one that values the worth and wisdom of every human life
Atul Gawande: Being Mortal

5 funny quotes

  1. "Old age isn't a battle; it's a massacre."
  2. "Aging is not a disease, but a natural part of life, like puberty or menopause. We should celebrate it, not fear it."
  3. "The secret to a long and happy life? Good genes, good luck, and a good sense of humor."
  4. "Growing old is like being increasingly penalized for a crime you haven't committed."
  5. "The best way to predict your future is to create it."

5 thought-provoking quotes​

  1. "Our ultimate goal, after all, is not a good death but a good life to the very end."
  2. "The job of medicine is to alleviate suffering and improve well-being, but too often we lose sight of these goals in the pursuit of cure."
  3. "Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need."
  4. "Our current approach to aging and dying is not only cruel but also unaffordable, because it fails to acknowledge the limits of medical intervention and the true value of human life."
  5. "The ultimate goal of medicine is not to save lives, but to enable people to live their lives as they wish, with the greatest possible degree of autonomy, dignity, and joy."

5 dilemmas

  1. The tension between the medical imperative to prolong life and the ethical imperative to respect patient autonomy and dignity.
  2. The challenge of providing high-quality end-of-life care within the constraints of the current healthcare system and reimbursement models.
  3. The importance of supporting patients and families in making difficult decisions about treatment and quality of life, even when there are no easy answers.
  4. The need for healthcare providers to communicate effectively with patients and families, while also managing their own fears and biases about aging and dying.
  5. The broader social and cultural challenge of promoting a more open and honest dialogue about aging, dying, and the value of human life.

5 examples

  1. The work of Dr. Bill Thomas, a geriatrician and advocate for person-centered care
  2. The Green House Project, a non-profit organization that promotes innovative, home-like nursing homes that prioritize resident autonomy and social interaction.
  3. The story of Lou Sanders, a retired surgeon with terminal cancer who chose to receive palliative care at home and live out his remaining days on his own terms.
  4. The case of Sara Monopoli, a young mother and physician who faced difficult decisions about treatment and quality of life after being diagnosed with terminal cancer.
  5. The experiences of the author's own family members, including his father, a surgeon who faced the challenges of aging and decline, and his grandfather, who lived a full and meaningful life despite his physical limitations.

Referenced books

  1. "On Death and Dying" by Elisabeth Kübler-Ross
  2. "How We Die: Reflections on Life's Final Chapter" by Sherwin B. Nuland
  3. "The Denial of Death" by Ernest Becker
  4. "Aging Well: Surprising Guideposts to a Happier Life from the Landmark Harvard Study of Adult Development" by George E. Vaillant
  5. "Knocking on Heaven's Door: The Path to a Better Way of Death" by Katy Butler

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"The ultimate goal of medicine is not to save lives, but to enable people to live their lives as they wish, with the greatest possible degree of autonomy, dignity, and joy."

Atul Gawande: Being Mortal
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