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A Physician's Quest to Transform Care Through the End of Life
by Ira Byock
Book Reviewed by:A palliative care doctor on the front lines of hospital care illuminates one of the most important and controversial ethical issues of our time on his quest to transform care through the end of life.
It is harder to die in this country than ever before. Statistics show that the vast majority of Americans would prefer to die at home, yet many of us spend our last days fearful and in pain in a healthcare system ruled by high-tech procedures and a philosophy to "fight disease and illness at all cost."
Dr. Ira Byock, one of the foremost palliative-care physicians in the country, argues that end-of-life care is among the biggest national crises facing us today. In addressing the crisis, politics has trumped reason. Dr. Byock explains that to ensure the best possible care for those we love - and eventually ourselves - we must not only remake our healthcare system, we must also move past our cultural aversion to talking about death and acknowledge the fact of mortality once and for all.
Dr. Byock describes what palliative care really is, and - with a doctor's compassion and insight - puts a human face on the issues by telling richly moving, heart-wrenching, and uplifting stories of real people during the most difficult moments in their lives. Byock takes us inside his busy, cutting-edge academic medical center to show what the best care at the end of life can look like and how doctors and nurses can profoundly shape the way families experience loss.
Like books by Atul Gawande and Jerome Groopman, The Best Care Possible is a compelling meditation on medicine and ethics told through page-turning, life or death medical drama. It is passionate and timely, and it has the power to lead a new kind of national conversation.
Introduction
Americans are scared to death of dying. And with good reason.
While rarely easy under any circumstances, we make dying a lot
harder than it has to be.
A large majority of Americans still die in hospitals or nursing homes.
Many suffer poorly controlled pain or other physical miseries and
endure their final days feeling undignified and a burden to others.
Few of us can even imagine how things might be different. Therein
lies the crux of the problem. Our society and mainstream American culture have never grappled with the fundamental fact of mortality; therefore, we do not know what to expect or what is possible. When someone we love is diagnosed with a life- threatening condition, the worst thing we can imagine is that he or she might die. The sobering fact is that there are worse things than having someone you love die.
Most basic, there is having the person you love die badly, suffering as he or she dies. Worse still is realizing later on that much of his or ...
In this suspenseful, moving and indispensable book, Byock shares a great deal of important information... I especially appreciate Byock's affectionate and optimistic view of human nature. He believes that caring for one another is essential to human character and that death, when done right, affirms love, heals loss and completes and enriches our lives...continued
Full Review
(753 words)
(Reviewed by Jo Perry).
Ellen Goodman, longtime syndicated columnist for the Boston Globe
In a world in which politics are polarized and ethical discussions often descend into a food fight, Ira Byock is that rare doctor: a humane guide leading us with honesty and compassion through complex stories about living and dying well. He's a real-life rebuke to those who think palliative doctors are "death panels" and a mentor to every medical student inevitably faced with mortality. This is must reading for everyone trying to make humane decisions in a high tech world. Jane Isay, author of Walking on Eggshells
With elegance, compassion, and energy, Ira Byock shows us how to get the best end of life care. He is a great storyteller and a brilliant analyst of health care in America. This is the book to read or give, if you are facing this hard situation. Nobody gets out of this life alive, but Byock shows us how to do it elegantly and well. Roshi Joan Halifax, author of Being with Dying
This is an extraordinary and wise book on how dying people can be cared for. Written by a master clinician, a man of great compassion, Ira Byock has a vision of health care that is brilliant and kindOne cannot finish Dr. Byock's book without resolving, as much as possible, to take responsibility for one's own death and to become deeply involved in the experiences and medical treatments of those we love who are dying.
His website, www.dyingwell.org, provides readers with additional information and helpful resources on the topic of dying, specifically on the emotional work required when saying our final farewells:
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