Being Mortal, which is subtitled “Medicine and What Matters in the End,” is about aging and frailty, decline and death, and dealing with those as well as possible. It’s not really a book about medical ethics or even about medicine as much as about our latter days. It’s full of stories about the loss of independence, assisted living, nursing homes, intensive care at the end of life, hospice, and finally having “difficult conversations” and “letting go” (those are two of the chapter titles).
The point of these stories is to plead for better, whole-person-driven palliative care throughout the practice of medicine.
I found it deeply about human dignity and autonomy, in the best sense of that word. As the author, Atul Gawande, M.D., puts it in his epilogue, “We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive.”
For me, the book’s key graph is on page 128:
“The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yet—and this is the painful paradox—we have decided that they should be the ones who largely define how we live in our waning days.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.