Bioethics Blogs

Unadorned: My Testament

by Steven Miles, MD

Many of you in the Bioethics community know me as a physician-ethicist. Early in my career, in the 1980s, I was prominent in the ethics and practice of end-of-life care. I published extensively on that topic before moving on to other topics. As an internist and geriatrician, I had decades of experience in hospitals, clinics, nursing homes and hospices. As a physician who disproportionately worked with dying persons, I have a greater than normal skepticism of the utility of aggressive technology and heightened insights into the nature of institutionalized life.

At sixty-six years of age, I am not currently ill excepting for incrementally increasing mild chronic diseases—harbingers of the approaching cold front. This past year, I lost close friends and family. Some planned well, others not so well. It has been trying. My wife of thirty-four years and my children have asked about how to update advance directive in light of these difficult experiences with a medical system that still clumsily accommodates human mortality. One of my kids was surprised to learn that I had an advance directive and kept it in an unlocked fireproof, waterproof box in our home. We had talked about it several times before.

The experiences of the past year have made me realize the implications of the likelihood that I am in my last decade of being able to teach through written and spoken word. For me, this realization has made my more forthright, and less inclined to the dilly-dally polite talk of those who believe that they can (or will) speak frankly later.

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.