Embracing our mortality : hard choices in an age of medical miracles

While surveys show that most of us would prefer to die at home, 80% of us will die in a health care facility, many hooked up to machines and faced with tough decisions. When you, a family member, or a friend are in this situation, what should you do next? In __Embracing Our Mortality,__ Dr. Lawrence J. Schneiderman, a physician who is our leading expert on medical ethics at the end of life, urges all of us, including health care professionals caring for people at the end of life, to face these decisions with sensitivity and realism informed by both the latest medical evidence as well as the oldest humanistic visions. Dr. Schneiderman vividly demonstrates the wisdom of this approach by interweaving true stories of his patients, current empirical research in care at the end of life, displays of the power of empathy and imagination as embodied in the work of writers like Tolstoy and Chekov, and examples of how the distortion of medical research by media, and its misunderstanding even by health care professionals, cloud the ability to think, feel, and decide clearly about mortal concerns. He ends by addressing the question implicit in all of this which is how to achieve a just and universal health care. Dr. Schneiderman proves a refreshingly honest, astringent, and life-affirming guide to thinking about the choices that we or people we love will face when we dienot if, as the technological imperatives of modern medicine can suggestand to making decisions at the end of life that respect all that has preceded it.

While surveys show that most of us would prefer to die at home, 80% of us will die in a health care facility, many hooked up to machines and faced with tough decisions. When you, a family member, or a friend are in this situation, what should you do next? In Embracing Our Mortality, Dr. Lawrence J. Schneiderman, a physician who is our leading expert on medical ethics at the end of life, urges all of us, including health care professionals caring for people at the end of life, to face these decisions with sensitivity and realism informed by both the latest medical evidence as well as the oldest humanistic visions. Dr. Schneiderman vividly demonstrates the wisdom of this approach by interweaving true stories of his patients, current empirical research in care at the end of life, displays of the power of empathy and imagination as embodied in the work of writers like Tolstoy and Chekov, and examples of how the distortion of medical research by media, and its misunderstanding even by health care professionals, cloud the ability to think, feel, and decide clearly about mortal concerns. He ends by addressing the question implicit in all of this which is how to achieve a just and universal health care.

Dr. Schneiderman proves a refreshingly honest, astringent, and life-affirming guide to thinking about the choices that we or people we love will face when we dienot if, as the technological imperatives of modern medicine can suggestand to making decisions at the end of life that respect all that has preceded it.

Doody Review Services

Reviewer:Sarah E. Hetue Hill, MA(Saint Louis University)
Description:Dr. Lawrence Schneiderman, respected physician and well known expert on ethics at the end of life, presents this book as a guide for wading through the chaos that occurs when having to make difficult decisions at the end of life.
Purpose:The book provides readers with the tools necessary to navigate treatment decisions that will occur during our own serious illnesses and those of our loved ones. As suggested in the preface, although most of us would prefer to die at home, a large majority of us will die in a healthcare facility hooked up to a myriad of machines and devices. This book is a timely and needed response to society's current immersion in the milieu of the technological imperative.
Audience:This is appropriate for a broad audience and is written in a manner that will be accessible to many, including those unfamiliar with medical terminology or ethics. The book also provides enough relevant information on the topics of empathy and empirical research to be useful to healthcare professionals whose patients are facing these intricate decisions.
Features:Throughout the book, the author recounts cases from his own practice as well as famous cases to illuminate his points. He provides a useful chapter on completing advance directives and another on how to accurately assess facts and statistics on treatment outcomes. He also incorporates literary references from Shakespeare, Chekhov, and Tolstoy into the text, and provides an appendix with poems by William Carlos Williams and Anne Sexton. The author concludes with a chapter addressing additional recent concerns in healthcare, including the need to provide universal healthcare and the inexorableness of rationing healthcare.
Assessment:This book is engaging, due in large part to the case studies and literary references. The concise arrangement of short chapters with numerous references makes the book manageable, but substantial enough to be valuable. The honest and realistic information is a welcome alternative to the inaccurate depictions of the end of life provided by the media.

"While surveys show that most of us would prefer to die at home, 80% of us will die in a health care facility, many hooked up to machines and faced with tough decisions. When you, a family member, or a friend are in this situation, what should you do next? In Embracing Our Mortality, Dr. Lawrence, J. Schneiderman, a physician who is our leading expert on medical ethics at the end of life, urges all of us, including health care professionals caring for people at the end of life, to face these decisions with sensitivity and realism informed by both the latest medical evidence as well as the oldest humanistic visions. Dr. Schneiderman vividly demonstrates the wisdom of this approach by interweaving true stories of his patients, current empirical research on care at the end of life, displays of the power of empathy and imagination as embodied in the work of writers like Tolstoy and Chekov, and examples of how the distortion of medical research by media, and its misunderstanding even by health care professional, cloud the ability to think, feel, and decide clearly about mortal concerns. He ends by addressing the question implicit in all of this which is how to achieve a just and universal health care."--Jacket Contents 10 INTRODUCTION: Facts, Statistics, Empathy and Imagination 16 ONE: Putting in Writing What You Want (and Don’t Want) 32 TWO: What May Happen If You Don’t Make It ‘‘Clear and Convincing’’ 45 THREE: Facts and Statistics 63 FOUR: Empathy and Imagination 77 FIVE: Ancient Myth and Modern Medicine: What Can We Learn From the Past? 87 SIX: Hoping for a Miracle 101 SEVEN: What Could Be Wrong with Hope? 114 EIGHT: Medical Futility 130 NINE: Beyond Futility to an Ethic of Care 149 TEN: Future Decisions We May All Have to Make 160 Appendix 212 ‘‘Unknown Girl in the Maternity Ward’’ 212 ‘‘Spring and All’’ 215 UCSD Medical Center Policy & Procedures: Limitation of Life-Sustaining Treatment 216 Index 226 A 226 B 226 C 226 D 227 E 228 F 228 G 228 H 229 I 229 J 229 L 229 M 229 N 230 O 230 P 230 Q 231 R 231 S 231 T 232 U 232 W 232 Y 232 Z 232 While surveys show that most of us would prefer to die at home, 80% of us will die in a health care facility, many hooked up to machines and faced with tough decisions. When you, a family member, or a friend are in this situation, what should you do next? Here, a leading expert on medical ethics at the end of life urges all of us, including health care professionals, to face these decisions with sensitivity and realism informed by both the latest medical evidence as well as the oldest humanistic visions. Dr. Schneiderman demonstrates the wisdom of this approach by interweaving true stories of his patients, current empirical research in care at the end of life, and displays of the power of empathy and imagination as embodied in the work of writers like Tolstoy and Chekhov Content: Putting in writing what you want (and don't want) -- What may happen if you don't make it "clear and convincing" -- Facts and statistics -- Empathy and the imagination -- Ancient myth and modern medicine: what can we learn from the past? -- Hoping for a miracle -- What could be wrong with hope? -- Medical futility -- Beyond futility to an ethic of care -- Future decisions we may all have to make.