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(38 reviews)
Author: Ira Byock MD
ISBN : B005GSZJ16
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Format: PDF, EPUB
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A doctor on the front lines of hospital care illuminates one of the most important and controversial social issues of our time. It is harder to die in this country than ever before. Though the vast majority of Americans would prefer to die at home—which hospice care provides—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 how we die represents a national crisis today. To ensure the best possible elder care, Dr. Byock explains we must not only remake our healthcare system but also move beyond our cultural aversion to thinking about death.
The Best Care Possible is a compelling meditation on medicine and ethics told through page-turning life-or-death medical drama. It has the power to lead a new national conversation.
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- File Size: 525 KB
- Print Length: 337 pages
- Page Numbers Source ISBN: 1583334599
- Publisher: Avery; 1 edition (March 15, 2012)
- Sold by: Penguin Group (USA) LLC
- Language: English
- ASIN: B005GSZJ16
- Text-to-Speech: Enabled
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- Lending: Not Enabled
- Amazon Best Sellers Rank: #68,170 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
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in Kindle Store > Kindle eBooks > Nonfiction > Professional & Technical > Medical eBooks > Physician & Patient > Hospice Care - #6
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Free The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life
Dr Ira Byock's new book, "The Best Care Possible" is one doctor's look at the inevitability we all face - death. Like taxes, death is a by-product of life and a "good death", while seemingly an oxymoron, is something Dr Byock has been writing about for many years. An "end-of-life" specialist at New Hampshire's Dartmouth-Hitchcock Medical Center, Ira Byock works with a team to put together as good and gentle a death experience as possible for his patients.
Byock writes, that as we baby-boomers age, we're facing both the inevitable deaths of two generations - our parents, and then, in our turn, ourselves. As overall medical treatments advance, we're living longer and what used to kill us at earlier ages, doesn't do that so much anymore. And we're not dying as often in a family-setting. Most deaths occur in hospitals and nursing homes, with the dying tied up to machines that often keep them alive far past the point most people want to be kept alive. The old conundrum of "quality of life" vs "quantity of life".
Dr Byock's book is not a "how-to" guide to making a "good death". There are no steps he advises taking, but rather he speaks to the larger issue, from both a medical standpoint and a personal one. As a doctor in a smallish community, Byock often has to look at both views when treating his patients. He writes about teaching medical students at Dartmouth Medical School to be aware of the responsibilities as future doctors when medical treatments fail at arresting illness and the patient moves on toward death. And when advanced chemo might be granting a cancer patient a somewhat longer life span but at the cost of agonising side effects. When does a "good life" sequence into a "good death"?
Dr. Byock is the head of the department of palliative care at Dartmouth-Hitchcock Medical Center and a professor at the associated medical school. This means he has dealt with a lot of patients who are reaching the end of their lives; his job is to make that end as comfortable and stress free as possible for both them and their families. It is his contention that Americans today suffer more and die worse deaths- and more expensive deaths- than ever before. How is this possible in an age when there are so many medical treatments available?
Part of it is that the patients don't make their wishes known via advance directives. If a person comes into a hospital without one, and they are unable to make their wishes known, the hospital has the right and obligation to do everything they can to prolong life. While this is absolutely the right thing to do most of the time, it isn't always what the person really wants. When a person is near death from cancer, say, and takes a fall that creates a brain bleed, the hospital will put them on life support and prolong their life, even if there is no chance of recovery. Would that person have wanted that, or would they prefer to let go at that point? Who wants to live another 2 weeks if they are intubated, on a ventilator and semi-conscious at best? But doctors have an obligation to preserve life, and the family feels guilty if they say `pull the plug'.
Add to this problem the fact that doctors get almost no training in palliative care and end of life issues. Many don't know the best ways to deal with pain and fear, or even how to broach the subject of impending death. Some even hesitate to prescribe opiates because they are addictive- as if that could possibly be an issue for a dying person. These things need to be addressed in medical school.
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