Embracing Our Mortality: Hard Choices in an Age of Medical Miracles

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While we would all prefer to die at home, quietly and peacefully, in fact most of us will die in a health care facility, many of us hooked up to machines and faced with tough alternatives. In Embracing Our Mortality , Dr. Lawrence J. Schneiderman captures medical decision-making in action at the end of life, a time when the physician's and patient's choices are the most difficult—and the most heart—wrenching-to make. Here readers will find vivid case studies drawn from Dr. Schneiderman's fifty-year career that illuminate the challenging medical decisions many of us have to make when we are seriously—and possibly even terminally—ill. The cases deal with patients ranging from newborns to the elderly. We discover how the wrong decision can actually increase our pain and suffering, while adding little time—and virtually no quality—to the end of our lives. Schneiderman discusses the latest empirical research, showing the reader how to evaluate statistical claims and assess the probability that a particular course of treatment will significantly improve our medical condition. Moreover, he draws on authors such as Tolstoy and Chekov to emphasize the importance of empathy and imagination in making these crucial decisions. Instead of promoting the false promises of "miracles," he urges patients, family members, and physicians to approach these difficult decisions with sensitive yet realistic outlooks, combining the latest medical technology and oldest humanistic visions. Perhaps most important, he underscores the life-enhancing value of honestly facing—and embracing—our mortality. Written by an eminent physician and ethicist recognized for his groundbreaking work on end-of-life medical issues, Embracing Our Mortality is an essential volume for everyone who wants the best possible care at the end of their life. *Features A unique approach to the trying medical choices many of us have to make at the end of our lives, combining science

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Editorial Reviews

Doody's Review Service
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.
Library Journal

As medical advances and lifestyle changes carry more and more Americans beyond the age of 80, decisions about quality of life and manner of death grow increasingly unavoidable. Schneiderman (Univ. of California at San Diego Medical Sch.) and geriatrician McCullough (The Little Black Book of Geriatrics ) remind us that the issues surrounding decline and death are not isolated, spectacular events happening to others, as in the Terri Schiavo case, but a part of all our lives. Here, they each discuss the need for advanced planning and thoughtful communication and care.

Schneiderman emphasizes the need for clear and current advance directives to balance the tendency of modern medicine, abetted by hopeful loved ones, to continue treatments to the detriment of the patient's comfort. Using many literary references (this M.D. is also a novelist, a short story writer, and a playwright) and calling on philosophy as well as science, Schneiderman argues that physicians need to work from an "ethic of care" that gives equal status to the relief of suffering and the restoration of health.

McCullough's concept of "slow medicine" is an example of that ethic of care in action. Having worked through these issues himself with his own mother's death, he here guides families as they move with an aging relative along what he calls the "eight stations of late life" preceding death. McCullough believes communication at this time is essential, and he emphasizes gentle, low-impact, and thoughtful care from the first signs of the body or mind's decline. Often, he points out, elderly patients can benefit more from attentive listening, conversation, touch, and a reduction in medications than fromacute interventions. Good additions to such works as Ira Byock's Dying Well , both these books are recommended for public libraries.-Dick Maxwell, Porter Adventist Hosp. Lib., Denver

Copyright 2006 Reed Business Information.
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Product Details

  • ISBN-13: 9780195339451
  • Publisher: Oxford University Press, USA
  • Publication date: 3/3/2008
  • Edition description: New Edition
  • Pages: 232
  • Product dimensions: 7.10 (w) x 5.30 (h) x 1.00 (d)

Meet the Author

Lawrence J. Schneiderman, M.D, is Professor Emeritus at UCSD Medical School and Visiting Scholar in the Program in Medicine and Human Values at the California Pacific Medical Center in San Francisco. He has been a visiting scholar and visiting professor at institutions in the United States and abroad and has written more than 170 medical and scientific publications, as well as a novel and award-winning plays and short stories.

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Table of Contents

Introduction: Facts, Statistics, Empathy, and Imagination
1. Putting in Writing What You Want (and Don't Want)
2. What May Happen If You Don't Make it "Clear and Convincing," and Lawyers and Judges (and Politicians!) Get Involved
3. Facts and Statistics
4. Empathy and the Imagination
5. Ancient Myth and Modern Medicine: What Can We Learn From the Past?
6. Hoping for a Miracle
7. What Could Be Wrong with Hope?
8. Medical Futility
9. Beyond Futility to an Ethic of Care
10. Future Decisions We Probably Will All Have to Make
"Unknown Girl in the Maternity Ward"—Ann Sexton
"Spring and All"—William Carlos Williams
UCSD Medical Center Policy & Procedures
Limitation of Life Sustaining Treatment

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