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Often when death is the inevitable and impending outcome of a health diagnosis, doctors are reluctant to discuss alternatives to treatment, feeding into a culture of denial that can result in expensive, ineffective, and unnecessary over treatment that may or may not extend life but almost always damages the quality of life. Here, a seasoned doctor and researcher looks at the ways in which we are accustomed to treating illness at all costs, even at the expense of the quality of a patient's life. He considers our culture of denial, the medical profession's role in over treating patients and end of life care, and the patient's options and role in these decisions. The goal is to help patients and families make informed decisions that may help the seriously ill live better with their illnesses. This profoundly empowering book will help people make informed decisions about their lives and medical care, especially those who have a life-threatening or life-changing illness themselves or have a family member living with one. Incorporating specific questions for patients to ask their doctors and discuss with their families, the book provides an analysis of various forces that influence our decision-making. The book also examines the professional, psychological, economic, and social pressures that influence physicians treating seriously ill patients, including those that lead doctors to recommend treatments that may be futile. The book concludes with resources that seriously ill patients and their families can call upon to give them support and assist with the logistical, emotional, and spiritual challenges of end-of-life care.
Aroop Mangalik, MD is a retired oncologist and an ethicist. He has been an active clinician for many years and continues to teach ethics at the University of New Mexico School of Medicine and at the University of New Mexico School of Law. He has worked for many years to reduce unnecessary and unwanted treatments, especially for patients in advanced stages of their diseases. He has several publications in peer-reviewed medical journals pertaining to his work in the laboratory and in clinical trials.
Table of Contents
Preface Introduction 1: Dealing with the Inevitability of Death 2: Communication, Hope and Honesty 3: Religion, Healing and Death 4: Patient Autonomy and Medical Expertise: How to Find a Balance 5: Planning for Your Life, Illness and Death 6: Do No Harm 7: Statistics: They Help and They Fool 8: Why Doctors Over-Treat: Training and Mindset 9: Why Doctors Over-Treat: Pressure from Society and the Medical Establishment 10: Why Doctors Over-Treat: Flaws in the Way They Deal with Patients 11: When Doctors Say "No" 12: Why Patients Demand Unrealistic Treatments 13: How to Reduce Over-Treatment 14: How to Proceed toward Comfort