Here's a way we patients can get doctors to do what we want, e.g. palliative care, rather than what they want, e.g. more operations

Atul Gawande is the surgeon/author who,after dealing with the final illness of his father, wrote the bestseller, Being Mortal, in which he meditates on how we can better deal with age-related frailty, serious illness and approaching death. He is a wonderful writer and thinker.

Overkill, his most recent article for the New Yorker, carried this subtitle:

An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

One of the best things we can do is prepare an advance directive that spells out for doctors and other healthcare providers what we want them to do, and what we don't want them to do.

I've just revised my will and my advance health care directive. This

led me to write three posts for my blog on these directives.

One is a general description of the advanced directive, living wills, and health care proxies -- It is preceded by two posts with the text of my standard directive and the text of a special provision that I hope will give my health care proxy the power to authorize VSED (voluntarily stopping eating and drinking) if I have dementia that has progressed to the point where I can no longer communicate

4 Replies

  • I just read this book and I cannot recommend it highly enough. It is required reading for all our children. This should be read by all physicians treating PwP's aND it should be carefully read by those people who are making arrangements for where and how they will be living the last few years of their lives. Most emphatically, all Assisted Living facilities are not the same and many children and caretakers DO NOT make the best choices for those things that most important to us. Considering the fact that 80% of us will disappear into dimentia and will rely on others for support, it is essential that PwP or anyone who will eventually expire (which is a lot of people) read this book.

  • 80%? Not 100%?

  • Here is a quote I like from Being Mortal:

    "People with serious illness have priorities besides simply prolonging their lives.Surveys find that their top concerns include avoiding suffering, strengthening relationships with family and friends, being mentally aware, not being a burden on others, and achieving a sense that their life is complete. Our system of technological medical care has utterly failed to meet these needs, and the cost of this failure is measured in far more than dollars. The question therefore is not how we can afford this system’s expense. It is how we can build a healthcare system that will actually help people achieve what’s most important to them at the end of their lives."

    I used that quote at the start of my blog post on the book --

  • I heard him being interviewed by Terry Gross on NPR and was riveted. Thanks for those directives -- much appreciated.

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