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Being Mortal: Medicine and What Matters in…
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Being Mortal: Medicine and What Matters in the End (vuoden 2017 painos)

– tekijä: Atul Gawande (Tekijä)

JäseniäKirja-arvostelujaSuosituimmuussijaKeskimääräinen arvioMaininnat
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Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families of the terminally ill.
Jäsen:carcosafriedcoyote
Teoksen nimi:Being Mortal: Medicine and What Matters in the End
Kirjailijat:Atul Gawande (Tekijä)
Info:Picador (2017), Edition: 1, 304 pages
Kokoelmat:HISTORICAL/POLITICAL
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Being Mortal: Illness, Medicine and What Matters in the End (tekijä: Atul Gawande)

Viimeisimmät tallentajatpetarus, yksityinen kirjasto, Gadi_Cohen, Gretchen_Dursch, chirrell, rbftlibrary, aksh04ay, jabarclay, jkpublic, docvoltage
  1. 10
    Final Exam: A Surgeon's Reflections on Mortality (tekijä: Pauline W. Chen) (BookshelfMonstrosity)
    BookshelfMonstrosity: Written by experienced and dedicated physicians, these compelling books question American health care's emphasis on management and technique to the detriment of human relationships between doctors and patients, especially when the patient's mortality is an important consideration.… (lisätietoja)
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» Katso myös 525 mainintaa

englanti (239)  unkari (2)  italia (1)  Kaikki kielet (242)
Näyttää 1-5 (yhteensä 242) (seuraava | näytä kaikki)
I remember the Terri Schiavo case and feeling so surprised that people were arguing about her. Of course she should be kept alive, I thought. I was 10 or 11 at the time. My mom, however, was shocked that it was even a question -- like almost all doctors, she told me, she values quality of life more than life. This idea -- that people should determine for themselves what "quality of life" means and how much they value it over living for living's sake -- was kind of revolutionary to me.

Reading this, I couldn't help thinking about the people in my life who've gone through those final stages of life, and of the people who were growing older and closer to those stages. The power of this book stems from the drama that's so inherent in the universal human experience of dying, of suffering, of finding out for yourself what you think the meaning of your life is, what your priorities are. Priorities in life -- and in old age -- and in dying.

Perhaps what this book conveys most piercingly is that death's not a truly universal experience -- we all die, but differently. The stories Gawande tells are haunting, in the way that the climactic, the startling, the tragic is portrayed as so ordinary. I guess what ties all the people together is their autonomy, their need for autonomy. That's what surprised me the most -- people, as they lost their sharpness, amassed disabilities, drew closer to a fatal fall, valued the ability to do things for themselves and make decisions for themselves more than anything else. More than prolonging their own lives, it seemed at times.

I didn't like the writing at the sentence structure; it seemed a bit expository, a bit vanilla. Perhaps because I've read parts of it in the New Yorker. But of course, the value of this book is in the message. ( )
  Gadi_Cohen | Sep 22, 2021 |
「要是我們不知道如何善終,那就只能讓醫學、科技和陌生人來操控自己的命運。」臨終規劃還是盡早開始好,畢竟死亡隨時可能降臨。書中既有對醫療體系和養老機構的考量、批判和建言,又討論了子女應該如何對待老去的父母、讓其老後生活過得更加舒適,還指引了在生命走到盡頭時如何作出是繼續和病魔(主要指癌症)纏鬥、還是放棄治療抓緊時間與家人相處的決定,佐以豐富的實際案例,無論是醫者、子女、老人/癌症患者這三者中的哪一個都值得一看(不要想著死亡太沈重而諱疾忌醫! ( )
  puripuri | Sep 9, 2021 |
death sounds terrible in this book but it's about what you can deal with and what you cannot. ( )
  mahallett | Aug 24, 2021 |
I still remember the early days of "S.T.E.M." as a concept. When that was introduced, and people were harkened to rekindle the national interest in being global leaders of scientific discovery, that included an unnecessary swipe at liberal arts/humanities (maybe we need our own acronym? L.A.H.? H.L.A.?). Politicians decried how useless it is to major in Philosohpy and English. I do not have much hope that this reigning view will go away soon, the view that immediate or tangible "practicality" or quantifiable results are what matters.

I can't help but see some sick joke in reading that this same attitude is replicated in the practice of medicine, and that such an attitude that demands immediate, tangible results is, to no surprise, worse for patients. And that even if it is worse for patients, just as it is bad for society to lose the breadth of human knowledge in thinking deeply about things that don't have an immediate effect, people will ignore (one of) the lessons here. In this book, Dr. Gawande describes how recalcitrant people are to changing the way we view the elderly and what is in store for them. He describes in one case a doctor who had a hard time convincing people to get funding for bringing pets into the elder care home. The idea was simple: those who are old, in their last years, want to maintain their dignity by having a purpose and having things to do.

It worked, bringing pets into the home, giving the residents a job to do other than waiting for medicine time and then nap time and then visiting time. They maintained higher levels of autonomy, they used less medication, they were overall happier. Yet, people balked at having to sign off on spending money at something that they could not perceive working. It wasn't a magic pill. It wasn't a solution culminating from decades of scientific advancement. It was merely a simple philosophical claim about the value of dignity, some minimal views about what is required to maintain it, and the confidence to try it despite being unconventional. Again, I have little hope that Gawande will change people's minds about this---it doesn't fit the fast food, customer service, unreflective twitter culture---but I think this is an important book.

He is a bit sloppy, I think, in discussing the bit about "death with dignity," assuming that this constitutes a right, but not saying much about what this is or what violates such a right. One reason this deserves more care is that it is possible that people may not have a right to die as they wish, but they would still value dying with dignity. So they are separate concepts, even if it goes hand-in-hand. That requires more discussion, and here he didn't bring in anyone who writes about this the way he did for other topics (such as Dworkin for autonomy, or Linda and Ezekial Emanuel for models of the patient-doctor relationship). So maybe he just hasn't read up on this kind of work.

And he also went by too quickly with the passive/active euthanasia distinction, sharing the majority view that there is a significant difference between them while hinting that there are problems with holding that there is one (the way he framed the difference made it seem fairly arbitrary to do so, or at least, friendly to such a suggestion). But maybe these gripes are ones I have because of my remembering self (a reference to a thesis he mentions about the experiencing/remembering self), having experienced these hesitations near the end of the book.

The book was well written, loaded with case studies, peppered with good introductory discussion of value questions with some indications for what else to read, and offered some simple, practical solutions that will improve the lives of anyone near the end of life and their family members. The only other musing I have is that I can imagine many of his readers will think that they are exceptions to the rule (oh that could never happen to me, I eat kale and blueberries...I know exactly what I want already and that will never change...if I, healthy 20-50 year old person, were to be in that position, I would rather die...). ( )
  tonberrysc | Aug 20, 2021 |
This is a must read for anyone who is going to die or have someone close to them die... ( )
  laurentipton | Aug 13, 2021 |
Näyttää 1-5 (yhteensä 242) (seuraava | näytä kaikki)
His new book, “Being Mortal,” is a personal meditation on how we can better live with age-related frailty, serious illness and approaching death.

It is also a call for a change in the philosophy of health care. Gawande writes that members of the medical profession, himself included, have been wrong about what their job is. Rather than ensuring health and survival, it is “to enable well-being.”
 

» Lisää muita tekijöitä (8 mahdollista)

Tekijän nimiRooliTekijän tyyppiKoskeeko teosta?Tila
Gawande, Atulensisijainen tekijäkaikki painoksetvahvistettu
Petkoff, RobertKertojamuu tekijäeräät painoksetvahvistettu
Pradera, AlejandroKääntäjämuu tekijäeräät painoksetvahvistettu
Röckel, SusanneÜbersetzermuu tekijäeräät painoksetvahvistettu
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Epigrafi (motto tai mietelause kirjan alussa)
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I see it now—this world is swiftly passing.
—the warrior Karna, in the Mahabharata

They come to rest at any kerb:
All streets in time are visited.
—Philip Larkin, "Ambulances"
Omistuskirjoitus
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I learned about a lot of things in medical school, but mortality wasn't one of them.
Sitaatit
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Modern scientific capability has profoundly altered the course of human life. People live longer and better than at any other time in history. But scientific advances have turned the processes of aging and dying into medical experiences, matters to be managed by health care professionals. And we in the medical profession have proved alarmingly unprepared for it.
In other words, our decision making in medicine has failed so spectacularly that we have reached the point of actively inflicting harm on patients rather than confronting the subject of mortality. If end-of-life discussions were an experimental drug, the FDA would approve it.
The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task. Death is the enemy. But the enemy has superior forces. Eventually, it wins. And in a war that you cannot win, you don't want a general who fights to the point of total annihilation. You don't want Custer. You want Robert E. Lee, someone who knows how to fight for territory that can be won and how to surrender it when it can't, someone who understands that the damage is greatest if all you do is battle to the bitter end.
… our driving motivations in life, instead of remaining constant, change hugely over time and in ways that don’t quite fit Maslow’s classic hierarchy. In young adulthood, people seek a life of growth and self-fulfillment, just as Maslow suggested. Growing up involves opening outward. We search out new experiences, wider social connections, and ways of putting our stamp on the world. When people reach the latter part of adulthood, however, their priorities change markedly. Most reduce the amount of time they spend pursuing achievement and social networks. They narrow in. Given the choice, young people prefer meeting new people to spending time with, say, a sibling; old people prefer the opposite. Studies find that as people grow older they interact with fewer people and concentrate more on spending time with family and established friends. They focus on being rather than doing and on the present more than the future.
Life is choices, and they are relentless. No sooner have you made one choice than another is upon you.
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Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families of the terminally ill.

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