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Anyone who is even remotely interested in end of life issues, and anyone who is a physician, should really read Atul Gawandes Being Mortal. Many people are unable to live their lives out the way Dr Sacks hopes to, simply because the medical establishment as is doesn't really allow for it. The best takeaway from this essay is that, in the end, you have to focus entirely on things that matter to you most. But you should also be clear on this with your treating providers - so at the end you are spending time with your loved ones, and not going in and out of the hospital.

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The advice reminds me of the article "How Doctors Die" ( http://www.nytimes.com/2013/11/20/your-money/how-doctors-die... ).

Having not read the book and the viewpoint it presents I do feel like there's also a bit of responsibility - I hesitate to use "blame" or "fault" - on the patient or patient's family for keeping them alive on machines and treatment that cost way too much. Perhaps the establishment is an enabler in that sense but what would they be if they didn't respect the wishes of the dying?

There's an interesting related article that goes a bit further than the NYT piece: http://slatestarcodex.com/2013/07/17/who-by-very-slow-decay/

I thought it was a pretty worthwhile read - maybe you will too.

Great article! Thanks.

Excerpt:

"The hospital lawyer mentioned during orientation that it never fails that the family members who live in the area and have spent lots of time with their mother/father/grandparent over the past few years are willing to let them go, but someone from 2000 miles away flies in at the last second and makes ostentatious demands that EVERYTHING POSSIBLE must be done for the patient.

Your doctors will nod their heads and tell your family they respect their wishes. It will be a lie. Oh, sure, they will carry out the family’s wishes, in terms of continuing to provide the care. But respect? [...]"

He delivered the BBC Reith Lectures this year too, which were fantastic.

http://www.bbc.co.uk/programmes/b00729d9

If you enjoyed those lectures, the EconTalk conversation with Becky Linddicoat on palliative care may also be of interest to you.

http://www.econtalk.org/archives/2014/11/becky_liddicoat.htm...

> because the medical establishment as is doesn't really allow for it.

I have many relatives and friends in medicine. They will let you end your life the way you want to (for the most part) but you have to be firm about what you want. Doctors don't like telling people they're dying because it is a hard conversation to have. And most people, even those who are aware of the statistics, like to cling to the hope that they could be different.

Thatse why it is important to know that, statistically, hospice provides better and longer life than aggressive treatment of advanced cancer. Hospice patience enjoy more hours of non-treatment "real life" than agressive-care patients (who spend far more time in hospital beds or surgery instead of outside, with family, Etc)

This is exactly the problem discussed in the book. Docotors are not equiped in dealing with end of life issues, something that has to change.

I just finished this book a couple weeks ago. It was definitely a great one. Although, a difficult book to read, purely from the perspective of the topic. Growing old and/or dying are both topics people tend to ignore.

I also hadn't fully grasped the condition of growing old, itself. No one wants to die, but growing old and losing your independence is a disease all to its own, described in vivid detail in the book.

(I also appreciate that the author was so honest about mentioning taking antibiotics before drinking water from the Ganges [and still getting sick!]).

>"should really read Atul Gawandes Being Mortal."

PBS Frontline (which consistently produces awesome journalism) recently did a documentary based on this book:

http://www.pbs.org/wgbh/pages/frontline/being-mortal/

Tuesdays with Morrie is also a good read on this topic.

I heartily second this recommendation (Being Mortal). It is very well written and thoughtful.

In fact, when my wife gave it to me, I wasn't even interested in end of life issues - who wants to read about death in the middle of winter? But I was immediately sucked in and enjoyed it thoroughly.

A book I found very helpful was "Final Journeys: A Practical Guide for Bringing Care and Comfort at the End of Life"

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