Synopses & Reviews
While surveys show that most of us would prefer to die at home, 80% of us will die in a health care facility, many hooked up to machines and faced with tough decisions. When you, a family member, or a friend are in this situation, what should you do next? In
Embracing Our Mortality, Dr. Lawrence J. Schneiderman, a physician who is our leading expert on medical ethics at the end of life, urges all of us, including health care professionals caring for people at the end of life, to face these decisions with sensitivity and realism informed by both the latest medical evidence as well as the oldest humanistic visions. Dr. Schneiderman vividly demonstrates the wisdom of this approach by interweaving true stories of his patients, current empirical research in care at the end of life, displays of the power of empathy and imagination as embodied in the work of writers like Tolstoy and Chekov, and examples of how the distortion of medical research by media, and its misunderstanding even by health care professionals, cloud the ability to think, feel, and decide clearly about mortal concerns. He ends by addressing the question implicit in all of this which is how to achieve a just and universal health care.
Dr. Schneiderman proves a refreshingly honest, astringent, and life-affirming guide to thinking about the choices that we or people we love will face when we dienot if, as the technological imperatives of modern medicine can suggestand to making decisions at the end of life that respect all that has preceded it.
Review
"Deciding how we ought to die is a subject that frightens most of us and leaves not a few unable to even enter into a discussion about it much less plan for our own mortality. If you fit this description, then you need to keep a copy of Embracing Our Mortality close at hand. Lawrence Schneiderman has the experience and the wisdom tomake you think and, more importantly, make you act."--Arthur Caplan, PhD, Emanual and Robert Hart Professor of Bioethics Chair, Department of Medical Ethics, and Director, Center for Bioethics, University of Pennsylvania
"Medicine has never had greater powers to cure disease, yet the same treatments that promote life in one case only prolong dying in another. This conundrum leads Dr. Lawrence Schneiderman to pose one of the essential ethical questions of contemporary medicine, What should we do now? Using case studies from his practice and cases of public notoriety (such as the Schiavo case), he provides the reader not only a wealth of facts, but also social, psychological, and spiritual insight into how some run from while others embrace mortality."--Robert L. Fine, MD, Director of Clinical Ethics, Baylor Health Care System, Houston
"A physician who is a playwright envisions his patients in the nuanced script of their lives. Dr. Schneiderman, who is indeed both, places the medical facts of drugs, operations, and statistics into human dramas of hope, anger, despair, and empathy pervading every encounter with a patient who is a person."--Albert R. Jonsen, PhD, Professor Emeritus of Ethics in Medicine, University of Washington; Senior Ethics Scholar, California Pacific Medical Center, San Francisco
"A passionate, story-rich reaffirmation that the practice of medicine is about caring for human persons whose natural history includes getting sick, getting well, flourishing, failing, and ultimately dying."--Lance K. Stell, PhD, FACFE, Charles A. Dana Professor of Philosophy, and Director, Medical Humanities Program, Davidson College; Vice-Chair, Ethics Committee and Director, Ethics Consult Service, Carolinas Medical Center
"This book is engaging...The honest and realistic information is a welcome alternative to the inaccurate depictions of the end of life provided by the media."--Doody's, a 5 star review
"Embracing Our Mortality is an eclectic collection of essays, some previously published, focusing broadly on end of life issues, advance directives and futility, then concluding with Schneiderman's take on the problems of our current healthcare system...While one may disagree with him on specifics, he has picked out some of the better current ideas for reparairing the system....These are complex issues, and he might actually supply better long-term answers than many of our politicians..."--Ethics and Medicine
Synopsis
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,
Synopsis
While surveys show that most of us would prefer to die at home, 80% of us will die in a health care facility, many hooked up to machines and faced with tough decisions. When you, a family member, or a friend are in this situation, what should you do next? In Embracing Our Mortality, Dr. Lawrence J. Schneiderman, a physician who is our leading expert on medical ethics at the end of life, urges all of us, including health care professionals caring for people at the end of life, to face these decisions with sensitivity and realism informed by both the latest medical evidence as well as the oldest humanistic visions. Dr. Schneiderman vividly demonstrates the wisdom of this approach by interweaving true stories of his patients, current empirical research in care at the end of life, displays of the power of empathy and imagination as embodied in the work of writers like Tolstoy and Chekov, and examples of how the distortion of medical research by media, and its misunderstanding even by health care professionals, cloud the ability to think, feel, and decide clearly about mortal concerns. He ends by addressing the question implicit in all of this which is how to achieve a just and universal health care.
Dr. Schneiderman proves a refreshingly honest, astringent, and life-affirming guide to thinking about the choices that we or people we love will face when we dienot if, as the technological imperatives of modern medicine can suggestand to making decisions at the end of life that respect all that has preceded it.
About 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.
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
Appendix
"Unknown Girl in the Maternity Ward"--Ann Sexton
"Spring and All"--William Carlos Williams
UCSD Medical Center Policy and Procedures
Limitation of Life Sustaining Treatment