Gawande, A. (2014). Being mortal: Medicine and what matters in the end. Metropolitan Books, Henry Holt and Company.
In modern times, medicine has triumphed and positively impacted the different aspects of life. Notable instances entail the transformation of birth, injuries, and the shift from harrowing infectious ailments to manageable interventions. However, in the unavoidable condition of aging and demise, the objectives behind medicines seem to go contrary to the interests posed by the human spirit (Sood & Moore, 2019). For example, there has been a rise in nursing homes that “pin” patients into wheelchairs and railed beds. In addition, it is common practice to witness healthcare facilities isolating dying patients and those critically ill, while trying to search for critical signals knowing too well chances of survival are nil. Physicians dedicated to propagating life often embark on procedures that worsen living and extend suffering (Kamm, 2021). Thus, Dr. Atul Gawande argues that despite the quality of life being the ultimate desire for most patients and their families, the medical profession must recognize their ultimate limitations.
Main Messages by Atul Gawande
Autonomy
In the book, Being Mortal, Gawande recalls the quagmire involving medics trying to save lives and admitting to failure when things do not go accordingly. The profession has medicalized old age to a significant degree that they are no longer livid at the idea that life sometimes cannot be curable. He further supposes that the profession should move away from simply fighting for extensive lives and instead focus on the things that result in a meaningful life (Gawande, 2014). Gawande supports his viewpoints via several stories highlighted, including those about his family, friends, and patients. He opinioned that autonomy is a very important aspect of life, and it arises from a sense of being the author of one’s life. Therefore, through his clinical expertise, research, and anecdote, Gawande maintains that when individuals have control over their life, the end of life becomes more fulfilling for them and better for their families.
Enjoying Life differently
Another message fronted by Gawande in Being Mortal is that people enjoy life differently. In this view, good life at 93 years for a particular individual may vary from the same thing at 33 years for a different person (Gawande, 2014). The book noted that some patients confessed to enjoying when they watched their favorite sports, while others rejoiced over the idea of having ice cream. For Gawande’s father, he gained his life fulfillment from sending emails and being a recipient to others. These instances show that acknowledging what matters enables physicians to formulate appropriate judgments concerning clinical measures of questionable outcomes, such as surgery (Kamm, 2021). While others may view the book as a plea for aided demise, such deliberations are unfounded. Essentially, the author is concerned that the dependence on assisted death is another distraction within the medical field regarding what makes the end of life fulfilling for the victim and their family.
Focusing on the Living
Interestingly, Atul Gawande termed care homes merely a “parking” place for older people. This deliberation was not ill-motivated but premised on the recurring failures to provide any value to the later stages of human life. Following the increased inventions and technology development, doctors have primarily emphasized health and safety above everything else, leading to the dependence on care homes (Sood & Moore, 2019). It is seemingly a system of containment that seeks to deal with individuals as if they are a source of inconvenience to society. This way, the big question is why people are allowed to live to such great lengths when they are viewed as baggage? Would not it be ideal for tearing down the medical procedures that seek to prolong life since it is unnecessary? Hence, if autonomy is desired, what benefit would an elderly individual who has Alzheimer’s Disease or debilitated gain when they embark on making poor choices?
Unproductive and Unhelpful Medical Interventions
Atul Gawande shows that various late medical measures are unhelpful and counterproductive. This deliberation was further affirmed by multiple medical studies that indicated that most terminally ill patients often lived longer after accepting the fate of their diagnosis and enrolled in palliative care (Gawande, 2014). Whereas it is justifiable to believe that a patient can outsmart the odds, it does not take away the need for preparation for opposite outcomes if they do not make it. One may argue that hope can never be an intervention plan, especially when people resort to spending multitrillion dollars on end-of-life measures. The author proceeded to ask a very valid question, inquiring whether any last-minute honest discussion between his father-in-law and a doctor could have alleviated the miserable last months of his life (Kamm, 2021). The truth is, it would have transpired into a desperately challenging interaction; hence, people should be left with things that matter.
Relevance of Being Mortal to Nursing Practice
The book points toward healthcare providers being in the frontline to ensure that patients can die with grace. Gawande has aired his frustrations throughout the document, signaling that care providers have become arrogant and unwilling to concede “defeat.” As a result, they are part of the modern problems, including the rise in hospice and palliative care (Gawande, 2014). Alternatively, the nurse should be open to helping patients through a good death, which is equally as significant as helping them flourish while alive. The practice entails telling patients that the interventions will potentially fail and that they could face death at any time (Kamm, 2021). Thus, nurses should not be part of the commercialized healthcare system that elevates private insurance companies’ interests to the detriment of patients and their families.
References
Kamm, F. M. (2021). Meaning in Lives Nearing Their End. Royal Institute of Philosophy Supplements, 90, 277-296.
Sood, M., & Moore, J. (2019). Empathy, emotional attachment, and the end. British Journal of General Practice, 69(680), 132-132.
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