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Last Updated on August 5, 2019, by eNotes Editorial. Word Count: 599

In his 2014 book, Being Mortal: Medicine and What Matters in the End, Atul Gawande contemplates the medicalization of death and dying in the modern era. Gawande will come to make a case against artificially prolonging end-of-life treatment, but he is not against the ability to extend people’s lives; he...

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In his 2014 book, Being Mortal: Medicine and What Matters in the End, Atul Gawande contemplates the medicalization of death and dying in the modern era. Gawande will come to make a case against artificially prolonging end-of-life treatment, but he is not against the ability to extend people’s lives; he is, after all, a celebrated surgeon and endocrinologist. He’s seen the effects of end-of-life decisions both as a physician and as a family member. He’s come to believe that the most peaceful deaths involve the fewest interventions.

Important quotes contrast the traditional way of dying with the modern one: the home versus the hospital. Modern medicine fixes ailments, and neither doctors nor patients have given up on trying to fix the problem of death. Gawande’s prose captures the ways people react to the inevitable, and how they have inspired him to rethink his own perception of death and his role in it as a physician.

“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.”

“The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all.”

“A few conclusions become clear when we understand this: that our most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.”

“Our ultimate goal, after all, is not a good death but a good life to the very end.”

“One has to decide whether one’s fears or one’s hopes are what should matter most.”

“You need to understand how much you’re willing to go through to have a shot at being alive and what level of being alive is tolerable to you.”

“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.”

“In the end, people don’t view their life as merely the average of all of its moments—which, after all, is mostly nothing much plus some sleep. For human beings, life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens. Measurements of people’s minute-by-minute levels of pleasure and pain miss this fundamental aspect of human existence. A seemingly happy life may be empty. A seemingly difficult life may be devoted to a great cause. We have purposes larger than ourselves.”

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