ATUL GAWANDE LETTING GO PDF

The opening and ultimately, closing anecdote is about an ill-fated patient of Dr. He believes, as do most people, that hospice care is meant to hasten death, even though at least one survey of terminal cancer patients found that those who elected for intensive care had similar survived no longer than those who entered hospice care. Curiously, hospice care seemed to extend survival for some patients; those with pancreatic cancer gained an average of three weeks, those with lung cancer gained six weeks, and those with congestive heart failure gained three months. The lesson seems almost Zen: you live longer only when you stop trying to live longer. Gawande relates this to the current health care crisis by pointing out a Aetna study in which policyholders expected to die within a year could choose hospice services and have all the other treatments. The benefits of accepting fate are not just monetary.

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Medical innovations have enabled us to wring a few more days, or months, out of life for the terminally ill; and anyone who's lost a loved one knows the outsize value of an extra hour. But as Atul Gawande , MD, works out in a heart-breaking New Yorker piece , aggressive end-of-life intervention often comes at great cost: We spend thousands of dollars on chemotherapy, surgery and intensive care stays, often depriving patients of the chance to be with family, enjoy physical touch and stay mentally aware as they approach death:.

The hard question we face, then, is not how we can afford this system's expense. It is how we can build a health-care system that will actually help dying patients achieve what's most important to them at the end of their lives. In "a war you can't win," Gawande says, "you don't want a general who fights to the point of total annihilation.

This certainly is a factor. The new health-reform act was to have added Medicare coverage for these conversations, until it was deemed funding for "death panels" and stripped out of the legislation. But the issue isn't merely a matter of financing. It arises from a still unresolved argument about what the function of medicine really is-what, in other words, we should and should not be paying for doctors to do.

Rather than attempting a summary of the essay, I'll only say, go read it. At the risk of sounding macabre, it's an issue we all have to confront at one point or another. Related: In commencement address, Atul Gawande calls for innovation around "entire packages of care" , The high-cost capital: Key to health reform? Advanced features of this website require that you enable JavaScript in your browser.

Thank you! But as Atul Gawande , MD, works out in a heart-breaking New Yorker piece , aggressive end-of-life intervention often comes at great cost: We spend thousands of dollars on chemotherapy, surgery and intensive care stays, often depriving patients of the chance to be with family, enjoy physical touch and stay mentally aware as they approach death: The hard question we face, then, is not how we can afford this system's expense.

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“Letting go,” and why it’s so hard to do: Atul Gawande explores the challenges of end-of-life care

Summary : In the August 2 issue of the New Yorker , Boston surgeon Atul Gawande writes about the ambiguities that plague end-of-life care. Ultimately, Gawande suggests, the problem with the way we deal with death today is that we have forgotten the art of dying. Palliative and hospice care can help us recover a lost art, he adds, though not quite in the way most of us expect. The goal is not to cut costs and curtail suffering by shortening the process of dying.

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Atul Gawande: “Letting Go: What Should Medicine Do When It Can’t Save Your Life?”

A surgeon and writer, Dr. In his article Dr. Gawande explains that expense is the reason that end-of-life medical care has become a topic of discussion. However, if the disease worsens, treatment escalates, and cancer-related expenses create a U-shaped curve. The discussion of end-of-life care should go far beyond money.

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Atul Gawande on "letting go" at life's end

Medical innovations have enabled us to wring a few more days, or months, out of life for the terminally ill; and anyone who's lost a loved one knows the outsize value of an extra hour. But as Atul Gawande , MD, works out in a heart-breaking New Yorker piece , aggressive end-of-life intervention often comes at great cost: We spend thousands of dollars on chemotherapy, surgery and intensive care stays, often depriving patients of the chance to be with family, enjoy physical touch and stay mentally aware as they approach death:. The hard question we face, then, is not how we can afford this system's expense. It is how we can build a health-care system that will actually help dying patients achieve what's most important to them at the end of their lives. In "a war you can't win," Gawande says, "you don't want a general who fights to the point of total annihilation. This certainly is a factor. The new health-reform act was to have added Medicare coverage for these conversations, until it was deemed funding for "death panels" and stripped out of the legislation.

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