A persuasive argument for giving the severely ill, and those facing a lingering death, options about levels of care, as well as the right to a dignified death. Former hospice-director Quill (Medicine and Psychiatry/University of Rochester) made headlines in 1991 with an article in the New England Journal of Medicine (reprinted here) describing how he assisted a terminally ill woman to commit suicide. Stories of other patients' dire experiences reinforce Quill's contention that medicine's traditional focus on fighting death to the end must be balanced by a humane philosophy of ``comfort care'' that concentrates on relieving suffering and improving the quality of life—even at the risk of shortening it. Comfort care, the author says, offers the terminally ill the chance to live their remaining time with less pain and more peace of mind, as well as the possibility of dying with more dignity, control, and support. Quill argues that the question of physician-assisted suicide should be examined anew, and he proposes some clinical guidelines to stimulate discussion. Unlike Derek Humphry (Final Exit, 1992) or Jack Kevorkian (Prescription: Medicine, 1991), Quill operates in the mainstream, urging cautious exploration and carefully considered changes in public policy. Meanwhile, he urges readers to prepare advance directives to guide their own medical treatment in the event of loss of mental capacity, and he includes samples of a living will and a health-care proxy statement, along with instructions on their use. In a final chapter, Quill sets specific tasks for potential patients (meaning all of us), physicians, institutions, and policy-makers concerned with modifying society's response to the life-and-death issues he has raised. A thoughtful, well-documented addition to the often high- pitched debates on this emotional subject.
Pub Date: March 29, 1993
ISBN: 0-393-03448-8
Page Count: 196
Publisher: Norton
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Feb. 1, 1993
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
PERSPECTIVES
Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.
“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.
It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.
Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.Pub Date: Nov. 12, 2019
ISBN: 978-1-61039-950-0
Page Count: 432
Publisher: PublicAffairs
Review Posted Online: Aug. 28, 2019
Kirkus Reviews Issue: Sept. 15, 2019
SEEN & HEARD
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