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Book Review: A Doctor's Prescription for Better End-of-Life Care

Ira Byock, M.D. The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life. Penguin Group, New York, N.Y. 2012. 320 pages.

$15.11 on Amazon. Click here to purchase.

Advances in medicine are allowing Americans to live longer than ever, but this brings with it increased medical problems at the end of life, meaning people are sicker than ever before they die. The Best Care Possible argues that we aren't doing a good job of helping people with the burden of living longer, and that this is becoming nothing short of a national crisis.  

Author Ira Byock, the director of palliative medicine at Dartmouth-Hitchcock Medical Center in New Hampshire, says that Americans make dying a lot harder than it has to be. People spend their last days in hospitals or nursing homes with poorly controlled pain and feeling like a burden to their families. Byock says a better alternative to the "fight disease and illness at all costs" approach is consistent and compassionate palliative care for the seriously ill.

A master storyteller, Byock uses narratives of his patients who have been diagnosed with serious illness to demonstrate how palliative care can provide people with a better quality of life for longer. He explains that palliative care means looking at the whole person, not just the immediate medical problem, and such care, he maintains, is not just for the immediately dying, but can provide comfort during all serious illnesses.  Byock believes not just in patient-centered care but family centered care as well. This means better support for caregivers as well as more alternative housing arrangements for seniors, like senior communities where residents watch out for each other. 

But to make any of this possible, Byock says we must end our cultural antipathy to confronting mortality.  With touching stories and compassion, he makes a compelling argument for changing the way end-of-life care is provided in the United States.