Dr. Atul Gawande: Make End Of Life More Humane

Dr. Atul Gawande began researching hospice and end-of-life care options because he says he didn't know how to broach the subject of death with his terminally ill patients.

The surgeon and New Yorker staff writer writes about the difficulties faced by medical professionals who must decide when to stop medical interventions and focus on improving the final days of life in his article "Letting Go" in the Aug. 2 New Yorker.

Gawande tells Fresh Air's Terry Gross that physicians are hesitant to tell patients that there's nothing else they can do, even if statistics show procedures are unlikely to work.

"Our system of medical care has successfully created a multitrillion-dollar system for dispensing lottery tickets — the lottery ticket that you could get this longer life," Gawande says. But he says it has not prepared people for the likelihood that physicians aren't good at preparing patients whose lives will not be prolonged by medical treatment. "So we've failed to meet the other needs people have, other than just prolonging life."

Gawande says medical professionals need to build a system that focuses on how to help dying patients achieve what's most important to them at the end of their lives.

"We want to be with others and family. We'd like to be mentally alert as much as possible. We'd like to avoid suffering, and we'd like to spend our last time doing stuff we care about and not just taking in treatments that make us suffer," he says. "As we face an incurable disease, what can we do to make it more likely that you've identified what's important to you — how you want those final months to go — and then help you achieve it?"

Atul Gawande is a staff member of Brigham and Women's Hospital and the Dana-Farber Cancer Institute. He is also a staff writer for The New Yorker. His books include Better, Complications and The Checklist Manifesto: How to Get Things Right.

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