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Through the Valley of Shadows - Living Wills, Intensive Care, and Making Medicine Human (Hardcover)
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Through the Valley of Shadows - Living Wills, Intensive Care, and Making Medicine Human (Hardcover)
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Hospital intensive care units have changed when and how we die-and
not always for the better. The ICU is a new world, one in which
once-fatal diseases can be cured and medical treatments greatly
enhance our chances of full recovery. But, paradoxically, these
places of physical healing can exact a terrible toll, and by
focusing on technology rather than humanity, they too often rob the
dying of their dignity. By some accounts, the expensive medical
treatments provided in ICUs also threaten to bankrupt the nation.
In an attempt to give patients a voice in the ICU when they might
not otherwise have one, the living will was introduced in 1969, in
response to several notorious cases. These documents were meant to
keep physicians from ignoring patients' and families' wishes in
stressful situations. Unfortunately, despite their aspirations,
living wills contain static statements about hypothetical
preferences that rarely apply in practice. And they created a
process that isn't faithful to who we are as human beings. Further
confusing difficult and painful situations, living wills leave
patients with the impression that actual communication with their
physicians has taken place, when in fact their deepest desires and
values remain unaddressed. In this provocative and empathetic book,
medical researcher and ICU physician Samuel Morris Brown uses
stories from his clinical practice to outline a new way of thinking
about life-threatening illness. Brown's approach acknowledges the
conflicting emotions we have when talking about the possibility of
death and proposes strategies by which patients, their families,
and medical practitioners can better address human needs before,
during, and after serious illness. Arguing that any solution to the
problems of the inhumanity of intensive care must take advantage of
new research on the ways human beings process information and make
choices, Brown imagines a truly humane ICU. His manifesto for
reform advocates wholeness and healing for people facing
life-threatening illness.
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