From Publishers Weekly
A physician, medical historian and bioethicist, Martensen pulls no punches: beyond the marvels of modern medical technology lies a treacherous morass of ethical, moral and spiritual dilemmas most of us are not ready to even consider: whether to opt for aggressive treatments, when to stop them, and how to die well. Too often the choice of aggressive treatment and heroic measures becomes an extended death by intensive care' in grim hospital units designed more like prisons than places of healing. Thoughtful and compassionate, Martensen narrates poignant case studies, such as that of Marguerite, who undergoes ineffective surgeries and drug trials for advanced breast cancer but has debilitating side effects. The author lays blame across the board, from patients with unrealistic expectations and doctors who don't explain treatment options fully, from profit-driven hospitals to an insurance bureaucracy that spurns routine health maintenance. Martensen makes his case with clear, compelling writing that never flinches from his conclusion that some things you just can't win the battle against; you can only hope for quality of life until the end. (Sept.)
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Once a straightforward process, dying has become a minefield, despite—nay, because of—medicine’s best efforts to sustain life in the face of overwhelming odds. Thus, physician and bioethicist Martensen worries, many people diagnosed with a terminal illness may not be receiving all the information they need to make informed decisions. Indeed, they may not fully comprehend the hopelessness of their situations, either because they are not hearing or, more likely, because physicians are hedging the responsibility to tell the unvarnished truth. Consequently, what ensues is too often a painful and futile battle including unnecessary tests, interventions, and drug or device trials that make what is left of the patient’s life not worth living. Just where the balance point lies between hegemony and patient autonomy becomes murky at best when each participant in a patient’s final care is marching toward his or her own goals. An ever-compassionate Martensen makes it apparent that the thorny questions need asking, but even more apparent is that there are no easy answers. --Donna Chavez