Nicole Piemonte and Shawn Abreu

Although dying is a normal, unavoidable, and profoundly human process, Western medicine frequently sees death as a sign of a medical failure. Physicians and hospitals frequently put patients and their families on an apparently irreversible trajectory toward medical therapies that may actually exacerbate pain at the end of life in their zeal to prevent death. The MIT Press Essential Knowledge volume investigates the medicalization of death and dying and suggests an alternative strategy that takes into account the existential and emotional realities of death.
The authors provide a description of Western-style death and dying that is based on both study and personal experience. One author is an academic who teaches and researches end-of-life care, while the other is a doctor with training in hospice and palliative care. They consider our reluctance to have end-of-life conversations, look into the medical profession’s attitude toward death as a biological dysfunction that needs to be fixed, describe the hospice movement and movements for palliative care and aid in dying, and explains why they failed to influence mainstream medicine. They assert that to assist patients in dying in accordance with their values, caregivers should place less emphasis on finding ways to postpone death and more on accompanying the dying throughout their journey.