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Books > Medical Books > Medicine > Medical Ethics > 0199392951
  1. Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human
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  2. Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human

    Delivery: 10-20 Working Days
    Customer Ratings (3 reviews)
    Price R681.00

Additional Information

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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Samuel Morris Brown
Oxford University Press
Oxford University Press
Oxford University Press
Oxford University Press
Most Helpful Customer Reviews

This book came to my attention when I had a personal conversation with the author, Sam Brown. I found the book both troubling and comforting. Troubling because Brown spares no words to describe the many ways that our current healthcare and legal systems impose burdens on people, leaving doctors and family members hands tied and with limited options as Advanced Medical Directives and Living Wills become effective at the end of life. These directives impose limits and burdens on those approaching death in modern medicine. Especially troublesome are simplified forms completed at time of hospital admission using “codes” as indicators for when to continue or stop medical care and life support. Also troubling is his description of the difficulty and sometimes brutality of life in the ICU and after. He considers how communication between the patient, loved ones and doctor are altered by advanced directives, leaving real communication out and forcing healthcare providers to follow... Read more
Most of us will encounter the ICU at some point, either ourselves or with someone close to us. This insightful and moving account by a leading intensive care physician shows how that experience could be improved for patients and those who love them. Dr. Brown's book combines the medical expertise of a Harvard trained physician with a deeply human desire to heal and help. A must read.
A detailed, comprehensive analysis of medical directives that is simultaneously deeply troubling and hopefully reassuring. Well done! A must read for everyone who is facing aging or illness -- that's all of us, folks! -- and their family members. Read and discuss. I'll be doing so with my family.
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