I think anyone who wants to understand making the realities of making medical decisions needs to understand the cases in this book. No simple answers here, and that's the point.
I'm deeply into the fields of shared decision making and patient autonomy, from the patient's perspective and as co-chair of the Society for Participatory Medicine. This isn't a lightweight book - the issues and cases presented are serious and thought provoking, at times heart-breaking - but it's highly readable and, as with Groopman's other books I've read (Anatomy of Hope, How Doctors Think), eminently understandable.
I like that he's joined here by his wife, also an MD, and that they start by sharing their own different preferences in decision making, arising out of their different upbringings.
They present principles and challenges, and then illustrate them with cases. Each is presented as it unfolded in reality, with no certainty about how things would go - because that's how it is in real time, for both the physician and the patient. (Any physician who asserts certainty is either blowing smoke, or lying, or misguided in his/her own sureness, because *nothing* is absolutely certain.)
At times I picked up what seemed to be signals that not every doctor who urges you to do something may be acting with *your* interests as the #1 priority. That can add to the reality of the uncertainty you face. But even in the best of circumstances, as you face decisions and plan for your own end of life, you just don't know, and it's best for all to understand this as part of the fabric of life.
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