Medicine
The main theme throughout the book is of end-of-life practices and identifying which is the best form of care for patients at the end stages of their life. Gawande explores different types of care such as, nursing homes and assisted-living homes, and using his own personal experiences with people who have used such facilities. He then goes on to discuss the use of assisted-suicide as a healthcare practice and whether it is acceptable or not.
Patient perspective
Gawande deploys the use of his own patients or people he has met throughout his lifetime to share their experiences of the end -of-life care they received. He describes his own grandfather’s experience of being subject to decision-making from the younger generation. Similarly, an elderly patient Lou, who suffers from Parkinson’s disease, places much burden on his daughter who eventually decides to put him in a nursing home, thus robbing Lou of many of his own choices and decisions.
Choosing death
One of the themes throughout the book is that of palliative care in place of medical intervention. Gawande argues that advocating palliative care makes patients last moments easier and states, “If end-of life discussions were an experimental drug, the FDA would approve it.” However, he does acknowledge these decisions are difficult for the family members but are crucial to have.
