Being Mortal: Medicine and What Matters in the End

Summary

Atul Gawande, a surgeon and writer, argues that modern medicine is very good at extending life but often poor at helping people live well as they age and approach death. He examines how care homes can prioritise safety over autonomy, leaving residents safe but unhappy, and describes alternative models that give older people more control over their lives. He shows how doctors, trained to fix problems, often offer more treatment to people who are dying without asking what they actually want. Through stories including his own father's illness, he makes the case for honest conversations about goals, fears and trade-offs — asking people what they understand, what they are worried about, and what they would be willing to go through for more time. He presents palliative care as active, skilled care rather than giving up.

Key takeaways

• More treatment is not always better care.
• Ask patients what matters to them, what they fear, and what trade-offs they would accept.
• Safety and autonomy can conflict in care of older people.
• Palliative care is active care focused on quality of life.

How to use it

Link to shared decision-making and the ICE model, or to assisted-dying debates about the quality of palliative care.

Questions it helps with

• Tell me about your work experience. What did you learn from it?
• You haven't been able to shadow doctors in a hospital. How can you be sure medicine is right for you?
• Tell me about a patient or person you met during your experience who has stayed with you.
• What is the difference between empathy and sympathy? Give an example of when you showed empathy.
• Should assisted dying be legal in the UK?
• An elderly woman has been diagnosed with advanced cancer. Her son asks the doctor not to tell her, saying the news would 'destroy her'. What should the doctor do?