Rowman & Littlefield Publishers
Pages: 274
•
Trim: 6½ x 9¼
978-1-4422-7280-4 • Hardback • January 2017 • $44.00 • (£35.00)
978-1-5381-2338-6 • Paperback • October 2018 • $29.00 • (£19.99)
978-1-4422-7281-1 • eBook • January 2017 • $27.50 • (£19.99)
Aroop Mangalik, MD is a retired oncologist and an ethicist. He has been an active clinician for many years and continues to teach ethics at the University of New Mexico School of Medicine and at the University of New Mexico School of Law. He has worked for many years to reduce unnecessary and unwanted treatments, especially for patients in advanced stages of their diseases. He has several publications in peer-reviewed medical journals pertaining to his work in the laboratory and in clinical trials.
Preface
Introduction
1: Dealing with the Inevitability of Death
2: Communication, Hope and Honesty
3: Religion, Healing and Death
4: Patient Autonomy and Medical Expertise: How to Find a Balance
5: Planning for Your Life, Illness and Death
6: Do No Harm
7: Statistics: They Help and They Fool
8: Why Doctors Over-Treat: Training and Mindset
9: Why Doctors Over-Treat: Pressure from Society and the Medical Establishment
10: Why Doctors Over-Treat: Flaws in the Way They Deal with Patients
11: When Doctors Say “No”
12: Why Patients Demand Unrealistic Treatments
13: How to Reduce Over-Treatment
14: How to Proceed toward Comfort
'Accepting death and making the time before death peaceful and comforting is one of the best gifts we can give to ourselves, our family, and our loved ones,' says oncologist and medical ethicist Mangalik as he takes on a big and often avoided topic in his debut book. His goal is to empower patients to avoid unnecessary medical treatments and to 'prepare you and your family for you to have a comfortable, peaceful death.' He educates readers on all aspects of the end of life, including accepting the inevitability of death, understanding why doctors over-treat—one reason is their 'refusal to accept failure'; another is 'competitiveness and ambition'—and resisting the urge to demand unrealistic treatments. There is a great deal of helpful information in these pages, on topics such as interpreting statistics and end-of-life directives. Among many good points the author makes is that patients may 'go for a treatment based on the best possible scenario' without understanding that 'improvement of heart function by x percent' might not actually make the patient feel better.... Readers will find much of value.— Publishers Weekly
Mangalik, who spent 50 years as an oncologist, radiates compassion in this common-sense guide to planning a 'good death.' People can take charge of how they want to die, ideally free of pain and surrounded by family and friends. 'Why do we not prepare for our own death?' Mangalik asks. Doctors tend to overdo treatment for many reasons, including financial incentives and fear of lawsuits, but patients don’t need to just say yes. He notes that patients can legally refuse feeding tubes and intravenous fluids. This thought-provoking book is meant for the healthy as well as those who are ill. 'The best time to ask yourself what you do, and don’t, want is when you are in good health,' Mangalik advises. He discloses that one big reason for his advocacy for honesty and openness is memories of how his own family stayed mum when his mother died in her thirties of an acute gallbladder infection. Mangalik provides invaluable information everyone can use to be prepared to face the inevitability of death and celebrate each life.— Booklist
Dealing with Doctors, Denial, and Death is a life-affirming, holistic look at approaches to pain, quality of life, treatment, and death. Mangalik examines these topics from multiple perspectives—the patient’s (and their family), the physician’s, differing world views, and the medical-industrial complex’s influence on the marketing and ‘incentivization’ of advanced medical technology and pharmacology. Central to this discussion is the patient-physician dyad, which is informed by sharing information and values, but which is often fraught by opposing understandings of what is considered reasonable treatment. Complicating these interactions are beliefs that reasonable means to treat at all costs, or that the judgment that deciding less treatment is equated with failure. Mangalik’s exploration of hidden influences ranges across world views of life and death, incentives fostering overtreatment, the downside of medical specialization, and most notably, personal denial. The reader is invited to consider what could be expressed as the long view, wherein death is part of life (exemplified by psychiatrist Elisabeth Kübler-Ross) and that death is the final act of living (a belief of Buddha). Mangalik’s humane and humble treatment of people, doctors, and death is strongly recommended....Summing Up: Highly recommended. All readers.— Choice Reviews
[Mangalik] breaks down complicated processes and language into a comprehensible guide to the types of questions one might ask to make the most appropriate decision for one’s own family. Dealing with Doctors, Denial, and Death would also be an excellent resource for medical students or providers who know they will be, or are, encountering situations where they have to guide patients through this challenging path of dying.
— H-Net: Humanities and Social Science Reviews Online
Dying in America has become, unfortunately, much more complicated and fraught with hazards than it needs to be. Dr. Mangalik has given us a much needed, and very practical, guide to navigating the process for ourselves and our loved ones. His insights and advice provide concrete strategies for ensuring that end-of-life care is compassionate, appropriate, and dignified.— Robert Truog M.D., Director, Center for Bioethics, Harvard Medical School
Dr. Aroop Mangalik’s book is a masterful, sensitive, and eminently readable discussion of one of life’s great, and always changing, problems: how to think about suffering, dangerous illness, and death. Like it or not, almost all of us will face that situation. His book brings considerable experience and insight to an ancient problem that is forever inescapable.— Daniel Callahan, cofounder and President Emeritus, The Hastings Center
Drawing on five decades of experience, oncologist Aroop Mangalik succinctly describes the steps patients and families can take to ease the end-of-life passage. With great clarity he shows readers why doctors are prone to over-treat and why the goal of comfort has become so elusive for so many. Dealing with Doctors, Denial and Death is a necessary, welcome guide through the maze of our problematic health care system. Readers will find useful information about CPR, hospice and palliative care, how to reduce non-beneficial treatments and most importantly, what to ask doctors when facing difficult medical choices.— Sharon R. Kaufman, author of Ordinary Medicine: Extraordinary Treatments, Longers Lives, and Where to Draw the Line