As a reader of this blog you know I focus on helping clients resolve conflict and negotiate winning solutions. Today I want to focus on the very real issue of being mortal and end of life decisions. I can’t think of a more serious conflict between our medical communities, a dying patient and family members. This article takes several of the insights from Dr. Atul Gawande book, Being Mortal, that address an area often full of potential conflict with family members, the dying patient and the medical community. Dr. Atul Gawande offers great insights related to family conflict and death punctuating key elements with very insightful stories that help bring these issues home.
In general, with conflict resolution the key is understanding the interests of the parties. Never is this more important than with end of life decisions. I want to offer several quotes from the book and encourage you to read the text. A friend told me about this book and when I checked on line at the library I found I was number 16 on the waiting list. A few weeks later when I was notified the book was available, I picked it up and was told given the demand instead of the normal three week check out it was only available for two weeks. I picked up the book on Friday, read it on Sunday, and then wrote this blog on Monday. That is how strongly I feel about this book. I was so stuck by his powerful insights and individual stories that I wanted to share this with you. I encourage anyone involved with conflict to read this book, but especially those concerned with end of life decisions related to themselves or loved ones. You need to understand the various perspectives and work with others to address concerns.
“We all require devotion to something more than ourselves.” (pg 126)
“The only way death is not meaningless is to see yourself as part of something greater: a family, a community, a society. If you don’t mortality is only a horror.” (pg 127)
“We also become more concerned with our legacy.” (pg 127)
“Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul.” (pg 128)
“The terror of old age is …isolation.” (pg 146)
“They ask only to be permitted, insofar as possible, to keep shaping the story of their life in the world – to make choices and sustain connections to others according to their own priorities.” (pg 147)
Note that “In ordinary medicine, the goal is to extend life. Hospice deploys, nurses, doctors, chaplains, and social workers to help people with a fatal illness have the fullest possible lives right now… In terminal illness that means focusing on objectives like freedom from pain and discomfort, or maintaining mental awareness for as long as feasible, or getting out with family once in a while . The emphasis is not living longer or shorter.” (pg 161)
Great phrases from hospice nurses and others in this field demonstrate how caring empathetic commentary can really help. We can learn from some of their statements and open ended questions such as:
“I’m the hospice nurse, and here’s what I have to offer you to make your life better. And I know we don’t have a lot of time to waste.” (pg 161)
“I wish things were different.” (pg 182)
“If time becomes short, what is most important to you?” (pg 182)
“People who had substantive discussions with their doctor about their end-of-life preferences were far more likely to die at peace and in control of their situation and to spare family anguish.” (pg 177)
“At least two kinds of courage are required in aging and sickness. The first is the courage to confront the reality of mortality – the courage to seek out the truth of what is to be feared and what is to be hoped… the second…the courage to act on the truth we find…. One has to decide whether one’s fears or one’s hopes are what should matter most.” (pg 232)
“The most cruel failure in how we treat the sick and the aged is the failure to recognize that they have priorities beyond merely being safe and living longer; that the chance to share one’s story is essential to sustaining meaning in life.” (pg 243)
I hope these quotes encourage you to read the actual stories including the very personal story at the end of the book regarding the death of his father (also a doctor), the challenges of his mother, the actions taken by the medical community and eventually his father’s death and burial. This is a very moving and insightful commentary that could help many avoid or at least minimize the conflict associated with end of life decisions.
As with any conflict, understanding interests, asking open ended questions, and developing trust go a long way towards resolving conflict.
Michael Gregory, NSA, ASA, CVA, MBA is an international speaker, that helps organization resolve conflict and negotiate winning solutions. Mike is dedicated to making individuals, organizations, thought-leading entrepreneurs and executives more successful. Michael’s books, including The Servant Manager, How to Work with the IRS, Second Edition and his most recent book, now available in hard copy and as an eBook, Peaceful Resolutions. On point resources are available online at www.mikegreg.com and check out the blog. Contact Mike directly at mg@mikegreg.com or call (651) 633-5311.
Photo: Death by Gisela Fotografie at Pixabay