The End-of-Life War

Atul Gawande, excellent as always, tackles the difficult issues around end-of-life care, arguing that modern medicine has failed people facing the end of their lives. “The simple view is that medicine exists to fight death and disease, and that is, of course, its most basic task,” writes Gawande. “Death is the enemy. But the enemy has superior forces. Eventually, it wins. And, in a war that you cannot win, you don’t want a general who fights to the point of total annihilation. You don’t want Custer. You want Robert E. Lee, someone who knew how to fight for territory when he could and how to surrender when he couldn’t, someone who understood that the damage is greatest if all you do is fight to the bitter end.” Expensive end-of-life care (and cancer treatment costs), of course, also contributes to runaway health-care costs.[%comments]