£16.53
  • RRP: £16.61
  • You Save: £0.08
FREE Delivery in the UK.
Only 2 left in stock (more on the way).
Dispatched from and sold by Amazon.
Gift-wrap available.
Quantity:1
Have one to sell?
Flip to back Flip to front
Listen Playing... Paused   You're listening to a sample of the Audible audio edition.
Learn more
See this image

The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life Hardcover – 15 Mar 2012


See all 2 formats and editions Hide other formats and editions
Amazon Price New from Used from
Hardcover
"Please retry"
£16.53
£2.95 £2.58


Product details

  • Hardcover: 320 pages
  • Publisher: Avery Publishing Group (15 Mar 2012)
  • Language: English
  • ISBN-10: 1583334599
  • ISBN-13: 978-1583334591
  • Product Dimensions: 16.2 x 2.9 x 23.6 cm
  • Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
  • Amazon Bestsellers Rank: 1,430,710 in Books (See Top 100 in Books)

More About the Author

Discover books, learn about writers, and more.

Inside This Book (Learn More)
Browse Sample Pages
Front Cover | Copyright | Table of Contents | Excerpt | Index
Search inside this book:

What Other Items Do Customers Buy After Viewing This Item?

Customer Reviews

5.0 out of 5 stars
5 star
1
4 star
0
3 star
0
2 star
0
1 star
0
See the customer review
Share your thoughts with other customers

Most Helpful Customer Reviews

2 of 2 people found the following review helpful By Jill Meyer TOP 500 REVIEWER on 31 Mar 2012
Format: Hardcover
Dr Ira Byock's new book, "The Best Care Possible" is one doctor's look at the inevitability we all face - death. Like taxes, death is a by-product of life and a "good death", while seemingly an oxymoron, is something Dr Byock has been writing about for many years. An "end-of-life" specialist at New Hampshire's Dartmouth-Hitchcock Medical Center, Ira Byock works with a team to put together as good and gentle a death experience as possible for his patients.

Byock writes, that as we baby-boomers age, we're facing both the inevitable deaths of two generations - our parents, and then, in our turn, ourselves. As overall medical treatments advance, we're living longer and what used to kill us at earlier ages, doesn't do that so much anymore. And we're not dying as often in a family-setting. Most deaths occur in hospitals and nursing homes, with the dying tied up to machines that often keep them alive far past the point most people want to be kept alive. The old conundrum of "quality of life" vs "quantity of life".

Dr Byock's book is not a "how-to" guide to making a "good death". There are no steps he advises taking, but rather he speaks to the larger issue, from both a medical standpoint and a personal one. As a doctor in a smallish community, Byock often has to look at both views when treating his patients. He writes about teaching medical students at Dartmouth Medical School to be aware of the responsibilities as future doctors when medical treatments fail at arresting illness and the patient moves on toward death. And when advanced chemo might be granting a cancer patient a somewhat longer life span but at the cost of agonising side effects. When does a "good life" sequence into a "good death"?
Read more ›
Comment Was this review helpful to you? Yes No Sending feedback...
Thank you for your feedback. If this review is inappropriate, please let us know.
Sorry, we failed to record your vote. Please try again

Most Helpful Customer Reviews on Amazon.com (beta)

Amazon.com: 55 reviews
58 of 58 people found the following review helpful
discussion of a critical issue which cannot be avoided 20 Mar 2012
By duditos - Published on Amazon.com
Format: Hardcover Verified Purchase
This book is not intended for everyone. Just for those of us with an ailing loved one, or a loved one who who is dying. Or those of us who may at some time have an ailing loved one, or a loved one who may die. Or those of us who may at some time ourselves be ailing or dying. Dr Byock transforms the discussion of how we live our final days from a political hot potato to a rational, personal and heartfelt fact of life. As a physician, I am keenly aware of the miraculous medical tools that we as Americans are fortunate to have available to us. I am equally aware, however how the inappropriate use of these tools can contradict our ultimate responsibility as physicians to "above all do no harm". More importantly, as the son of one of the patients whose journey through critical illness and hospice care is chronicled in The Best Care Possible, I have witnessed and experienced how an informed and caring medical team can positively effect not only the patient, but those who love her as well. Let the publication of this book awaken us all to the need for a national discussion, in a sane and rational way, of the need of advanced directives, and an assessment of how we choose to spend our final days. Sanford E Glikin, MD
26 of 26 people found the following review helpful
A "good death?"... 31 Mar 2012
By Jill Meyer - Published on Amazon.com
Format: Hardcover Verified Purchase
Dr Ira Byock's new book, "The Best Care Possible" is one doctor's look at the inevitability we all face - death. Like taxes, death is a by-product of life and a "good death", while seemingly an oxymoron, is something Dr Byock has been writing about for many years. An "end-of-life" specialist at New Hampshire's Dartmouth-Hitchcock Medical Center, Ira Byock works with a team to put together as good and gentle a death experience as possible for his patients.

Byock writes, that as we baby-boomers age, we're facing both the inevitable deaths of two generations - our parents, and then, in our turn, ourselves. As overall medical treatments advance, we're living longer and what used to kill us at earlier ages, doesn't do that so much anymore. And we're not dying as often in a family-setting. Most deaths occur in hospitals and nursing homes, with the dying tied up to machines that often keep them alive far past the point most people want to be kept alive. The old conundrum of "quality of life" vs "quantity of life".

Dr Byock's book is not a "how-to" guide to making a "good death". There are no steps he advises taking, but rather he speaks to the larger issue, from both a medical standpoint and a personal one. As a doctor in a smallish community, Byock often has to look at both views when treating his patients. He writes about teaching medical students at Dartmouth Medical School to be aware of the responsibilities as future doctors when medical treatments fail at arresting illness and the patient moves on toward death. And when advanced chemo might be granting a cancer patient a somewhat longer life span but at the cost of agonising side effects. When does a "good life" sequence into a "good death"? How does the doctor, his or her support staff, and the patient's family and friends make that "good death" occur? He's a long-time believer in hospice.

I think Dr Byock has written a few books on the subject of dying. This is the first one I've read, but not the last one. He asks questions of the reader in subtle ways that make the reader look past the often first and easy answers, to the tougher ones. But those are the answers that need to be thought about in end-of-life issues.
25 of 25 people found the following review helpful
Just What the Doctor Ordered for US Health Care 24 Mar 2012
By Patrick Clary, MD - Published on Amazon.com
Format: Hardcover
I wish I could send a copy of this to my mother, an RN who loved Dr. Byock's work and died 6 years ago... This book has changed the way I think about hospice and palliative medicine, not a minor accomplishment as I have been practicing this subspecialty since 1988, before it officially even existed.

Dr. Byock's earlier book "Dying Well" was a revelation to me because it held up a mirror, convinced me of the terrific potential of the work I had just begun doing and let me share that with others; "The Best Care Possible" holds such a mirror up to the whole country, showing us as a nation where we are failing to provide the care needed by the seriously ill, and how we can transform that, not only to benefit the suffering but to change the system.

Patrick Clary, MD
Exeter, New Hampshire
10 of 10 people found the following review helpful
Making a case for love in healthcare 22 April 2012
By Tarris Rosell - Published on Amazon.com
Format: Hardcover
The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life

There is a first time for everything, inclusive of posting comments to Amazon. Despite many years of online buying and hundreds of purchases, I admit to not having left a comment--until now. It's about time. Dr. Byock is compelling.

I literally know of no colleague in the field of bioethics who would admit to not having read Ira Byock's first book, Dying Well. It already has become a classic in our field. Dr. Byock's third book may well become another of that sort. He writes that well.

Who among us doesn't long for "the best care possible" when in need of health care for ourselves and those we love? The medical students and residents I teach and providers for whom I consult all strive for excellence in that regard. Why then does it elude us as a society? Why do so many of our elders and children still slip through the cracks of a notoriously expensive healthcare system with some of the best facilities and resources in the world? It is something of an enigma. Ira Byock is one of few people I know who can take this on with integrity and intelligence, grounded in decades of hands on, in the trenches, clinical experience.

We all have read and heard enough nonsense during recent years of highly politicized "healthcare reform" debates. It is refreshing then to read something provocative that also makes good sense. Byock tells a good story, of course. "Masterful" is the adjective that comes to mind. But this book is more than gripping narrative. It is an insightful ethics analysis and a rational policy proposal. In the end, what it boils down to, is . . . love. Dr. Byock makes a non-religious moral case for teaching, practicing, and affirming love in healthcare.

"Love is, after all, the primal impetus and sustaining force of all the caring professions. There is nothing unethical or unseemly about loving our patients" (p. 284). The preacher in me (or is it the patient?) wants to shout, "Amen!"

"Love is not all we need--science, technology, good judgment, and sound policy are also required--but without love we are without hope of fixing this crisis" (p. 285). To which the ethicist in me also says, "Amen."

Tarris Rosell, PhD, DMin
Center for Practical Bioethics
Kansas City, MO
13 of 14 people found the following review helpful
Important book for everyone 16 Jun 2012
By Laurie A. Brown - Published on Amazon.com
Format: Hardcover
Dr. Byock is the head of the department of palliative care at Dartmouth-Hitchcock Medical Center and a professor at the associated medical school. This means he has dealt with a lot of patients who are reaching the end of their lives; his job is to make that end as comfortable and stress free as possible for both them and their families. It is his contention that Americans today suffer more and die worse deaths- and more expensive deaths- than ever before. How is this possible in an age when there are so many medical treatments available?

Part of it is that the patients don't make their wishes known via advance directives. If a person comes into a hospital without one, and they are unable to make their wishes known, the hospital has the right and obligation to do everything they can to prolong life. While this is absolutely the right thing to do most of the time, it isn't always what the person really wants. When a person is near death from cancer, say, and takes a fall that creates a brain bleed, the hospital will put them on life support and prolong their life, even if there is no chance of recovery. Would that person have wanted that, or would they prefer to let go at that point? Who wants to live another 2 weeks if they are intubated, on a ventilator and semi-conscious at best? But doctors have an obligation to preserve life, and the family feels guilty if they say `pull the plug'.

Add to this problem the fact that doctors get almost no training in palliative care and end of life issues. Many don't know the best ways to deal with pain and fear, or even how to broach the subject of impending death. Some even hesitate to prescribe opiates because they are addictive- as if that could possibly be an issue for a dying person. These things need to be addressed in medical school. Medicare adds to the problem by not paying for palliative care or hospice care if the patient is still being treated for their health problem; I know from experience that some of these treatments should NOT be considered as trying to cure the patient but rather offering a better quality to their remaining life.

This book achieved what I would have thought impossible: it's both very difficult to read, because the subject matter is emotional and painful for someone who has dealt with end of life issues, but easy to read because of Dr. Byock's talent with words. He includes medical details but at a level that is understandable to all; he includes details about death that don't gross a sensitive person out. I hope that this book gets very widely read by both doctors and lay people; having gone through five deaths in our families it would have been much easier on us as family and on the patients if we'd known a lot of what is in this book way ahead of time- and if the doctors had been more comfortable dealing with end of life.
Were these reviews helpful? Let us know


Feedback