In The Conversation: A Revolutionary Plan for End-of-Life Care, experienced physician Angelo Volandes focuses on the extensive, intensive, intrusive medical interventions that patients routinely receive at the end of life, many of which extend life by a matter of hours or days or not at all, while decreasing its quality substantially. He earnestly argues that every patient should be offered the option to choose among three broad categories of care: life-prolonging, limited medical and comfort care--in other words, the choice between quantity and quality of life. The Conversation advocates for all patients and families to receive information about what end-of-life care looks like within these three categories, and firmly states the importance of patients, families and medical professionals having what he calls the Conversation about end-of-life wishes openly and often.
The majority of the book is devoted to stories of patients, families and circumstances--and Volandes's own attempts, good and bad, at approaching the Conversation. With names changed, these are real-life anecdotes of choices made with more or less preparation and knowledge of what a decision will entail, or what an incapacitated patient would have wanted. The last quarter of the book is composed of several appendices and a narrative notes section that provide substantive advice for the patient or the patient's spouse or children. The Conversation is a how-to manual, enlivened by engaging--if occasionally painful--true stories. Volandes makes his points succinctly and convincingly and offers readers the tools to make change within their own lives. --Julia Jenkins, librarian and blogger at pagesofjulia