The Way We Die Now

by Seamus O’Mahoney, Head of Zeus, £14.99

Medical advances since the war have given Western populations unprecedented levels of health, cures for disease and longer life-spans. This is a good thing. But inevitably such advances bring with them new ethical questions for doctors and patients alike, such as when is further treatment useless, when should intervention give way to palliative care, and so on. O’Mahoney, a consultant gastroenterologist at Cork University Hospital, brings his own thoughtful and intelligent voice to this debate.

The author, born in 1960 and from a Catholic background (he mentions priests and nuns in the family), does not discuss his own faith. But he does acknowledge that the swift collapse of traditional Catholicism in Ireland has left a spiritual chasm in people’s lives. From being a theocracy in all but name, modern Ireland has become a “pleasure island”. Death is less of a spiritual event and “fear of death has replaced fear of God”; yet “our needs are spiritual”.

O’Mahoney is critical of the way modern medicine has turned doctors into “service providers” rather than professionals, who are afraid of possible litigation, angry relatives and patients who don’t want to hear the truth about their condition. As a doctor treating the dying (many of his patients are alcoholics, dying from cirrhosis of the liver), he believes it is his duty to tell them the truth with kindness and compassion.

Against him are all the treatments patients know about from the internet. In America, he points out, there is an insatiable appetite for medicine, scans, drugs, tests and screenings; yet it doesn’t make good medical sense to “offer every conceivable option to every patient”.

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