Choosing Medical Care in Old Age: What Kind, How Much, When to Stop

* Preface
* Prologue
* Robbed of Mind and Memory: The Demented Elderly
* Blessed with Vim and Vigor: The Robust Elderly
* Facing the Final Days: The Dying Elderly
* Living with Limited Reserves: The Frail Elderly
* The Means to the Ends: Institutional Changes
* Epilogue
* Notes
* Index

Muriel R. Gillick, M.D. is Clinical Professor of Ambulatory Care and Prevention at Harvard Medical School. She is a staff physician for Harvard Vanguard Medical Associates, and she is also on the medical staff of Brigham and Women's Hospital and Faulkner Hospital.

Gillick's personal and compassionate approach to medical decision making in old age is bound to spark controversy about patients' autonomy, proxy rights, rationing, and standards of care. Her ideas about institutional change strike at the structure and process of today's health care delivery system. I hope this book will be widely read, not only by clinicians, but also by ethicists, policymakers, and the general public and that it will stimulate the conversations that will ultimately lead to the social consensus Gillick feels is missing today when we choose medical care in old age. -- Katherine A. Hesse, M.D., M.S.W New England Journal of Medicine A unique and fertile source of impressions from a seasoned clinician, grappling with the tensions between patients and policy. -- Sheldon M. Retchin, M.D Journal of the American Medical Association Dr. Gillick is an advocate for her patients and other older persons...Additionally she is a realist; her ready recognition of the inherent ambiguities and uncertainties of prediction and prognosis that characterizes geriatrics--indeed, that infiltrate all facets of medical practice--only adds to her credibility. She does not hesitate in these pages to ask the hard questions. Her approach to difficult ethical circumstances is a model of compassionate reason for other physicians. -- Marshall B. Kapp, J.D., M.P.H Journal of Ethics, Law, and Aging