Conversations about death during hospitalization are among the most difficult imaginable: the moral weight of a human life is suspended by stressful conversations in which medical knowledge and personal context must be negotiated. In Through the Valley of Shadows: Living Wills, Intensive Care, and Making Medicine Human
(Oxford University Press, 2016), Samuel Morris Brown
approaches the problem of end-of-life care with a clinician's eye and a scholar of religion's touch.
The book places advance directives in the clinic in their historical context while unpacking their ethical and legal nature, describes the psychological aspects of medical decision-making and how moral distress clouds judgment, and provides recommendations on how to heal the process of healing in the Intensive Care Unit (ICU). An ICU physician himself, Brown's account is interwoven with powerful stories that render his argument for humanistic care particularly salient. As such, Through the Valley of Shadows
offers as much to dyed-in-the-wool humanists as it does to those focused on measuring and improving outcomes.
This is the second of a pair of interviews on communication in health care, preceded by Listening for What Matters: Avoiding Contextual Errors in Health Care
, by Saul Weiner and Alan Schwartz.