Care for the dying needs more imagination – and less hospitalisation

‘To die of age is a rare, singular and extra-ordinary death’, wrote Montaigne, ‘and so much less natural than others: it is the last and extremest form of dying.’ Not any more. Thanks to the marvels of modern medicine, we are limping and stumbling and mumbling and forgetting our way into the grave at greater ages than ever before. Since such longevity is still new, we’re not really prepared for it: we are dying beyond our means, outliving our usefulness, our pensions and even our individual body parts. Outliving, too, the patience of our families. In affluent countries like ours, the spectre of the care home holds more menace than death itself.

Atul Gawande is a surgeon, as well as a professor at Harvard Medical School. He writes on medicine and medical ethics for the New Yorker and has published several bestselling books about how to be a better doctor, all of them excellent and of great interest to the lay reader.