An exploration of end-of-life care – something that’s of interest to us all, of course, but very seldom addressed properly. And that’s Gawande’s essential point: people leave decisions about their last days until their last days, and so have a far worse time of it than perhaps they need to.

There’s much more to this book that this, though. Gawande explores the different approaches to assisted living and hospice care, the ways in which focusing on social rather than medical aspects can lead to far better outcomes, and shares his own family’s experiences with the difficulties that gradual illness can bring. (This is perhaps the greatest contribution of the book, and shows an enormous openness of spirit to share something so personal.) He demolishes the utopian visions of multi-generational living that sometimes cloud the debate, showing that this brings its own tensions: different to those of our more individualistic society, but certainly no less divisive. If nothing else, he shows that there is an alternative to medicalising old age, and that this is something we should all work towards in our own self-interest.

4/5. Finished Sunday 27 September, 2015.

(Originally published on Goodreads.)