The Journey’s End: An Investigation into Death and Dying in Modern America

Connelly, former CEO of a health care company, argues in his informative debut that death should be better handled in the medical system. Suggesting that current practices prize excessive interventions that can prolong suffering for end-of-life patients, Connelly details how features like fee-for-service insurance pay structures, which compensate doctors for the amount of procedures they complete, reinforce an overly aggressive form of elderly medical care. Instead of keeping patients alive at all costs, Connelly recommends helping them better come to grips with death, which can confer “closure, freedom, and a sense of purpose.” Connelly suggests patients create advance healthcare directives, explore palliative care options, and proactively discuss their philosophy on end-of-life care with loved ones. More broadly, his suggested policy reforms include eliminating prescription drug advertisements, which give patients false hope for cures, and taxing healthcare benefits to decrease demand for high-cost treatments. Connelly constructs a convincing case for reimagining cultural conceptions of death, though the discussions of policy recommendations and “death literacy” (an understanding of “what life will be like near the end”) sometimes fail to cohere. Readers curious about end-of-life care practices will find this a helpful if imperfect primer. (Apr.)