Being Mortal is a memoir of the professional and personal reflections about the end-of-life care that people receive in the United States. Atul Gawande weaves his personal experiences as a surgeon and his interviews with people and their families as he discusses the various aspects of the US healthcare industry and its effects on the elderly and terminally ill patients in the 20th and early 21st century.

He argues that modern American medicine is overly focused on discrete and measurable outcomes like treating specific a illness. Providers and doctors work in a system that prioritizes treatments. This system works to improve outcomes broadly but the process of dying is an inevitability for all people. The outcome is certain and during this process treating disease won't prevent the final outcome. Patient choices to maximize time or to grasp an improbable cure can easily result in suffering and pain in their last days. This attitude conflicts with end of life care that people prefer when they honestly consider their last available options.

Instead of the healthcare industry treating dying as a medical problem to attack systematically it should be more attuned to the needs and wants of patients to make the best possible decisions. Better outcomes are not simply a matter of having informed options either. The people's stories Gawande recounts suggest that when people understand and accept they are dying only then can they make decisions that maximize their comfort and peace in the face of dying. And when that is achieved it makes death easier for everyone.

The book cites specific studies and recount medical histories of the development of nursing homes and philosophies of patient care but otherwise this book is a very careful, personal narrative. For his subjects the stakes are high because we understand deaths finality. Gawande's storytelling is very effective and the people he highlights generally have the best outcomes using hospice. I suppose a more thorough review of scientific studies might paint a more accurate picture. However Gawande argues that honest discussions between the dying, their providers, and their families are critical to making any choice regarding end of life care. So in spite of whatever details are missing from Being Mortal's scientific analysis the effect of the personal and social lessons of his stories resonates clearly.