Trains Departing from Different Stations: Being Mortal and Dying in the 21st Century

While physician-writers and medical humanists both characterize contemporary deaths as train wrecks, they sometimes disagree about what causes such consistent wreckage. In Being Mortal (2014), the surgeon-writer Atul Gawande attributes the wreckage to forces that so reduce aging and dying persons’ autonomy that they prevent those persons from being themselves. For the leading medical humanists in Dying in the Twenty-First Century (2015), edited by Lydia Dugdale, it is our emphasis on autonomy over interdependence that causes contemporary death and dying to go off the rails. To understand the gap between these two accounts, their implicit conversation is compared to the explicit dialogue between a previous generation’s leading surgeon-writer and medical humanists: How We Die (1993) by Sherwin Nuland and Facing Death (1996), edited by Howard Spiro and colleagues.