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WORK TITLE: The Way We Die Now
WORK NOTES:
PSEUDONYM(S):
BIRTHDATE:
WEBSITE:
CITY:
STATE:
COUNTRY:
NATIONALITY: Irish
http://apc.ucc.ie/seamus_omahony2/ * https://us.macmillan.com/author/seamusomahony/ * https://www.irishtimes.com/culture/books/the-way-we-die-now-by-seamus-o-mahony-review-a-doctor-s-perspective-1.2689145
RESEARCHER NOTES:
LC control no.: no2017016696
LCCN Permalink: https://lccn.loc.gov/no2017016696
HEADING: O’Mahony, Seamus
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100 1_ |a O’Mahony, Seamus
372 __ |a Gastroenterology |a Editing |2 lcsh
374 __ |a Gastroenterologists |a Editors |2 lcsh
375 __ |a male
377 __ |a eng
670 __ |a O’Mahony, Seamus. The way we die now, 2017: |b title page (Seamus O’Mahony) page i (Consultant Gastroenterologist at Cork University Hospital; associate editor for medical humanities of the Journal of the Royal Physicians of Edinburgh; regular contributor to the Dublin review of books)
PERSONAL EDUCATION:
University College Cork, Ireland, graduated (with honors), 1983, M.D., 1991.
ADDRESS
CAREER
Writer, editor, gastroenterologist, consultant physician, and patient advocate. Cork University Hospital, Cork, Ireland, consultant gastroenterologist, 1996—.
MEMBER:Philosophical Society (auditor, 1980-81).
AWARDS:Blayney Prize in Medicine, 1983; RGG Barry Prize in Pediatrics; Honan Scholar; fellow of the Royal Colleges of Physicians of London and Edinburgh.
WRITINGS
Contributor to medical journals and periodicals, including the Dublin Review of Books.
Journal of the Royal College of Physicians of Edinburgh, editor for medical humanities.
SIDELIGHTS
Writer and physician Seamus O’Mahony is a consultant gastroenterologist at Cork University Hospital in Cork, Ireland. He graduated with honors from University College Cork and obtained his M.D. in 1991. He received his medical training at institutions in Cork; Edinburgh, Scotland; and Leeds, England. O’Mahony writes frequently on medical subjects such as endoscopy, celiac disease, and inflammatory bowel disease, and conducts research in the area of medical humanities. O’Mahony is a fellow of the Royal Colleges of Physicians in London and Edinburgh.
In his role as a physician, O’Mahony is an advocate for patients’ right to choose the way they die and for the availability of options that let them die with dignity. He urges the development of a respectful relationship between the patient, the patient’s family, and the physician in charge of the case. In his book The Way We Die Now, O’Mahony “addresses many aspects of this murky relationship and provides us with a rare glimpse into this world from the vantage point of a medical doctor,” commented Irish Times contributor Paul D’Alton.
O’Mahony “makes the brave call for the demedicalization of death and dying, and argues for a halt to the madness that characterizes modern medicine’s culture of excess,” D’Alton stated. For example, he notes that modern medical practices generally involve keeping terminally ill patients uninformed about their impending deaths. Though some may believe this is a humane and compassionate approach, O’Mahony argues that patients facing the end of life should be fully aware of what is coming. The role of the doctor in this case is to be a source of support and comfort until the inevitable end.
The author also sees problems with letting patients die in general wards or even in intensive care units instead of in more peaceful surroundings, such as at home or in hospice care. The chaos of a hospital setting is unnecessary, he believes, when it is possible for patients to come to their end in an environment that is calming enough to ease their final passing.
O’Mahony also addresses issues such as overmedication and overintervention at the end of a patient’s life, such as using too many procedures to extend life in a way that is often artificial. He endorses better use of living wills and similar orders addressing the end of life. He cautions that the use of assisted suicide may not be the best choice if it is a manifestation of excessive control rather than a means to allow patients to end their lives with dignity and on their own terms.
“O’Mahony’s thorough exploration of an increasingly urgent topic should create solid demand” for his book, commented Booklist reviewer Dane Carr. A Publishers Weekly writer concluded, “O’Mahony’s clear-eyed analysis is important, poignant, and immensely humane.
BIOCRIT
PERIODICALS
Booklist, June, 2017. Dane Carr, review of The Way We Die Now: The View from Medicine’s Front Line, p. 32.
Irish Times, June 18, 2016, Paul D’Alton, review of The Way We Die Now.
Publishers Weekly, May 8, 2017, review of The Way We Die Now, p. 50.
ONLINE
APC Microbiome Ireland Website, http://apc.ucc.ie/ (February 19, 2018), biography of Seamus O’Mahony.
Macmillan Website, http://us.macmillan.com/ (February 19, 2018), biography of Seamus O’Mahony.
Seamus O’Mahony – APC Faculty
Dr Seamus O’Mahony is a Consultant Gastroenterologist at Cork University Hospital and graduate of UCC. He entered UCC as Honan Scholar, and was Auditor of the Philosophical Society in 1980-81. He graduated with honours in 1983, winning the Blayney Prize in Medicine, and the RGG Barry Prize in Paediatrics. He subsequently trained in Cork, Edinburgh and Leeds. He has been a consultant physician since 1996, and is a Fellow of the Royal Colleges of Physicians of London and Edinburgh. His has published extensively in the fields of endoscopy, coeliac disease and inflammatory bowel disease, and was awarded the MD in 1991. His current main academic interest is medical humanities, and has written extensively in this field. He is associate editor for medical humanities of the Journal of the Royal College of Physicians of Edinburgh, and is a regular contributor to the Dublin Review of Books
Email: seamus.omahony@hse.ie
DR. SEAMUS O’MAHONY is a Consultant Gastroenterologist at Cork University Hospital. He is associate editor for medical humanities of the Journal of the Royal College of Physicians of Edinburgh and is a regular contributor to the Dublin Review of Books.The Way We Die Now: The View from Medicine's Front Line is his first book.
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Print Marked Items
The Way We Die Now: The View from
Medicine's Front Line
Dane Carr
Booklist.
113.19-20 (June 2017): p32.
COPYRIGHT 2017 American Library Association
http://www.ala.org/ala/aboutala/offices/publishing/booklist_publications/booklist/booklist.cfm
Full Text:
The Way We Die Now: The View from Medicine's Front Line. By Seamus O'Mahony. July 2017. 304p. St.
Martin's/Thomas Dunne, $26.99 (9781250112798); e-book (9781250112804). 616.02.
Gastroenterologist O'Mahony focuses on "the Lie": the tendency in wealthy Western countries to keep the
terminally ill ignorant of imminent death and how this approach often undermines a more peaceful close to
life. It also encourages over-reliance on medicine, with much pointless treatment and many graceless
deaths, such as putting extremely old and sick people in ICU units. Many Westerners view hospitals as
"dust bins" meant to process all unpleasant medical situations. This, along with health care and legal
systems that foment overtreatment, creates impossible situations, with doctors accused of overintervention,
then being sued for giving false hope. Should nursing homes send declining patients to the hospital or let
them stay in a familiar setting at the risk of the home being accused of neglect? O'Mahony shows how
living wills and other directives meant to clarify end-of-life decisions can be misconstrued and how assisted
suicide can be more about excessive control than dignity. Though he seems, at times, to view any fight
against terminal disease as delusional, O'Mahony's thorough exploration of an increasingly urgent topic
should create solid demand.--Dane Carr
Source Citation (MLA 8th
Edition)
Carr, Dane. "The Way We Die Now: The View from Medicine's Front Line." Booklist, June 2017, p. 32.
General OneFile, http://link.galegroup.com/apps/doc/A498582620/ITOF?
u=schlager&sid=ITOF&xid=067f3cdd. Accessed 28 Jan. 2018.
Gale Document Number: GALE|A498582620
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The Way We Die Now: The View from
Medicine's Front Line
Publishers Weekly.
264.19 (May 8, 2017): p50.
COPYRIGHT 2017 PWxyz, LLC
http://www.publishersweekly.com/
Full Text:
* The Way We Die Now: The View from Medicine's Front Line
Seamus O'Mahony. St. Martin's/Dunne, $26.99 (304p) ISBN 978-1-250-11279-8
Irish gastroenterologist O'Mahony adopts an extraordinary view of end-of-life care in the 21st century,
exploring the difficult conversation that many doctors have come to avoid in a world of consumer-friendly
medicine. O'Mahony persuasively argues for telling dying patients "things they do not want to hear,"
thereby becoming the "amicus mortis" who "tells you the bitter truth and stays with you to the inexorable
end." He writes from his own experiences with people dying in hospitals, as well as those of friends and
family. O'Mahony also reflects on the accounts of writers and philosophers, including Phillipe Aries, Ernest
Becker, Christopher Hitchens, Ivan Illich, and Susan Sontag. He tracks the medical movement toward living
wills and assisted suicide as "informed by a passion for personal autonomy: for control," eloquently
reasoning that "human agency has replaced the powers of nature, 'majestic, cruel, and inexorable.'" Death is
messy and always will be, he notes, and "eventually, inevitably, nature, or the syringe-driver, takes control."
The "wer-medicalization" of modern dying is at the core of O'Mahony's criticism; he maintains that doctors
might better help their dying patients by giving up "the quest to conquer nature" and returning "to a core
function of providing comfort and succor." O'Mahony's clear-eyed analysis is important, poignant, and
immensely humane. (July)
Source Citation (MLA 8th
Edition)
"The Way We Die Now: The View from Medicine's Front Line." Publishers Weekly, 8 May 2017, p. 50.
General OneFile, http://link.galegroup.com/apps/doc/A491949113/ITOF?
u=schlager&sid=ITOF&xid=b8b45af4. Accessed 28 Jan. 2018.
Gale Document Number: GALE|A491949113
The Way We Die Now by Seamus O’Mahony review: a doctor’s perspective
Some complex issues are treated reductively and subjectively in an otherwise brave plea by a hospital consultant for the demedicalisation of death
Whose choice? The late assisted-suicide campaigner Marie Fleming, who suffered from multiple sclerosis, with her partner, Tom Curran, in 2013. Photograph: Garry O’Neill
Whose choice? The late assisted-suicide campaigner Marie Fleming, who suffered from multiple sclerosis, with her partner, Tom Curran, in 2013. Photograph: Garry O’Neill
Paul D'Alton
Sat, Jun 18, 2016, 02:18
First published:
Sat, Jun 18, 2016, 02:18
BUY NOW
Book Title:
The Way We Die Now
ISBN-13:
9781784974268
Author:
Seamus O'Mahony
Publisher:
Head of Zeus
Guideline Price:
€20.26
Woody Allen famously quipped: “I’m not afraid of death, I just don’t want to be there when it happens.” This probably captures how a lot of people feel about the subject, and perhaps, in particular, how they feel about medical doctors.
Death is often viewed as being a failure within the medical world. Modern medicine has sometimes been accused of helping us airbrush death from our lives by supporting the illusion that we are immortal. There is a murky, ambivalent psychological relationship between us humans and medicine when it comes to death. This is a relationship that has the propensity to change in a heartbeat. On the one hand, medicine colludes with the human tendency to avoid that which we most fear (death), and, on the other hand, medical teams can quickly become the focus of blame when death eventually occurs.
A strange saviour-failure dynamic can exist between the patient, their families and the medical team because death is seen as a failure and it often requires someone to blame.
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Seamus O’Mahony’s book The Way We Die Now addresses many aspects of this murky relationship and provides us with a rare glimpse into this world from the vantage point of a medical doctor. This glimpse seeks to contextualise the greatest threat and fear of humankind: death. A couple of centuries ago, life expectancy averaged about 40 years; this figure has now almost doubled for most people. We are now much more likely to die from non-communicable diseases – such as cancer, for example – than were our ancestors, who generally died in childbirth or as a result of accidents or diseases. Thereby, the landscape of death and dying has changed dramatically, and it is rare we hear such personal and anecdotal comment on death and dying from a medical doctor.
O’Mahony, a consultant gastroenterologist at Cork University Hospital, makes the brave call for the demedicalisation of death and dying, and argues for a halt to the madness that characterises modern medicine’s culture of excess.
He accurately identifies the fact that the vast majority of us will die in an acute hospital or nursing home rather than a hospice setting. O’Mahony’s text is highly critical of acute hospitals, and illustrates, by way of personal experience, the environmental challenges of death in a busy acute hospital, as opposed to a hospice. He states that “the environment of the hospice is notable for the absence of chaos, squalor, frayed tempers and shabbiness”, and he also notes that “the squalor and chaos of the general ward is not in evidence”.
He is critical, at times, of those who staff acute hospitals, saying: “Christmas is excruciating in this regard: for two weeks, many hospital staff behave like five-year-olds who have had too many fizzy drinks.” He concludes that “The idea of ‘death with dignity’ in this sort of milieu is almost laughable”.
Moreover, he appears to be very sceptical of the Hospice-Friendly Hospitals Programme, the work carried out by the Irish Hospice Foundation to assist in improving the patient experience in the hospital environment. O’Mahony refers to the foundation’s “glossy policy document” and “celebrity endorsements” by drawing a rather unusual analogy between these policy documents and an inarticulate priest he knew as a boy. I suspect O’Mahony’s perspective on the Irish Hospice Foundation is at odds with that of many Irish people, who seem to hold the work it does in very high regard.
He draws an interesting parallel between our medicalisation of current social problems in acute hospitals (which he feels has transformed them into “dustbins” for all sorts of nonmedical problems) and how, historically, we did the same with our psychiatric hospitals. While this is a point worth consideration, it nonetheless overlooks the well-established link between investment in the provision of high-quality social and primary care so as to prevent acute hospitals being put under extra pressure.
Our historical use of psychiatric hospitals and our current configuration of acute hospitals share something critical in common – ideology. Both systems of “care” are ideologically driven, and many commentators would argue that as long as we have a two-tiered healthcare system, where medical treatment is determined by capacity to pay, our healthcare system will remain in crisis.
O’Mahony discusses the importance of ritual in dealing with death and writes movingly about the “bleakest funeral” of a friend in Amsterdam. The friend “had emigrated from his native west Cork more than 25 years before, and left behind all those things about Ireland he regarded and backward, such as religion. His funeral, therefore, was a singularly secular event.”
He refers to ritual as the preserve of organised religion and questions the need to reinvent the wheel. The complexity, the historical sensitivities and what many would see as a naturally evolving capacity of humanity to develop new death rituals is sadly missing from O’Mahony’s account. He goes on to say: “Ritual helps the dying too: In Ireland, the sacrament of anointing the sick carries a powerful significance even for those with little or no religious belief.”
This understanding of Ireland and what carries significance completely fails to capture contemporary Ireland, which is made up of tremendous ethnic, racial, sexual and religious diversity. It also fails to recognise how deeply distressing and sometimes re-traumatising religious practices and religious iconography can be for those who were brought up and abused in religious-run institutions.
There are two fundamentally important issues raised in this book, two issues of crucial importance to contemporary Irish society: assisted suicide, and advance healthcare directives. Perhaps the most disappointing aspect of O’Mahony’s study is how the author reduces these extremely complex issues to symptoms of our contemporary obsession with control and distraction. The complexity inherent in human beings deciding what kind of medical intervention they require in the event of becoming incapacitated is huge, as it is if they take the decision to end their lives. O’Mahony’s concluding comments on Marie Fleming’s battle to determine how she would die are concerning. He states: “Those who have suffered are regarded as having a special moral authority. We can acknowledge, and sympathise with, Marie Fleming’s suffering, but we cannot, as a society, alter our laws to indulge the fanciful notions, held by a single individual, of a special death.”
The often subjective and anecdotal position adopted in this book on two of the most important issues of our time is very regrettable.
O’Mahony presents a picture of palliative and hospice care professionals as being territorial and creating some kind of exclusivity and superiority when dealing with death and dying. He says of this that “care of the dying needs to return to the core of what doctors do, and should not become the exclusive preserve of palliative care specialists, no matter how caring, intuitive and charismatic they my be”.
The idea of exclusivity seems very much at odds with the work done by leading palliative and hospice care professionals. The recently developed palliative care competency framework for all healthcare professionals, for example, is driven by the clearly articulated palliative and hospice leadership position that death and dying is everybody’s business.
Undoubtedly, The Way We Die Now gives us a rare glimpse into the world of death and dying from the vantage point of a medical doctor. The author asks some pertinent questions, including “Is there a better option?” as to how we currently die in Ireland. However, the over-reliance on, and extrapolation from, his personal experience dilutes the potency, and sometimes the credibility, of the challenges he raises for contemporary Irish society.
Paul D’Alton is head of the department of psycho-oncology at St Vincent’s University Hospital, Dublin, and is a former president of the Psychological Society of Ireland