An examination of the contemporary medicalization of death and dying that calls us to acknowledge death's existential and emotional realities. Death is a natural, inevitable, and deeply human process, and yet Western medicine tends to view it as a medical failure. In their zeal to prevent death, physicians and hospitals often set patients and their families on a seemingly unstoppable trajectory toward medical interventions that may actually increase suffering at the end of life. This volume in the MIT Press Essential Knowledge series examines the medicalization of death and dying and proposes a different approach—one that acknowledges death's existential and emotional realities. The authors—one an academic who teaches and studies end-of-life care, and the other a physician trained in hospice and palliative care—offer an account of Western-style death and dying that is informed by both research and personal experience. They examine the medical profession's attitude toward death as a biological dysfunction that needs fixing; describe the hospice movement, as well as movements for palliative care and aid in dying, and why they failed to influence mainstream medicine; consider our reluctance to have end-of-life conversations; and investigate the commodification of medicine and the business of dying. To help patients die in accordance with their values, they say, those who care for the dying should focus less on delaying death by any means possible and more on being present with the dying on their journey.

An analysis of how findings in behavioral economics challenge fundamental assumptions of medical ethics, integrating the latest research in both fields. Bioethicists have long argued for rational persuasion to help patients with medical decisions. But the findings of behavioral economics—popularized in Thaler and Sunstein's Nudge and other books—show that arguments depending on rational thinking are unlikely to be successful and even that the idea of purely rational persuasion may be a fiction. In Good Ethics and Bad Choice s, Jennifer Blumenthal-Barby examines how behavioral economics challenges some of the most fundamental tenets of medical ethics. She not only integrates the latest research from both fields but also provides examples of how physicians apply concepts of behavioral economics in practice. Blumenthal-Barby analyzes ethical issues raised by “nudging” patient decision making and argues that the practice can improve patient decisions, prevent harm, and perhaps enhance autonomy. She then offers a more detailed ethical analysis of further questions that arise, including whether nudging amounts to manipulation, to what extent and at what point these techniques should be used, when and how their use would be wrong, and whether transparency about their use is required. She provides a snapshot of nudging “in the weeds,” reporting on practices she observed in clinical settings including psychiatry, pediatric critical care, and oncology. Warning that there is no “single, simple account of the ethics of nudging,” Blumenthal-Barby offers a qualified defense, arguing that a nudge can be justified in part by the extent to which it makes patients better off.