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January 18, 1995

Choosing Medical Care in Old Age: What Kind, How Much, When to Stop

Author Affiliations

Virginia Commonwealth University Richmond

JAMA. 1995;273(3):261. doi:10.1001/jama.1995.03520270097054

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The science of geriatric medicine has largely been cultivated as a means of dispelling myths. Whether repudiating the effectiveness of multiple medications or avoiding the conventional approach for aggressive therapeutic interventions, geriatricians preach the merits of "less is more."

Choosing Medical Care in Old Age, by Muriel Gillick, debates conventional medical care for the oldest old and offers profound advice on the intersect of frailty and medical decision making. Dr Gillick's premise is that prevailing medical care often runs counter to geriatric intentions for preserving dignity and function. This premise is elaborated by a series of case histories, almost like folk tales, all representing Gillick's patients and their families. The result is a series of novelettes, richly described anecdotes about her elderly patients in the throes of difficult decisions over medical care or social support. Though the book is predominantly aimed at a nonprofessional audience, health care scholars will also

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