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Ira Byock—Service 

Ira Byock—Service
Chapter:
Ira Byock—Service
Author(s):

Philip J Larkin

DOI:
10.1093/med/9780198703310.003.0004
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date: 25 October 2020

As a physician, author, and advocate for better end-of-life care, Ira Byock presents an important ‘crossover’ perspective to clinical palliative and end-of-life care. His books Dying Well (1997) and The Four Things That Matter Most (2004) are equally valued by the public and health care professionals. His most recent book, The Best Care Possible (2012), debates the current crisis in US health care and the impact that will have on the care for those at end of life. For clinicians in palliative care, he is best known for the Missoula Demonstration Project, which sought to transform the end-of-life experience for one community and provide the evidence for how this learning could be applied nationally. This chapter is about authenticity and service, and how they work together to meet the needs of a young girl dying from cystic fibrosis. It argues that a focus on well-being, even in the face of failing health, should be endorsed and supported by palliative care practitioners. The importance of being able to keep one’s heart open to the suffering of another person is key to managing the pain of suffering for both the patient and practitioner. Additionally, an approach to the challenge of daily engagement with patients who have complex needs is offered, and the context of managing that in the current US health care environment is debated.

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