Transforming care through the end of life

Byock’s first book, Dying Well, (1997) has become a standard in the field of hospice and palliative care. The Four Things That Matter Most, (2004) is used as a counseling tool widely by palliative care and hospice programs, as well as within pastoral care. His most recent book, The Best Care Possible tackles the crisis that surrounds serious illness and dying in America and his quest to transform care through the end of life. It has been praised by the Wall Street Journal, the Economist and other major publications, and won the Annual Books for a Better Life Award in the category of Wellness.

The Four Things That Matter Most:

10th Anniversary Edition: A Book About Living

Four simple phrases: “Please forgive me,” “I forgive you,” “Thank you,” and “I love you” — carry enormous power to mend and nurture our relationships and inner lives. These four phrases and the sentiments they convey can help us resolve interpersonal difficulties with integrity and grace. In The Four Things That Matter Most, Dr. Ira Byock, an international leader in palliative care, explains how we can practice these life-affirming words in our day-to-day lives and improve our emotional well-being. He demonstrates the value of “stating the obvious” in letting the people we love know that we love them and provides practical insights into the benefits of letting go of old grudges and toxic emotions.
  • Cat Saunders
    The Four Things That Matter Most is a tribute to compassion.  Master storyteller and physician Ira Byock shows how four simple statements can improve your life, heal your relationships, and transform your understanding of death.  Every home deserves of copy of this gem!
    Cat Saunders, PhD
    Author of  “Dr. Cat’s Helping Handbook
  • Caroline Mysse
    The Four Things that Matter Most is a book of common sense wisdom that has the power to dynamically change your life. It is a pleasure to recommend a book that encourages you to transform the quality of your life in simple ways that actually work.
    Caroline Myss
    Author of “Sacred Contracts” and “Anatomy of the Spirit”
  • Larry Dorsey
    For anyone who believes that years of therapy are required for transforming relationships with others, this book will come as a pleasant surprise. Great wisdom has always been simple – that is why it is elusive – and great wisdom is what this book contains.
    Larry Dossey, MD
    Author of “Healing beyond the Body”, “reinventing medicine,” and “Healing Words”
  • Maggie Callanan
    A tender read I highly recommend — The Four Things That Matter Most offers simple but solid solutions for healing our complex and fragile relationships — wisdom that will surely enrich our lives.
    Maggie Callanan
    Co-author of “Final Gifts”
  • Zorba Paster
    The 4 Things That Matter Most provides simple, insightful words and stories that move the heart and the soul.  Dr. Byock shows us a graceful way to nurture relationships and heal those that need mending.
    Zorba Paster, MD
    Author of "The Longevity Cod"
  • Dr. Stephen R. Covey
    This beautiful book, full of wisdom and warmth, teaches us how to protect and preserve our most valuable possessions–the relationships with those we love. It shows that the things that matter definitely aren’t “things,” and how to empower your life in the right direction.
    Dr. Stephen R. Covey
    Author of "The 7 Habits of Highly Effective People"
  • Rochi Joan Halifax
    Ira Byock’s compassionate and important work in the field of dying has given him the four great treasures of love and freedom that all of us can use throughout our life. This wonderful book opens the doors to these jewels of compassion.”
    Joan Halifax, PhD
    Abbot, Upaya Zen Center, Sante Fe, author of “Being with Dying”

Dying Well:

The Prospect for Growth at the End of Life

In 1997, too many Americans were dying in hospitals, often in pain, often alone. Progress has been made in alleviating pain and expanding hospice and palliative care for people nearing the end of their lives. Yet, even today, too many people are dying badly! The stories in Dying Well enable readers to imagine that wellbeing is possible through these most difficult times of life. This book remains as vital and valuable to individuals and their families today as it did when it was first published.
  • Katy Butler
    I was death-naive before I read Dr. Ira Byock’s book, Dying Well when my father was in his early 80s and in his final, painful decline. It introduced me to the possibility that with appropriate support, dying did not have to be a chaotic, fear-ridden and painful experience. In fact, families could be well-supported and death could even be meaningful. I found it immensely reassuring, informative and helpful when I was beginning my research for Knocking on Heaven’s Door. Dying Well, since its first publication, has, opened a door in our culture and allowed people to stop pretending death doesn’t exist and instead explore the meaning and practices of good dying. We have so much further to go until we give all Americans a chance for a humane and sacred passage from life to death. Dr. Byock’s work has opened up many people, family by family, to options they didn’t know were possible.
    Katy Butler
    Knocking on Heaven’s Door and A Good End of Life
  • Karen Wyatt
    Through masterfully crafted stories Dr. Ira Byock’s book Dying Well broke new ground upon its initial release in 1997 by portraying the transformational message that death can be peaceful and beautiful when well managed. His words were an inspiration to me then, a hospice physician seeking a mentor for my new role tending to both life and death for my patients. Dr. Byock’s vision of living and dying well is needed now more than ever as we still struggle to provide better care to the dying and to create a new societal attitude toward death. Dying Well is not only a guidebook for navigating the end of life, but also a case study for medical providers in caring for the entire lifecycle of our patients. Read Dying Well for the first time or read it again to recall the uplifting message that growth is always possible, even in the most hopeless of situations—a message that speaks as deeply to each of us now as in the past.
    Karen Wyatt
    What Really Matters: 7 Lessons for Living from the Stories of the Dying
  • Harvey Chochinov
    The wisdom embedded in Dying Well is every bit as relevant today as when Byock first put pen to page twenty years ago.”
    Professor Harvey Chochinov
    Dignity Therapy
  • Angelo Volandes
    Before Being Mortal and When Breath Becomes Air, there was (and remains) Ira Byock’s prescient and unforgettable Dying Well. With the deep sensitivity of Abraham Verghese and the profound humanism of Atul Gawande, Ira Byock’s Dying Well remains the ‘go to’ guidebook for all mortals and their loved ones. After 20 years, this classic remains required reading for all patients, medical students, doctors, nurses, and anyone that will face mortality, in other words, required reading for all humanity.
    Angelo Volandes, MD, MPH
    Co-founder & President ACP Decisions
  • Ellen Goodman
    Ira Byock’s book Dying Well was a remarkable and path-breaking book when it was first published 20 years ago. Since then it has remained the gold standard of books teaching us how to live deeply to the end. He is a truly humane guide speaking warmly to a country that is just now beginning to break the taboo and needs to talk meaningfully about living and dying well.
    Ellen Goodman
    Co-founder and Director of The Conversation Project
  • Sensei Koshin Paley Ellison
    Dying Well has never been more relevant. We live in a society that still is in need the medicine Dying Well prescribes: compassion, wisdom, connection and the relief of suffering. Ira’s words are a balm for how to live and die with respect and dignity.
    Sensei Koshin Paley Ellison
    Co-Founder of the New York Zen Center for Contemplative Care and author and editor of Awake at the Bedside
  • The field of palliative care has grown exponentially with more than 68% of hospitals with greater than 50 beds having a palliative care program and with the expansion of palliative care services into the outpatient and community programs. But the challenges to patients’ accessing palliative care remain and millions of people with serious illness do not receive the care they need. We need them to demand such care by learning about palliative care and how it is associated with a better quality of life, and a true value based care program. That is why Dying Well is even more relevant today that when it was published. It offers a way forward for the public to engage in talking about dying that gives them the opportunity to learn what is possible and understand that they can make choices in their medical care to enhance their quality of life living as fully as possible and dying well.
    Kathleen M. Foley, M.D.
    The Society of Memorial Sloan Kettering Cancer Center Chair
  • This book is more relevant than ever. The country has been primed by more attention being paid to how we die, and at the same time to the ills of our healthcare system. Ira shows us how much better things could be. Not with exotic knowledge or more information, but by doing what we already know how to do. Given the nature of the subject, that means that Ira’s counsel has the power to affect every single one of us. Thrilling and daunting too, I realize, but far better than the alternative! And, thanks to Ira, we have a playbook.
    BJ Miller
    M.D. senior advisor to the Zen Hospice Project

The Best Care Possible:

A Physician’s Quest to Transform Care Through the End of Life

A doctor on the front lines of hospital care illuminates one of the most important and controversial social issues of our time.
It is harder to die in this country than ever before. Though the vast majority of Americans would prefer to die at home—which hospice care provides—many of us spend our last days fearful and in pain in a healthcare system ruled by high-tech procedures and a philosophy to “fight disease and illness at all cost.”
Dr. Ira Byock, one of the foremost palliative-care physicians in the country, argues that how we die represents a national crisis today. To ensure the best possible elder care, Dr. Byock explains we must not only remake our healthcare system but also move beyond our cultural aversion to thinking about death. The Best Care Possible is a compelling meditation on medicine and ethics told through page-turning life-or-death medical drama. It has the power to lead a new national conversation.

  • Peer reviews for ira byock by jane isay
    With elegance, compassion, and energy, Ira Byock shows us how to get the best end of life care. He is a great storyteller and a brilliant analyst of health care in America. This is the book to read or give, if you are facing this hard situation. Nobody gets out of this life alive, but Byock shows us how to do it elegantly and well.
    Jane Isay
    Walking on Eggshells
  • Rochi Joan Halifax
    This is an extraordinary and wise book on how dying people can be cared for. Written by a master clinician, a man of great compassion, Ira Byock has a vision of health care that is brilliant and kind.
    Roshi Joan Halifax
    Abbot, Upaya Zen Center, Sante Fe, author of “Being with Dying”
  • Elliott Fisher
    Dr. Byock, one of the country’s leading experts in palliative care, shares his wisdom and insights on how to get the best care possible when we are confronted with a potentially life-limiting illness. When my own mother was seriously ill, Ira’s words helped our family make the right choices and make sure she got the care she wanted – and no more –during her last months. His words can help you.
    Elliott S. Fisher – MD, MPH
    Director of Population Health and Policy, The Dartmouth Institute
  • Terry Tempest
    Having traveled this landscape with loved ones, taking care of individuals at the end of their life is both a privilege and a tremendous challenge, both physically and spiritually. We need a map. Ira Byock has created a map of compassionate intelligence for palliative care with grace. Through the power of story and his own intuitive sense of what dignity means to the dying, this is more than a manual, it is a godsend. It is also a call for health care with heart, conscience, and consequence.
    Terry Tempest Williams
  • Donald Schumacher
    Once again, Dr. Ira Byock delivers a message of hope and promise to all of us who will face our own deaths. Dying is always sad, but with proper professional insight and skill, an individual’s last chapter need not be dominated by suffering and isolation. Dr. Byock demonstrates that growth and completion are possible in the midst of grief and loss. His clinical stories and commentary point to the resilience people find and the importance they discover in their relationships as they face life’s final challenges. This is an important look at the personal, social and political implications of how we care for one another and how we die. The Best Care Possible is a rallying cry to all of us who are concerned about the direction of health care in the United States.
    Donald Schumacher, PsyD
    President and CEO, National Hospice and Palliative Care Organization
  • Wesley-Smith.jpg
    Dr. Ira Byock, one of the nation’s premier medical experts on the loving care of dying patients, understands to the core of his being that “dying” isn’t “dead.” To the contrary, it is a time when people can be helped to live robustly as they prepare for that most universal of human experiences. In THE BEST CARE POSSIBLE, Byock issues a clarion call for all of us—whatever our political, ideological, religious, or any other persuasion—to join together in unity to create a Culture of Loving Care that will end the isolation of the dying, ease their suffering, banish their loneliness, and assure that we all remain important and cherished members of the human community no matter the state of our health, ability, or age.
    Wesley J. Smith
    “Forced Exit: Euthanasia, Assisted Suicide, and the New Duty To Die”
  • Christiane Northrup
    The baby boom generation has transformed every stage of life we’ve touched. We’re now transforming the dying process. And Dr. Byock is leading the way … brilliantly!”
    Christiane Northrup, MD, ob/gyn physician
    New York Times bestsellers: “Women’s Bodies, Women’s Wisdom” and “The Wisdom of Menopause”
  • jack-wennberg.jpg
    In The Best Care Possible, Ira Byock tells us why we need to move beyond medicine’s fixation on conquering death to a vision of end-of-life care focused on the quality of the patient’s experience.  This is a beautifully written, highly personal account that makes real the struggle of patients and families to escape the “high-tech”, more is better imperative that dominates the American way of death. It provides compelling examples of how the physician, committed to reform, can help patients achieve the care they want and need. But Byock goes further: he makes the case that professional reform is only part of the solution; overcoming the medicalization of death will require the mobilization of the wider community in the support of the dying (and those with chronic illness).
    Jack Wennberg, MD
    “Tracking Medicine: a Researcher’s Quest to Understand Health Care”
  • “There is no palliative care physician for whom I have more respect and admiration than Ira Byock. In this strikingly important book, he presents an agenda for end-of-life care that should serve as an ideal template on which to build our best hopes for the final days of those we love and of ourselves — and a corrective for our society.”
    Sherwin B. Nuland, MD
    Yale Interdisciplinary Center for Bioethics, author of “How We Die"
  • This is a profoundly truthful book. Ira Byock uses powerful stories about real people to explain the complications, nuances and often absurdity of advanced illness in 21st century America. He shows how courage, shared decisions, wise doctors and nurses and palliative care can make the difference. Above all, he calls for a cultural transformation so we can deal with the end of life as individuals, families and society. Who should read it? All of us who are mortal.
    Bill Novelli, Professor
    Georgetown University and co-chair, the Coalition to Transform Advanced Care and former CEO, AARP
  • “At a time when a long life can become a curse as readily as a blessing, this lucid and compassionate book points the way to more humane treatment of a life’s last days.”
    Rabbi Harold Kushner
    Author of “When Bad Things Happen to Good People”

Foreign Translations

The Best Care Possible

Les Meilleurs Soins Possibles - ISBN 978-2-89733-415-4
Canada: Editions ADA Inc.
France: D.G. Diffusion, Z.I des Bogues, 31750 Escalquens, France; Tel.
Switzerland: Transat; Tel.
Belgium: D.G. Diffusion; Tel.

Dying Well

Japanese: Dying Well - ISBN 4-88135-560-0 C0098
Tuttle-Mori Agency Inc., Tokyo, Japan
German: Sterben: Wachsen im Umgang mit dem Tod – ISBN 3-426-26926-0
Germany: Ventura Publisher im Verlag

The Four Things That Matter Most

Chinese: The Four Things That Matter Most – ISBN 978-986-248-620-7
Taiwan: Heliopolis Publishing
Korean: The Four Things That Matter Most – ISBN 979-11-6220-287-6
Korea: Mulpure Publishing, Inc., 2F, 961-11 Hokye-dong, Dongan-gu, Angyang-si, Kyungki-do, 431-080, Republic of Korea
Spanish: Decir Lo Que Importa: Perdoname, Te Perdono, Gracias, Te Quiero – ISBN 84-7953-612-8
Spain: Ediciones Urano, S. A., Aribau142, pral.-08036 Barcelona, Espanya

Other Books

Co-authored and Co-edited by Ira Byock – primarily for Clinicians and Academics

Palliative and End-of-Life Pearls

Co-authored with John E.Heffner, MD, Hanley and Belfus, Inc., 2002

This addition to the popular Pearls Series® presents 71 case presentations of clinical interest related to end-of-life and palliative care for both hospitalized patients and patients receiving home care. The patient vignettes highlight considerations of pain and symptom management at the end of life, ethical issues related to life-supportive care, and approaches to assisting patients and families with the difficulties that surround death and dying.

A Few Months to Live: Different Paths to Life’s End

Co-authored with Jana Staton and Roger Shuy, Georgetown University Press, 2001

A Few Months to Live describes what dying is like from the perspectives of nine terminally ill individuals and their caregivers. Documenting a unique study of end-of-life experiences that included detailed conversations in home care settings, the book focuses on how participants lived their daily lives, understood their illnesses, coped with symptoms-especially pain-and searched for meaning or spiritual growth in their final months of life. The accounts are presented largely in the participants’ own words, illuminating both the medical and non-medical challenges that arose from the time each learned the “bad news” through their final days of life and memorial services.