Dying in America

Dying in America

Author: Institute of Medicine

Publisher: National Academies Press

Published: 2015-03-19

Total Pages: 470

ISBN-13: 0309303133

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For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.


Advance Care Planning

Advance Care Planning

Author: Leah Rogne, Ph.D.

Publisher: Springer Publishing Company

Published: 2013-07-29

Total Pages: 402

ISBN-13: 0826110215

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Making Sense of Advance Directives

Making Sense of Advance Directives

Author: Nancy M.P. King

Publisher: Georgetown University Press

Published: 1996-02-01

Total Pages: 308

ISBN-13: 9781589018600

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Advance directives—such as living wills and health care proxies—are documents intended to declare and preserve the health care choices of patients if they become unable to make their own decisions. This book provides a comprehensive overview of advance directives and clear, practical directions for writing and interpreting them. Nancy M.P. King provides a legal, philosophical, and historical analysis of the moral and legal force of advance directives. She explains the types and models of advance directives currently in use and offers guidelines for individuals seeking to write, read, and use directives to promote individuals' health care choices within the laws of their own states. King emphasizes that advance directives are not orders given by patients to their doctors; instead, they are documents that invite conversation between doctors and patients about health care decisions of great importance. The purpose of advance directives is to support patients' health care choices, and the book promotes a thoughtful use of advance directives that is best calculated to achieve that purpose, whatever form individual advance directives may take. This new edition has been updated to reflect the many changes in advance directive statutes since 1991, including expanded discussions of health care proxy statutes, the impact of the Patient Self-Determination Act and the Supreme Court's Cruzan decision. King also has extended her analysis of the implications for advance directives of managed care, resource allocation, resource scarcity, and the debate over futile treatment at the end of life. Making Sense of Advance Directives is a valuable handbook for patients, health care providers and administrators, patient counselors, lawyers, policymakers, and any individual interested in advance directives.


The Patient Self-Determination Act

The Patient Self-Determination Act

Author: Lawrence P. Ulrich

Publisher: Georgetown University Press

Published: 2001-07-18

Total Pages: 370

ISBN-13: 9781589014534

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The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices. According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient. Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates.


New Law and Ethics in Mental Health Advance Directives

New Law and Ethics in Mental Health Advance Directives

Author: Penelope Weller

Publisher: Routledge

Published: 2012-12-12

Total Pages: 210

ISBN-13: 1136159568

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The recognition of positive rights and the growing impact of human rights principles has recently orchestrated a number of reforms in mental health law, bringing increasing entitlement to an array of health services. In this book, Penelope Weller considers the relationship between human rights and mental health law, and the changing attitudes which have led to the recognition of a right to demand treatment internationally. Weller discusses the ability of those with mental health problems to use advance directives to make a choice about what treatment they receive in the future, should they still be unable to decide for themselves. Focusing on new perspectives offered by the Conventions on the Rights of Persons with Disabilities (CRPD), Weller explores mental health law from a variety of international perspectives including: Canada, Australia, New Zealand and the United Kingdom, where policies differ depending on whether you are in England and Wales, or Scotland. These case studies indicate how human rights perspectives are shifting mental health law from a constricted focus upon treatment refusal, towards a recognition of positive rights. The book covers topics including: refusing treatment new approaches in human rights international perspectives in mental health law the right to demand treatment. The text will appeal to legal and mental health professionals as well as academics studying mental health law, and policy makers.


Deciding for Others

Deciding for Others

Author: Allen E. Buchanan

Publisher: Cambridge University Press

Published: 1989

Total Pages: 450

ISBN-13: 9780521311960

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This book is the most comprehensive treatment available of one of the most urgent problems in bioethics: decision-making for incompetents.


Palliative Care in Cardiac Intensive Care Units

Palliative Care in Cardiac Intensive Care Units

Author: Massimo Romanò

Publisher: Springer Nature

Published: 2021-09-29

Total Pages: 195

ISBN-13: 3030801128

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This book analyzes the main topics of Palliative Care in Cardiac Intensive Care Units (CICU), from the changing epidemiology of patients admitted to the ICU, to the main clinical and ethical issues. The changing epidemiology of patients has led to new and emerging patient needs at the end of life. Care has shifted from acute coronary syndrome patients towards elderly patients, with a high prevalence of non-ischemic cardiovascular diseases and a high burden of non-cardiovascular comorbid conditions: both increase the susceptibility of patients to developing life-threatening critical conditions. These conditions are associated with a significant symptom burden, high mortality rate, and increased length of stay. The main new challenges involve shared decision-making, symptom control (pain, dyspnea, etc.), and ethical issues (withholding/withdrawing life sustaining treatments, deactivation of implanted cardiac devices, palliative sedation), all of which necessitate formal education on end-of-life care. Written by opinion leaders in their respective fields, who share their experience with improving the cultural and clinical competence of medical/nursing teams, this volume is chiefly intended for cardiologists, anesthesiologists, palliative care doctors and nursing staff.


Measurement Tools in Clinical Ethics

Measurement Tools in Clinical Ethics

Author: Barbara Redman

Publisher: SAGE

Published: 2002

Total Pages: 313

ISBN-13: 0761915184

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"The evolution of ethical issues in clinical and research work in health has acclerated dramatically due to the struggle toward patient automony in end-of-life decisions and patients' access to choices in health care and in research. How do we clarify the assumptions and consequences of these decisions in the development of measurement instruments that gather data of their psychometic characteristics? This book presents a number of these instruments ... each chapter examines a specific topic category (for example, patient preference, aggressiveness of care, and others) and then explains each of the various instruments that have been developed to measure that topic. Next, the description, psychometric properties, summary and critique, references, and a copy of the instrument are provided so as to facilitate the reader's search for a usable instrument."--Back cover.


The Mayo Clinic Book of Home Remedies

The Mayo Clinic Book of Home Remedies

Author: Mayo Clinic

Publisher: Oxmoor House

Published: 2010-10-26

Total Pages: 0

ISBN-13: 9781603201599

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Many common health problems can be treated with simple remedies you can do at home. Even if the steps you take don't cure the problem, they can relieve symptoms and allow you to go about your daily life, or at least help you until you're able to see a doctor. Some remedies, such as changing your diet to deal with heartburn or adapting your home environment to cope with chronic pain, may seem like common sense. You may have questions about when to apply heat or cold to injuries, what helps relieve the itch of an insect bite, or whether certain herbs, vitamins or minerals are really effective against the common cold or insomnia. You'll find these answers and more in Mayo Clinic Book of Home Remedies. In situations involving your health or the health of your family, the same questions typically arise: What actions can I take that are immediate, safe and effective? When should I contact my doctor? What symptoms signal an emergency? Mayo Clinic Book of Home Remedies clearly defines these questions with regard to your health concerns and guides you to choose the appropriate and most effective response.