This first-of-its-kind text provides a multidisciplinary overview of a significant problem in hospital-based healthcare: patients who decline inpatient medical care and leave the hospital against medical advice (AMA). Compared to standard hospital discharges, AMA discharges are associated with worse health and health services outcomes. Patients discharged AMA have been found to have disproportionately higher rates of substance use, psychiatric illness, and report stigmatization and reduced access to care. By providing a far reaching examination of AMA discharges for a wide academic and clinical audience, the book serves as a reference for clinical care, research, and the development of professional guidelines and institutional policy. The book provides both a broad overview of AMA discharges with chapters on the epidemiology, ethical and legal aspects, as well as social science perspectives. For clinicians in the disciplines of hospital medicine, pediatrics, emergency medicine, nursing, and psychiatry, the book also provides a patient-centered analysis of the problem, case-based discussions, and a discussion of best practices. This comprehensive review of AMA discharges and health care quality will interest physicians and other health care professionals, social workers, hospital administrators, quality and risk managers, clinician-educators, and health services researchers.
Refusal, delay, or limitation of medical treatments, including vaccines, is an increasing phenomenon facing nurses and other healthcare practitioners daily. When a patient or family refuses treatment—maybe even lifesaving treatment—because it is contrary to their social, religious, or cultural beliefs, it can plunge healthcare providers, families, and patients into a difficult, emotionally charged conversation. Complex and diverse ethical dilemmas such as this can profoundly impact the health, welfare, and mental and emotional well-being of everyone involved. What’s more, today’s nurses and healthcare professionals will almost inevitably face this situation or one like it. Against Medical Advice details many of the medical, legal, social, cultural, and religious factors associated with treatment refusals. Authors Luanne Linnard-Palmer and Ellen Christiansen prepare healthcare professionals to compassionately assess and understand people’s beliefs, cultures, and philosophical perspectives. Their proven strategies and step-by-step examples guide providers to consider the patient’s and family’s point of view, share concerns with other healthcare team members, and negotiate the best possible outcome for all involved. TABLE OF CONTENTS Chapter 1: When Medical Treatment and Patient Needs Clash Chapter 2: Overview and Reasons for Treatment Refusals Chapter 3: Childhood Vaccines, Hesitancy, and Refusals Chapter 4: Pediatric Healthcare, Ethics, and Children’s Rights Chapter 5: Legal Implications and Consent: Informed Consent, Assent, and Parental Permission Chapter 6: Legal Perspectives of Treatment Refusal: Refusal Defined Chapter 7: In the Name of Religion: Historical Influences to Legal Exemptions Chapter 8: Adult Medical Treatment Refusals, Limitations, and Delays Chapter 9: Overview of Religious Doctrines Chapter 10: The Importance of Cultural Competence Chapter 11: Professional Groups’ Reactions to Treatment Refusal: Nursing, Medicine, Researchers, and Journalists Chapter 12: Overview of Professional Interventions: Power Distance, Negotiation, and Safety Appendix A: Reasons for Parental Decisions to Refuse Medical Treatment Appendix B: Guidelines for Staff Facing Parental Refusal of Pediatric Vaccines or Medical Treatments Appendix C: Guidelines for Staff Facing Adult Refusal of Medical Treatments Appendix D: Loss of Parental Guardianship: Court Overriding of a Parent’s Right to Refuse Medical Treatment Appendix E: Common Concerns About Vaccine Administration Appendix F: Pandemics and Trust in Rapid Vaccine Creation, Distribution, and Mandates Appendix G: Best Interest and the Law: Should State Statutes on Child Abuse Be Modified? Appendix H: Spiritual Abuse Defined Appendix I: Resources for More Information AVAILABLE ON THE SIGMA REPOSITORY · Chapter 2: Overview and Reasons for Treatment Refusals · AMA Quick Facts ABOUT THE AUTHORS Luanne Linnard-Palmer, EdD, RN, CPN, is a Professor of Nursing at Dominican University of California in San Rafael, California, and a Pediatric Educational Consultant and Pediatric Clinical Nurse at Sutter Health’s California Pacific Medical Center in San Francisco. Ellen Christiansen, DNP, RN, FNP-BC, PHNA-BC, is an Associate Professor of Nursing at Dominican University of California, where she teaches Community and Public Health Nursing.
In the middle of a painful divorce and becoming a single mother, Simone, a beautiful 30something-year-old, suddenly falls ill.She finds herself in the resuscitation room of the hospital, fearing for her life, having just suffered a stroke.What caused Simone to have a stroke at such a young age, no doctor could answer.Frustrated with the lack of answers and by being treated like older stroke patients, she decides to take healing into her own hands and starts rebuilding her life on her own terms. Simone reclaims her life against medical advice.
An authoritative guide to the legal and ethical issues faced daily by nurses, this handbook includes real-life examples and information from hundreds of court cases. It covers the full range of contemporary concerns, including computer documentation, workplace violence and harassment, needlesticks, telephone triage, pain management, prescribing, privacy, and confidentiality. An entire chapter explains step-by-step what to expect in a malpractice lawsuit.
Every day we make decisions about our health - some big and some small. What we eat, how we live and even where we live can affect our health. But how can we be sure that the advice we are given about these important matters is right for us? This book will provide you with the right tools for assessing health advice.
For any woman who has experienced illness, chronic pain, or endometriosis comes an inspiring memoir advocating for recognition of women's health issues In the fall of 2010, Abby Norman's strong dancer's body dropped forty pounds and gray hairs began to sprout from her temples. She was repeatedly hospitalized in excruciating pain, but the doctors insisted it was a urinary tract infection and sent her home with antibiotics. Unable to get out of bed, much less attend class, Norman dropped out of college and embarked on what would become a years-long journey to discover what was wrong with her. It wasn't until she took matters into her own hands -- securing a job in a hospital and educating herself over lunchtime reading in the medical library -- that she found an accurate diagnosis of endometriosis. In Ask Me About My Uterus, Norman describes what it was like to have her pain dismissed, to be told it was all in her head, only to be taken seriously when she was accompanied by a boyfriend who confirmed that her sexual performance was, indeed, compromised. Putting her own trials into a broader historical, sociocultural, and political context, Norman shows that women's bodies have long been the battleground of a never-ending war for power, control, medical knowledge, and truth. It's time to refute the belief that being a woman is a preexisting condition.
This book presents the first comprehensive review of all major government-supported health insurance schemes in India and their potential for contributing to the achievement of universal coverage in India are discussed.
Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system—and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
