Advance Directives And Substitute Decision Making In Personal Healthcare

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.

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

This unique title offers a novel exploration into the world of advance directives for patients with dementia. Based on real life ethics consultations the expert author has undertaken, the cases depict fascinating and challenging moral issues arising in a variety of healthcare facilities. The dynamics of the interdisciplinary health care teams of these patients, along with the dynamics of the families who are grappling to best serve their loved ones, are outlined and assessed; and the role each player’s personal histories have on the ethical issues and their resolution in real life are explored. Following each case study, the author applies a range of concepts introduced in the beginning of the book to the relevant case study, thus integrating theory with a case-based approach. A user-friendly question-and-answer format provides a thought provoking and accessible learning experience for readers. Dementia and the Advance Directive: Lessons from the Bedside tackles complicated and realistic healthcare scenarios and offers an invaluable addition to the literature on advance directives.

"The objective of this transnational, transdisciplinary study was not to predict the future. Much less was it to determine which culture has the best legal, public policy, and ethical systems. Rather, it was to understand the systems--their similarities and differences--and their implications for shaping the public policies that will shape the legal and medical world to come."--from the introduction Advance directives to determine the care of terminally ill patients have revolutionized health care decision making. But writing a directive that accomplishes exactly what a patient wants can be a difficult process and can be ethically controversial. While Americans, deeply immersed in Western liberal political philosophy, have an intuitive attraction to advance directives, other cultures do not. In this volume, an international team of experts examines the controversy surrounding advance directives in three countries: the United States, Germany, and Japan. Within each section, the subjects are addressed from the points of view of clinicians, legal experts, and bioethicists. The authors find that the United States and Japan are at opposite ends of a spectrum of opinion regarding patient autonomy, whereas Germany falls somewhere between.