Ethics In Palliative Care

A comprehensive analysis of ethical topics in palliative care, combining clinical experience and philosophical rigor. A broad array of topics are explored from historical, legal, clinical, and ethical perspectives, offering both the seasoned clinician and interested lay reader a thorough examination of the complex ethical issues facing patients suffering from life-threatening illness

"An innovative approach to caring for the terminally ill patient, A palliative ethic of care provides deeper insights into why end-of-life care is so challenging and suggests how to improve the care of the dying" -- Back cover.

Law, Palliative Care and Dying critically examines the role of the legal framework in shaping the boundaries of palliative care practice. The work underlines the importance of a distinct legal framework for specialist palliative care which can provide clarity for both the healthcare professional and the patient. It examines the legal and ethical justifications for specialist palliative care practices and, in doing so, it questions the legitimacy of the distinction between euthanasia and practices such as palliative sedation. Moreover, this work discusses the influence of a human rights discourse on palliative care and examines the contribution of autonomy, dignity, and the right to palliative care. This book includes detailed comparative research on several European jurisdictions. The jurisdictions illustrate varied approaches to palliative care regulation and promotion. In this manner, the role of professional guidelines and legislation are drawn out and common themes in the regulation of palliative care emerge.

Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it does not include a comprehensive system of care as is provided by hospice. The practice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directed treatment) ethical issues. The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering; and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges within their domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers.

Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment explores the pressures and challenges facing hospice and aims to produce new studies and educational materials on hospice ethics to help professionals in the field. Many of the tensions felt by caregivers and practitioners in hospice stem from uncertainty about the ethical mission of hospice and the ethical dilemmas arising in practice. This volume, a result of The Hastings Center and the Hospice Foundation of America’s project on Ethical and Policy Issues in Hospice Care, addresses these issues in a clear, accessible way. Ethics in Hospice Care outlines the economic, social, and cultural challenges facing hospice care in a changing society and a changing health care environment. Issues of concern include: financial pressures as policymakers limit Medicare spending organizational pressures as hospice organizations enter a variety of new relationships with managed care organizations, home health agencies, and hospitals cultural and social challenges as Americans wrestle with moral and legal issues of death and dying and physician-assisted suicide the rapid and unplanned growth of the movement--from a single hospice in 1973 to over 2500 today While primarily for practicing hospice professionals, Ethics in Hospice Care is vital reading for everyone concerned with assisted suicide, patients’rights, quality of life, managed care, physician referral, professional development, pain management, quality of care, and ethics committees.

Palliative Care Within Mental Health: Ethical Practice explores the comprehensive concerns and dilemmas that occur surrounding people experiencing mental health problems and disorders. Working beyond narrow, stereotypical definitions of palliative care as restricted to terminal cancer patients, this balanced and thought-provoking volume examines the many interrelated issues that face the individual, families, and caregivers, setting the groundwork for improved, ethical relationships and interventions. Chapters by experts and experienced practitioners detail the challenges, concerns, and best practices for ethical care and responses in a variety of individual and treatment contexts. This is an essential and thoughtful new resource for all those involved in the fast-developing field of palliative mental health.

This book is the first comprehensive collection devoted to analyzing distinctive ethical issues arising in the delivery of hospice care and designed to promote best ethical practices for hospice care professionals and organizations.

This book on the history of palliative care, 1500-1970 traces the historical roots of modern palliative care in Europe to the rise of the hospice movement in the 1960s. The author discusses largely forgotten premodern concepts like cura palliativa and euthanasia medica and describes, how patients and physicians experienced and dealt with terminal illness. He traces the origins of hospitals for incurable and dying patients and follows the long history of ethical debates on issues like truth-telling and the intentional shortening of the dying patients’ lives and the controversies they sparked between physicians and patients. An eye opener for anyone interested in the history of ethical decision making regarding terminal care of critically ill patients.