Life And Death Decisions In The Clinical Setting

This book moves away from the frameworks that have traditionally guided ethical decision-making in the Western clinical setting, towards an inclusive, non-coercive and, reflective dialogic approach to moral decision-making. Inspired in part by Jürgen Habermas’s discourse theory of morality and principles of communicative action, the book offers a proportionist approach as a way of balancing out the wisdom in traditional frameworks, set in the actual reality of the clinical situation at hand. Putting this approach into practice requires having a conversation, a dialogue or a discourse, with collaboration amongst all the stakeholders. The aim of the dialogue is to reach consensus in the decision, via mutual understanding of the values held by the patient and others whom they see as significant. This book aims to underscore the moral philosophical foundations for having a meaningful conversation. Life and Death Decision in the Clinical Setting is especially relevant in our contemporary era, characterised medically by an ever-increasing armamentarium of life-sustaining technology, but also by increasing multiculturalism, a multiplicity of faiths, and increasing value pluralism.

Physician-Assisted Death is the eleventh volume of Biomedical Ethics Reviews. We, the editors, are pleased with the response to the series over the years and, as a result, are happy to continue into a second decade with the same general purpose and zeal. As in the past, contributors to projected volumes have been asked to summarize the nature of the literature, the prevailing attitudes and arguments, and then to advance the discussion in some way by staking out and arguing forcefully for some basic position on the topic targeted for discussion. For the present volume on Physician-Assisted Death, we felt it wise to enlist the services of a guest editor, Dr. Gregg A. Kasting, a practicing physician with extensive clinical knowledge of the various problems and issues encountered in discussing physician assisted death. Dr. Kasting is also our student and just completing a graduate degree in philosophy with a specialty in biomedical ethics here at Georgia State University. Apart from a keen interest in the topic, Dr. Kasting has published good work in the area and has, in our opinion, done an excellent job in taking on the lion's share of editing this well-balanced and probing set of essays. We hope you will agree that this volume significantly advances the level of discussion on physician-assisted euthanasia. Incidentally, we wish to note that the essays in this volume were all finished and committed to press by January 1993.

This title was first published in 2002.The wide range of essays contained within this volume present contemporary thinking on the legal and ethical implications surrounding modern medical practice.

Seven in ten Americans over the age of age of sixty who require medical decisions in the final days of their life lack the capacity to make them. For many of us, our biggest, life-and-death decisions—literally—will therefore be made by someone else. They will decide whether we live or die; between long life and quality of life; whether we receive heroic interventions in our final hours; and whether we die in a hospital or at home. They will determine whether our wishes are honored and choose between fidelity to our interests and what is best for themselves or others. Yet despite their critical role, we know remarkably little about how our loved ones decide for us. Speaking for the Dying tells their story, drawing on daily observations over more than two years in two intensive care units in a diverse urban hospital. From bedsides, hallways, and conference rooms, you will hear, in their own words, how physicians really talk to families and how they respond. You will see how decision makers are selected, the interventions they weigh in on, the information they seek and evaluate, the values and memories they draw on, the criteria they weigh, the outcomes they choose, the conflicts they become embroiled in, and the challenges they face. Observations also provide insight into why some decision makers authorize one aggressive intervention after the next while others do not—even on behalf of patients with similar problems and prospects. And they expose the limited role of advance directives in structuring the process decision makers follow or the outcomes that result. Research has consistently found that choosing life or death for another is one of the most difficult decisions anyone can face, sometimes haunting families for decades. This book shines a bright light on a role few of us will escape and offers steps that patients and loved ones, health care providers, lawyers, and policymakers could undertake before it is too late.

Issues of Life and Death such as abortion, assisted suicide, capital punishment and others are among the most contentious in many societies. Whose rights are protected? How do these rights and protections change over time and who makes those decisions? Based on the author’s award-winning and hugely popular undergraduate course at the University of Texas, this book explores these questions and the fundamentally sociological processes which underlie the quest for morality and justice in human societies. The Author’s goal is not to advocate any particular moral "high ground" but to shed light on the social movements and social processes which are at the root of these seemingly personal moral questions. Under 200 printed pages, this slim paperback is priced and sized to be easily assigned in a variety of undergraduate courses that touch on the social bases underlying these contested and contentious issues.

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.

NEW YORK TIMES BESTSELLER • The award-winning book that inspired an Apple Original series from Apple TV+ • A landmark investigation of patient deaths at a New Orleans hospital ravaged by Hurricane Katrina—and the suspenseful portrayal of the quest for truth and justice—from a Pulitzer Prize–winning physician and reporter “An amazing tale, as inexorable as a Greek tragedy and as gripping as a whodunit.”—Dallas Morning News After Hurricane Katrina struck and power failed, amid rising floodwaters and heat, exhausted staff at Memorial Medical Center designated certain patients last for rescue. Months later, a doctor and two nurses were arrested and accused of injecting some of those patients with life-ending drugs. Five Days at Memorial, the culmination of six years of reporting by Pulitzer Prize winner Sheri Fink, unspools the mystery, bringing us inside a hospital fighting for its life and into the most charged questions in health care: which patients should be prioritized, and can health care professionals ever be excused for hastening death? Transforming our understanding of human nature in crisis, Five Days at Memorial exposes the hidden dilemmas of end-of-life care and reveals how ill-prepared we are for large-scale disasters—and how we can do better. ONE OF THE TEN BEST BOOKS OF THE YEAR: The New York Times Book Review • ONE OF THE BEST BOOKS OF THE YEAR: Chicago Tribune, Seattle Times, Entertainment Weekly, Christian Science Monitor, Kansas City Star WINNER: National Book Critics Circle Award, J. Anthony Lukas Book Prize, PEN/John Kenneth Galbraith Award, Los Angeles Times Book Prize, Ridenhour Book Prize, American Medical Writers Association Medical Book Award, National Association of Science Writers Science in Society Award