Dying in America

Dying in America PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309303133
Category : Medical
Languages : en
Pages : 470

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Book Description
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.

Dying in America

Dying in America PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309303133
Category : Medical
Languages : en
Pages : 470

Get Book Here

Book Description
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.

Relational Autonomy

Relational Autonomy PDF Author: Catriona Mackenzie
Publisher: Oxford University Press
ISBN: 0195352602
Category : Philosophy
Languages : en
Pages : 327

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Book Description
This collection of original essays explores the social and relational dimensions of individual autonomy. Rejecting the feminist charge that autonomy is inherently masculinist, the contributors draw on feminist critiques of autonomy to challenge and enrich contemporary philosophical debates about agency, identity, and moral responsibility. The essays analyze the complex ways in which oppression can impair an agent's capacity for autonomy, and investigate connections, neglected by standard accounts, between autonomy and other aspects of the agent, including self-conception, self-worth, memory, and the imagination.

Meta-Ethnography

Meta-Ethnography PDF Author: George W. Noblit
Publisher: SAGE
ISBN: 9780803930230
Category : Social Science
Languages : en
Pages : 112

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Book Description
How can ethnographic studies be generalized, in contrast to concentrating on the individual case? Noblit and Hare propose a new method for synthesizing from qualitative studies: meta-ethnography. After citing the criteria to be used in comparing qualitative research projects, the authors define the ways these can then be aggregated to create more cogent syntheses of research. Using examples from numerous studies ranging from ethnographic work in educational settings to the Mead-Freeman controversy over Samoan youth, Meta-Ethnography offers useful procedural advice from both comparative and cumulative analyses of qualitative data. This provocative volume will be read with interest by researchers and students in qualitative research methods, ethnography, education, sociology, and anthropology. "After defining metaphor and synthesis, these authors provide a step-by-step program that will allow the researcher to show similarity (reciprocal translation), difference (refutation), or similarity at a higher level (lines or argument synthesis) among sample studies....Contain(s) valuable strategies at a seldom-used level of analysis." --Contemporary Sociology "The authors made an important contribution by reframing how we think of ethnography comparison in a way that is compatible with the new developments in interpretive ethnography. Meta-Ethnography is well worth consulting for the problem definition it offers." --The Journal of Nervous and Mental Disease "This book had to be written and I am pleased it was. Someone needed to break the ice and offer a strategy for summarizing multiple ethnographic studies. Noblit and Hare have done a commendable job of giving the research community one approach for doing so. Further, no one else can now venture into this area of synthesizing qualitative studies without making references to and positioning themselves vis-a-vis this volume." -Educational Studies

Approaching Death

Approaching Death PDF Author: Committee on Care at the End of Life
Publisher: National Academies Press
ISBN: 0309518253
Category : Medical
Languages : en
Pages : 457

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Book Description
When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

Autonomy, Consent and the Law

Autonomy, Consent and the Law PDF Author: Sheila A.M. McLean
Publisher: Routledge
ISBN: 1135219052
Category : Law
Languages : en
Pages : 244

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Book Description
The notion that consent based on the concept of autonomy, underpins a good or beneficent medical intervention is deeply rooted in the jurisprudence of most countries throughout the world. Autonomy, Consent and the Law examines these notions in the UK, Australia and the US, and critiques the way in which autonomy and consent are treated in bioethics and law.

Choosing Life, Choosing Death

Choosing Life, Choosing Death PDF Author: Charles Foster
Publisher: Bloomsbury Publishing
ISBN: 1847314902
Category : Law
Languages : en
Pages : 216

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Book Description
Autonomy is a vital principle in medical law and ethics. It occupies a prominent place in all medico-legal and ethical debate. But there is a dangerous presumption that it should have the only vote, or at least the casting vote. This book is an assault on that presumption, and an audit of autonomy's extraordinary status. This book surveys the main issues in medical law, noting in relation to each issue the power wielded by autonomy, asking whether that power can be justified, and suggesting how other principles can and should contribute to the law. It concludes that autonomy's status cannot be intellectually or ethically justified, and that positive discrimination in favour of the other balancing principles is urgently needed in order to avoid some sinister results. 'This book is a sustained attack on the hegemony of the idea of autonomy in medical ethics and law. Charles Foster is no respecter of authority, whether of university professors or of law Lords. He grabs his readers by their lapels and shakes sense into them through a combination of no-nonsense rhetoric and subtle argument that is difficult to resist.' Tony Hope, Professor of Medical Ethics, Oxford University 'This book is unlikely to be in pristine state by the time you have finished reading it. Whether that is because you have thrown it in the air in celebration or thrown it across the room in frustration will depend on your perspective. But this book cannot leave you cold. It is a powerful polemic on the dominance of autonomy in medical law, which demands a reaction. Charles Foster sets out a powerful case that academic medical lawyers have elevated autonomy to a status it does not deserve in either ethical or legal terms. In a highly engaging, accessible account, he challenges many of the views which have become orthodox within the academic community. This will be a book which demands and will attract considerable debate.' Jonathan Herring, Exeter College, Oxford University 'This is a learned, lively and thought-provoking discussion of problems central to the courts' approach to ethical issues in medical law. What principles are involved? More significantly, which really underlie and inform the process of seeking justice in difficult cases? Charles Foster persuasively argues, and demonstrates, that respect for autonomy is but one of a number of ethical principles which interact and may conflict. He also addresses the sensitive issue of the extent to which thoughts and factors which go to influence legal decisions may not appear in the judgments.' Adrian Whitfield QC. 'Introducing the Jake La Motta of medical ethics. Foster is an academic street-fighter who has bloodied his hands in the court room. He provides a stinging, relentless, ground attack on the Goliath of medical ethics: the central place of autonomy in liberal medical ethics. This is now the first port of call for those who feel that medical ethics has become autonomized.' Julian Savulescu, Uehiro Chair in Practical Ethics, University of Oxford. "This important book offers a robust challenge to anyone, whether lawyer or 'ethicist', who sees respect for autonomy as the only game in town. It argues eloquently and effectively that, on the one hand, despite the reverence paid to it by judges, in practice the law, even in the context of consent, weaves together a number of moral threads of which autonomy is merely one, in the pursuit of a good decision. It argues on the other hand, that were the day-to-day practice of law to be guided primarily by respect for autonomy, this would be wrong. Foster concludes that whilst, 'any society that does not have laws robustly protecting autonomy is an unsafe and unhappy one', so too would be a society in which too much emphasis was placed on respect for autonomy at the expense of other important moral principles. This is essential reading for anyone interested in the role of autonomy and indeed of medical ethics, in the law." Michael Parker, Professor of Bioethics, University of Oxford

Theories of the Self and Autonomy in Medical Ethics

Theories of the Self and Autonomy in Medical Ethics PDF Author: Michael Kühler
Publisher: Springer Nature
ISBN: 3030567036
Category : Philosophy
Languages : en
Pages : 218

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Book Description
This book engages in a critical discussion on how to respect and promote patients’ autonomy in difficult cases such as palliative care and end-of-life decisions. These cases pose specific epistemic, normative, and practical problems, and the book elucidates the connection between the practical implications of the theoretical debate on respecting autonomy, on the one hand, and specific questions and challenges that arise in medical practice, on the other hand. Given that the idea of personal autonomy includes the notion of authenticity as one of its core components, the book explicitly includes discussions on underlying theories of the self. In doing so, it brings together original contributions and novel insights for “applied” scenarios based on interdisciplinary collaboration between German and Serbian scholars from philosophy, sociology, and law. It is of benefit to anyone cherishing autonomy in medical ethics and medical practice.

Physician-Assisted Death

Physician-Assisted Death PDF Author: James M. Humber
Publisher: Springer Science & Business Media
ISBN: 1592594484
Category : Medical
Languages : en
Pages : 159

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Book Description
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.

Pediatric Palliative Care

Pediatric Palliative Care PDF Author: Betty Ferrell
Publisher:
ISBN: 0190244186
Category : Family & Relationships
Languages : en
Pages : 161

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Book Description
Pediatric palliative care is a field of significant growth as health care systems recognize the benefits of palliative care in areas such as neonatal intensive care, pediatric ICU, and chronic pediatric illnesses. Pediatric Palliative Care, the fourth volume in the HPNA Palliative Nursing Manuals series, highlights key issues related to the field. Chapters address pediatric hospice, symptom management, pediatric pain, the neonatal intensive care unit, transitioning goals of care between the emergency department and intensive care unit, and grief and bereavement in pediatric palliative care. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. Plentiful tables and patient teaching points make these volumes useful resources for nurses.

Autonomy, Rationality, and Contemporary Bioethics

Autonomy, Rationality, and Contemporary Bioethics PDF Author: Jonathan Pugh
Publisher: Oxford University Press
ISBN: 0198858582
Category : Law
Languages : en
Pages : 298

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Book Description
Personal autonomy is often lauded as a key value in contemporary Western bioethics, and the claim that there is an important relationship between autonomy and rationality is often treated as an uncontroversial claim in this sphere. Yet, there is also considerable disagreement about how we should cash out the relationship between rationality and autonomy. In particular, it is unclear whether a rationalist view of autonomy can be compatible with legal judgments that enshrine a patient's right to refuse medical treatment, regardless of whether ". . . the reasons for making the choice are rational, irrational, unknown or even non-existent". In this book, I bring recent philosophical work on the nature of rationality to bear on the question of how we should understand autonomy in contemporary bioethics. In doing so, I develop a new framework for thinking about the concept, one that is grounded in an understanding of the different roles that rational beliefs and rational desires have to play in personal autonomy. Furthermore, the account outlined here allows for a deeper understanding of different form of controlling influence, and the relationship between our freedom to act, and our capacity to decide autonomously. I contrast my rationalist with other prominent accounts of autonomy in bioethics, and outline the revisionary implications it has for various practical questions in bioethics in which autonomy is a salient concern, including questions about the nature of informed consent and decision-making capacity.