Download or read book Deciding for Others written by Allen E. Buchanan and published by Cambridge University Press. This book was released on 1989 with total page 450 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is the most comprehensive treatment available of one of the most urgent problems in bioethics: decision-making for incompetents.
Download or read book Surrogate Decisionmaking for Adults written by and published by . This book was released on 1989 with total page 128 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Strange Bedfellows written by Ben A. Rich and published by Springer Science & Business Media. This book was released on 2007-05-08 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: The pervasive influence of law on medical practice and clinical bioethics is often noted with a combination of exasperation and lamentation. Physicians and non-physician bioethicists, generally speaking, consider the willingness of courts, legislatures, and regulatory agencies to insinuate themselves into clinical practice and medical research to be a distinctly negative aspect of contemporary American society. They are quick to point out that their colleagues in other Western developed nations are not similarly afflicted, and that the situation which obtains elsewhere is highly preferable to the legalization and purported over-regulation of medicine that has taken place in the United States during the last fifty years. In this book I offer a decidedly different perspective. It is, admittedly, not entirely without personal and professional bias. Prior to becoming a fu- time academic, teaching bioethics in the setting of an academic medical center, I was, for nearly 20 years, an attorney specializing in health law. Even after earning a doctorate in philosophy, I was frequently considered to be the “resident lawyer” on the bioethics faculty, much more frequently looked to for my insights on the law than my perspective as one who had formally studied moral philosophy and applied ethics. I note this not out ofa sense of frustration or disappointment, but as confirmation that even among physicians and n- physician bioethicists, there is widespread recognition that the law does have important contributions to make in assessing the practice ofmedicine and the conduct of medical research.
Download or read book Dying in America written by Institute of Medicine and published by National Academies Press. This book was released on 2015-03-19 with total page 470 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Ethical Considerations and Challenges in Geriatrics written by Angela Georgia Catic and published by Springer. This book was released on 2017-01-31 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is designed to present an overview of common geriatrics ethical issues that arise during patient care and research activities. Each chapter includes a case example and practical learning pearls that are useful in day-to-day patient care. Coverage includes a brief overview of geriatric epidemiology, highlighting the high rates of dementia, use of surrogate decisions makers at the end-of-life, relocation from home to long-term care facilities, and low health literacy in the geriatrics population. Sections are devoted to issues around capacity, surrogate decision making, end-of-life care, hemodialysis in the elderly, and futility as well as challenges presented by independence questions, such as dementia care, driving, feeding, and intimacy in nursing homes. The text also addresses questions around recognizing, reporting, and treating elder abuse and self-neglect, ethics related to research and technology in the geriatric population, and the use of e-mail, Facebook, and open notes. Written by experts in the field, Ethical Considerations and Challenges in Geriatrics is a valuable tool for trainees at a variety of levels including medical students, residents, and fellows. In addition, it provides practical guidance and a useful reference for practicing geriatricians, primary care physicians, geriatric nurses, social workers, nursing home workers, hospice care employees, and all medical health professionals working with the elderly.
Download or read book Surrogate Decision making in the Context of Critical Illness written by Barbara Birriel and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Purpose: The purpose of this study was to explore the process of surrogate decision-making during critical illness. The specific aims of the study were to describe the process of surrogate decision-making for critically ill adult patients, including surrogate decision-makers cognitive and moral decision-making processes and to develop a model explaining the process. Background: Critically ill patients are often unable to make independent decisions about their health care, requiring a family member to serve as surrogate decision-maker. Decisions made by surrogates affect not only their individual situations, but have implications for the health care system and society as a whole. The majority of work on surrogate decision-making has been related to chronic or slow progressing illness but little is known about the experiences of surrogate decision-makers during critical illness. Methods: A prospective qualitative approach was used based in grounded theory. The setting included four intensive care units (ICUs) in a large university medical center. The sample consisted of 19 surrogate decision-makers (as identified on patient record) of critically ill patients in the acute phase of critical illness who were unable to make independent health care decisions. Participants were interviewed on enrollment and 14 days later, or at the time the patient for whom they were making decisions was transferred from the ICU if sooner than 14 days. The interviews explored participants cognitive and moral decision-making processes. An interview guide framed the interviews, though participants were encouraged to speak freely. Data analysis was completed per the tenets of grounded theory, beginning with the first interview and concluding when data saturation was achieved.Results: A model of the Process of Surrogate Decision-Making in Critical Illness was developed, grounded in the data, to explain the process of surrogate decision-making in the context of acute critical illness. Four major themes emerged from the data and are included in the model: Understanding the Patients Values and Preferences, Acquiring Health Care Knowledge, Considering Family Perspectives, and Recognizing Personal Values. The overarching theme that explains the connections between the themes is Integration. Conclusions: The findings of this study bring a new perspective to surrogate decision-making during critical illness, intertwining the cognitive and moral processes. Through integration of the four identified themes, the surrogate decision-maker reaches decisions based on a broader understanding of the factors involved. Nurses are well positioned to assist surrogates through this process during the critical illness of a family member. The model of the Process of Surrogate Decision-Making in Critical Illness forms a basis for education of nurses and other healthcare providers and the development of intervention studies to optimize the results of the surrogate decision-making process.
Download or read book Approaching Death written by Committee on Care at the End of Life and published by National Academies Press. This book was released on 1997-10-30 with total page 457 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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."
Download or read book Difficult Decisions in Surgical Ethics written by Vassyl A. Lonchyna and published by Springer Nature. This book was released on 2022-01-11 with total page 743 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides a detailed guide to the ethical considerations involved when making decisions in surgery. Chapters feature a uniform format, which feature a case that represents a real-life problem, discussion of the medical indications of that issue, the latest available medical solutions, and related ethical considerations. In some cases, more in-depth debate is provided on why a particular decision should or should not be made based-upon ethical principles. Information boxes containing key statements and relevant data in clear easy-to-digest tables facilitates the reader in being able to assimilate the most important points covered in each chapter. Difficult Decisions in Surgical Ethics: An Evidence-Based Approach is a thorough review of ethical considerations in a range of surgical scenarios encompassing both adult and pediatric topics, training surgical residents, ethical care during a pandemic, critical care, palliative care, sensitivity to religious and ethnic mores, clinical research, and innovation. It is intended to be a vital resource for practicing and trainee surgeons seeking a comprehensive up-to-date resource on ethical topics in surgical practice. The work is part of the Difficult Decisions in Surgery series covering a range of surgical specialties.
Download or read book Families Caring for an Aging America written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2016-11-08 with total page 367 pages. Available in PDF, EPUB and Kindle. Book excerpt: Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.
Download or read book Yearbook of Intensive Care and Emergency Medicine 2009 written by Jean-Louis Vincent and published by Springer. This book was released on 2009-02-20 with total page 998 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Yearbook compiles the most recent developments in experimental and clinical research and practice in one comprehensive reference book. The chapters are written by well recognized experts in the field of intensive care and emergency medicine. It is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine.
Download or read book Assessing Capacities of Older Adults written by Jennifer Moye and published by American Psychological Association (APA). This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book demonstrates how to address practical and ethical challenges when assessing older adults with neurocognitive disorders, like dementia. Expanding on the ABA/APA's Assessment of Older Adults with Diminished Capacity: A Handbook for Psychologists, it explores the tension between ensuring a client's autonomy while protecting them from harm, particularly when decision-making capacity or daily living skills are impaired. Chapters cover a range of complex issues in careful detail, including financial exploitation, undue influence, sexual consent, and medical aid in dying.
Download or read book Deciding for Others written by Allen E. Buchanan and published by . This book was released on 1989 with total page 422 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is the most comprehensive treatment available of one of the most urgent problems in bioethics: decision-making for incompetents.
Download or read book Supported Decision Making written by Karrie A. Shogren and published by Cambridge University Press. This book was released on 2018-11-22 with total page 323 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrates research, theory, and practice in supported decision-making and describes implications for supports provision in the disability field.
Download or read book The Patient Self Determination Act written by Lawrence P. Ulrich and published by Georgetown University Press. This book was released on 2001-07-18 with total page 370 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices. According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient. Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates.
Download or read book Cottrell and Young s Neuroanesthesia written by James E. Cottrell and published by Elsevier Health Sciences. This book was released on 2016-10-24 with total page 481 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cottrell's Neuroanesthesia 5th Edition, edited by James E. Cottrell, MD, FRCA and William L. Young, MD, delivers the complete and authoritative guidance you need to ensure optimal perioperative safety for neurosurgical patients. Integrating current scientific principles with the newest clinical applications, it not only explains what to do under any set of circumstances but also why to do it and how to avoid complications. Comprehensive updates reflect all of the latest developments in neurosurgical anesthesia, and contributions from many new experts provide fresh insights into overcoming tough clinical challenges. New co-editor William L. Young, MD joins James E. Cottrell, MD, FRCA at the book's editorial helm, providing additional, complementary expertise and further enhancing the book's authority. New chapters keep you current on interventional neuroradiology, anesthetic management of patients with arteriovenous malformations and aneurysms, awake craniotomy, epilepsy, minimally invasive and robotic surgery, and pregnancy and neurologic disease. Comprehensive updates reflect all of the latest developments in neurosurgical anesthesia, and contributions from many new experts provide fresh insights into overcoming tough clinical challenges. Comprehensive and broad coverage of all important aspects of neuroanesthesia, including special patient populations, enables you to find reliable answers to any clinical question. Chapters written by neurointensivists, neurosurgeons, and radiologists provide well-rounded perspectives on each topic. A consistent, logical organization to every chapter makes answers easy to find quickly. Clear conceptual illustrations make complex concepts easier to understand at a glance.
Download or read book Handbook of Assessment in Clinical Gerontology written by Peter A. Lichtenberg and published by Academic Press. This book was released on 2010-08-20 with total page 753 pages. Available in PDF, EPUB and Kindle. Book excerpt: New trends in mental healthcare practice and a rapid increase in the aged population are causing an explosion in the fields of clinical gerontology and geropsychology today. This comprehensive second edition handbook offers clinicians and graduate students clear guidelines and reliable tools for assessing general mental health, cognitive functioning, functional age, psychosocial health, comorbidity, behavior deficits, and more. Psychopathology, behavioral disorders, changes in cognition, and changes in everyday functioning are addressed in full, and a wide range of conditions and disorders common to this patient population are covered. Each chapter provides an empirical review of assessment instruments, assessment scales in their totality, a review of how these instruments are used with and adapted for different cultural groups, illustration of assessments through case studies, and information on how to utilize ongoing assessment in treatment and/or treatment planning. This combination of elements will make the volume the definitive assessment source for clinicians working with elderly patients. - The most comprehensive source of up-to-date data on gerontological assessment, with review articles covering: psychopathology, behavioral disorders, changes in cognition, and changes in everyday functioning - Consolidates broadly distributed literature into single source, saving researchers and clinicians time in obtaining and translating information and improving the level of further research and care they can provide - Chapters directly address the range of conditions and disorders most common for this patient population - i.e. driving ability, mental competency, sleep, nutrition, sexual functioning, demntias, elder abuse, depression, anxiety disorders, etc - Fully informs readers regarding conditions most commonly encountered in real world treatment of an elderly patient population - Each chapter cites case studies to illustrate assessment techniques - Exposes reader to real-world application of each assessment discussed
Download or read book And a Time to Die written by Sharon Kaufman and published by Simon and Schuster. This book was released on 2005-04-19 with total page 415 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most Americans, when pressed, have a vague sense of how they would like to die. They may imagine a quick and painless end or a gentle passing away during sleep. Some may wish for time to prepare and make peace with themselves, their friends, and their families. Others would prefer not to know what's coming, a swift, clean break. Yet all fear that the reality will be painful and prolonged; all fear the loss of control that could accompany dying. That fear is justified. It is also historically unprecedented. In the past thirty years, the advent of medical technology capable of sustaining life without restoring health, the expectation that a critically ill person need not die, and the conviction that medicine should routinely thwart death have significantly changed where, when, and how Americans die and put us all in the position of doing something about death. In a penetrating and revelatory study, medical anthropologist Sharon R. Kaufman examines the powerful center of those changes -- the hospital, where most Americans die today. In the hospital world, the deep, irresolvable tension between the urge to extend life at all costs and the desire to allow "letting go" is rarely acknowledged, yet it underlies everything that happens there among patients, families, and health professionals. Over the course of two years, Kaufman observed and interviewed critically ill patients, their families, doctors, nurses, and other hospital staff at three community hospitals. In...And a Time to Die, her research places us at the heart of that science-driven yet fractured and often irrational world of health care delivery, where empathetic yet frustrated, hard-working yet constrained professionals both respond to and create the anxieties and often inchoate expectations of patients and families, who must make "decisions" they are ill-prepared to make. Filled with actual conversations between patients and doctors, families and hospital staff,...And a Time to Die clearly and carefully exposes the reasons for complicated questions about medical care at the end of life: for example, why "heroic" treatment so often overrides "humane" care; why patients and families are ambivalent about choosing death though they claim to want control; what constitutes quality of life and life itself; and, ultimately, why a "good" death is so elusive. In elegant, compelling prose, Kaufman links the experiences of patients and families, the work of hospital staff, and the ramifications of institutional bureaucracy to show the invisible power of the hospital system itself -- its rules, mandates, and daily activity -- in shaping death and our individual experience of it. ...And a Time to Die is a provocative, illuminating, and necessary read for anyone working in or navigating the health care system today, providing a much-needed road map to the disorienting territory of the hospital, where we all are asked to make life-and-death choices.
