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Finding Dignity at the End of Life discusses the need for palliative care as a human right and explores a whole-person methodology for use in treatment. The book examines the concept of palliative care as a holistic human right from the perspective of multiple aspects of faith, ideology, culture, and nationality. Integrating a humanities-based approach, chapters provide detailed discussions of spirituality, suffering, and healing from scholars from around the world. Within each chapter, the authors address a different cultural and religious focus by examining how this topic relates to questions of inherent dignity, both ethically and theologically, and how different spiritual lenses may inform our interpretation of medical outcomes. Mental health practitioners, allied professionals, and theologians will find this a useful and reflective guide to palliative care and its connection to faith, spirituality, and culture.
Maintaining dignity for patients approaching death is a core principle of palliative care. Dignity therapy, a psychological intervention developed by Dr. Harvey Max Chochinov and his internationally lauded research group, has been designed specifically to address many of the psychological, existential, and spiritual challenges that patients and their families face as they grapple with the reality of life drawing to a close. In the first book to lay out the blueprint for this unique and meaningful intervention, Chochinov addresses one of the most important dimensions of being human. Being alive means being vulnerable and mortal; he argues that dignity therapy offers a way to preserve meaning and hope for patients approaching death. With history and foundations of dignity in care, and step by step guidance for readers interested in implementing the program, this volume illuminates how dignity therapy can change end-of-life experience for those about to die - and for those who will grieve their passing.
ad;bnpaio nbqw;oreb n Is it possible to have a good death, free from unnecessary pain and trauma? What if our final days were designed to bring about reconciliation and release? In this wise and large-hearted book, Dr. Jim deMaine offers advice pointing the way toward a grace-filled transition out of life. Facing Death is both a memoir-in-vignettes and a handbook full of practical advice from Dr. deMaine's forty years in busy hospitals and ICUs. Using stories from his own life and practice, the veteran physician walks readers through ethical questions around "heroic" interventions: Do we fully understand what we're asking when we tell doctors to "do everything" to prolong life, even in cases when a patient has no chance of regaining consciousness? If we write advance directives outlining the kinds of care we would, or would not want, how can we ensure that they will be followed? As a pulmonary and critical care specialist, Dr. deMaine developed deep experience navigating such quandaries with patients and their families. In Facing Death he also treads into territory many physicians avoid, such as the role of spirituality; conflicts between doctors and families; cultural traditions that can aid or impede the goal of a peaceful transition, and ways to leave a moral legacy for our descendants.
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.
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."
Death is inevitable. But bad deaths-- accompanied by unnecessarily prolonged pain and suffering, often aggravated by immensely costly and frequently futile medical treatments-- can be avoided. This book offers clear and valuable examples of how, through frank communication with caregivers and loved ones and the use of Advance Medical Directives such as living wills, those who are facing the possibility of death in the foreseeable future, and those who help them cope, can greatly minimize or eliminate end-of-life turmoil, family dissension, and pain.
From a longtime end-of-life "midwife," a practical guide to navigating the transition from life to death. Fersko-Weiss recounts beautiful stories that show that dying doesn't need to be as bleak and soul-wrenching as we think. It can be meaningful and even life-affirming. The doula approach to death offers opportunities to explore the meaning of life and to convey that meaning through legacy work. Based on the model of care provided by birth doulas, it emphasizes thoughtful planning for how the last days of life should look, sound, and feel, and calls for around-the-clock vigil care, which provides emotional and spiritual support for both the dying person and their loved ones.
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
For readers of Being Mortal and Modern Death, an ICU and Palliative Care specialist offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care—to become an ICU physician—and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter’s journey from wanting to be one kind of hero to becoming another—a doctor who prioritizes the patient’s values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients’ pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.
Degradation, dehumanization, instrumentalization, humiliation, and nonrecognition – these concepts point to ways in which we understand human beings to be violated in their dignity. Violations of human dignity are brought about by concrete practices and conditions; some commonly acknowledged, such as torture and rape, and others more contested, such as poverty and exclusion. This volume collates reflections on such concepts and a range of practices, deepening our understanding of human dignity and its violation, bringing to the surface interrelationships and commonalities, and pointing to the values that are thereby shown to be in danger. In presenting a streamlined discussion from a negative perspective, complemented by conclusions for a positive account of human dignity, the book is at once a contribution to the body of literature on what dignity is and how it should be protected as well as constituting an alternative, fresh and focused perspective relevant to this significant recurring debate. As the concept of human dignity itself crosses disciplinary boundaries, this is mirrored in the unique range of perspectives brought by the book’s European and American contributors – in philosophy and ethics, law, human rights, literature, cultural studies and interdisciplinary research. This volume will be of interest to social and moral philosophers, legal and human rights theorists, practitioners and students.