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This book provides the best information available on the ways priorities are currently set for health care around the world. It describes the methods now used in the six countries leading the process, and contrasts the differences between them. It shows how, except in the UK, frameworks have now been developed to set priorities. Making Choices for Health Care sets forth the key issues that need to be tackled in the years ahead. Descriptions of the leading trends are accompanied by suggestions to resolve outstanding difficulties. Topics include: the need for national research and development funding for new treatments, ways to shift resources permanently towards prevention and chronic care, and how DALYs may replace QALYs. While the concepts and values underlying priority setting have been discussed elsewhere, Making Choices for Health Care highlights real current practice. It is a vital tool for policy-makers, health care managers, clinicians, patient organizations, academics, and executives in pharmaceutical and medical supply industries.
'The Textbook of Palliative Care Communication' is the authoritative text on communication in palliative care. Uniquely developed by an interdisciplinary editorial team to address an array of providers including physicians, nurses, social workers, and chaplains, it unites clinicians and academic researchers interested in the study of communication.
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.
This major new work updates and significantly expands The Hastings Center's 1987 Guidelines on the Termination of Life-Sustaining Treatment and Care of the Dying. Like its predecessor, this second edition will shape the ethical and legal framework for decision-making on treatment and end-of-life care in the United States. This groundbreaking work incorporates 25 years of research and innovation in clinical care, law, and policy. It is written for physicians, nurses, and other health care professionals and is structured for easy reference in difficult clinical situations. It supports the work of clinical ethicists, ethics committee members, health lawyers, clinical educators, scholars, and policymakers. It includes extensive practical recommendations. Health care reform places a new set of challenges on decision-making and care near the end of life. The Hastings Center Guidelines are an essential resource.
This casebook provides a set of cases that reveal the current complexity of medical decision-making, ethical reasoning, and communication at the end of life for hospitalized patients and those who care for and about them. End-of-life issues are a controversial part of medical practice and of everyday life. Working through these cases illuminates both the practical and philosophical challenges presented by the moral problems that surface in contemporary end-of-life care. Each case involved real people, with varying goals and constraints,who tried to make the best decisions possible under demanding conditions. Though there were no easy solutions, nor ones that satisfied all stakeholders, there are important lessons to be learned about the ways end-of-life care can continue to improve. This advanced casebook is a must-read for medical and nursing students, students in the allied health professions, health communication scholars, bioethicists, those studying hospital and public administration, as well as for practicing physicians and educators.
Focusing on counselling bereaved clients and those with terminal illness, this book contains case studies, reflective thoughts and feelings of both the client and counsellor. Boxed key points and references to person-centred theory aid easy comprehension.
This practical guide briefly covers the historical and epidemiological background of palliative care and the growth of palliative medicine as a specialty, before dealing with major physical, psychological, spiritual, and symptom management issues from diagnosis to bereavement care.
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."
'Healthcare professionals spend much of their time listening to stories of sickness related by patients and their families. It thus seems appropriate that drama, which is primarily concerned with exploring narratives, change and crises and relies, like the clinical situation, on communication, is an ideal medium for healthcare professionals to gain new insights into care.' From the Introduction Good communication forms the heart of patient-centred care and is the cornerstone of a trusting relationship. Enhancing Compassion in End-of-Life Care Through Drama explores a broad range of plays from Greek tragedy to the present day and investigates how particular theatrical dynamics help to understand complexities in the setting of end-of-life care. It examines fresh ways to interpret the action and subtext represented on the stage and finds symmetries in a clinical context. It is ideal for use in a range of educational contexts, with practical ideas for workshops and summaries of key concepts in each chapter. This book will motivate all members of the multidisciplinary palliative care team including palliative care professionals, doctors, nurses, psychologists, spiritual advisers and social workers. Although based in the setting of palliative care, the learning points are relevant to all areas of clinical practice.
Ethics in Mental Health-Substance Use aims to explore the comprehensive concerns and dilemmas occurring from mental health and substance use problems, and to inform, develop, and educate by sharing and pooling knowledge, and enhancing expertise, in this fast developing region of ethics and ethical care and practice. This volume concentrates on ethical concerns, dilemmas, and concepts specifically interrelated, as a collation of problem(s) that directly or indirectly affect the life of the individual and family. Whilst presenting a balanced view of what is ethically best practice today, this title challenges concepts and stimulates debate, exploring all aspects of the development in treatment, intervention and care responses, and the adoption of research-led best practice.