This book examines the ethics of end of life care, focusing on the kinds of decisions that are commonly made in clinical practice. Specific attention is paid to the intensification of treatment for terminal symptoms, particularly pain relief, and the withdrawal and withholding of care, particularly life-saving or life-prolonging medical care. The book is structured into three sections. The first section contains essays examining end of life care from the perspective of moral theory and theology. The second sets out various conceptual terms and distinctions relevant to decision-making at the end of life. The third section contains chapters that focus on substantive ethical issues. This format not only provides for a comprehensive analysis of the ethical issues that arise in the context of end of life care but allows readers to effectively trace the philosophical, theological and conceptual underpinnings that inform their specific interests. This work will be of interest to scholars working in the area as well as clinicians, specialists and healthcare professionals who encounter these issues in the course of their practice.

This book provides detailed analysis of the manifold ways in which COVID-19 has influenced death, dying and bereavement.

Through three parts: Reconsidering Death and Grief in Covid-19; Institutional Care and Covid-19; and the Impact of COVID-19 in Context, the book explores COVID-19 as a reminder of our own and our communities’ fragile existence, but also the driving force for discovering new ways of meaning-making, performing rites and rituals, and conceptualising death, grief and life. Contributors include scholars, researchers, policymakers and practitioners, accumulating in a multi-disciplinary, diverse and international set of ideas and perspectives that will help the reader examine closely how Covid-19 has invaded social life and (re)shaped trauma and loss.

It will be of interest to all scholars and students of death studies, biomedicine, and end of life care as well as those working in sociology, social work, medicine, social policy, cultural studies, anthropology, psychology, counselling and nursing more broadly.

Table of Contents

List of figures

List of tables

Acknowledgements

List of abbreviations

Introduction: Capturing the beginning of a long journey of loss, trauma and grief Panagiotis Pentaris

PART 1: Reconsidering Death and Grief in Covid-19

Chapter 1. Familiarity with death

Panagiotis Pentaris and Kate Woodthorpe

Chapter 2: Grief in the COVID-19 pandemic

Kenneth Doka

Chapter 3: Apocalypse now: COVID-19 and the crisis of meaning

Robert Neimeyer, Evgenia Milman and Sherman Lee

Chapter 4: Physically distant but socially connected: Streaming funerals, memorials and ritual design during COVID-19

Stacey Pitsillides and Jayne Wallace

Chapter 5: Social death in 2020: Covid-19, which lives matter and which deaths count?

Jana Králová

PART 2: Institutional Care and Covid-19

Chapter 6: End-of-life decision-making in the context of a pandemic

Natalie Pattison and Lucy Ryan

Chapter 7: NHS Values, Ritual, Religion, and Covid-19 Death

Douglas Davies

Chapter 8: Non-COVID-19 related dying and death during the pandemic

Wai Yee Chee, Samuel Wang, Winnie Teo, Melissa Fong, Andy Lee and Woon Chai Yong

Chapter 9: Covid-19 and care home deaths and harms: A case study from the UK

Alisoun Milne

Chapter 10: Impact of Covid-19 on mental health and associated losses

Manju Shahul-Hameed, John Foster, Gina Finnerty and Panagiotis Pentaris

Chapter 11: Assisted dying and Covid-19

Theo Boer and Kevin Yuill

PART 3: Impact of COVID-19 in Context

Chapter 12: Losing touch? Older people and COVID-19

Renske Claasje Visser

Chapter 13: Between cultural necrophilia and African American activism: life and loss in the age of COVID

Kami Fletcher and Tamara Waraschinski

Chapter 14: The biopolitics and stigma of the HIV and Covid-19 Pandemics

Jason Schaub

Chapter 15: Suicide in the context of the COVID-19 pandemic

Mohammed Mamun and Jannatul Mawa Misti

Chapter 16: Death and dying during the COVD-19 pandemic: The Indian context

Apurva Kumar Pandya and Khyati Tripathi

This book examines the central structures in medicine-medical knowledge, economics, technological innovation, and medical authority-from the perspective of an ethics of care. The author analyzes each of these structures in detail before considering the challenges they present to end of life care. The perspective of an ethics of care allows for a careful focus on how these structures affect the capacity of the health care system to provide the care patients need, on the impact they have on the relationships between patients and care-givers, and on how they affect the care-givers in terms of their own sense of identity and capacity for care. This book offers one of the first focused discussions of an ethics of care across a wide range of social issues and structures in contemporary medicine. It will be of keen interest to advanced students and scholars in bioethics and health care ethics who are interested in these important issues.

High quality instruction in an authentic clinical environment is a must for all healthcare programs. Packed with strategies to help clinical instructors develop as educators and strengthen their teaching practice, this text is a key resource for those new to educating in a clinical setting. The first part of this practical book explores becoming a clinical instructor. It looks at the responsibilities of the role as well as the traits of effective clinical instructors. Introducing the concept of teacher identity, it offers suggestions for making the transition from healthcare practitioner to clinical educator. The book's second part provides information on teaching in the healthcare environment. It introduces principles of curriculum design and planning, pedagogy and teaching strategies, performance assessment, and the delivery of constructive feedback. The final chapter in this part discusses helping students prepare for entry into the healthcare workforce. The book ends with a chapter on ways to support clinical instructors. Including reflective practice exercises, practical tips for dealing with challenging situations, and sample rubrics and templates, this useful book provides a foundation for the healthcare practitioner who is beginning a career in clinical education. It is also a valuable guide for more experienced instructors and those who manage clinical instructors.

This issue of Physician Assistant Clinics, guest edited by Donna Seton and Rich Lamkin, is devoted to Hospice and Palliative Care Medicine. Articles in this issue include: Introduction to Hospice and Palliative Care Medicine, The Role of the Physician Assistant in Hospice and Palliative Care Medicine, Breaking Serious News: Communication in Hospice and Palliative Care Medicine, Advance Care Planning and Goals of Care in Hospice and Palliative Care Medicine, Palliative Care and Spirituality, Prognostic Tools in Hospice and Palliative Care Medicine, Basics of Pain Management in Hospice and Palliative Care Medicine, Dyspnea in Hospice and Palliative Care Medicine, Gastrointestinal Symptoms in Hospice and Palliative Care Medicine, Psychiatric Issues in Hospice and Palliative Care Medicine, Pediatric Palliative Care Basics in Hospice and Palliative Care Medicine, and more.

Using Guided Imagery and Hypnosis in Brief Therapy and Palliative Care presents a model for effective single-session therapy. Chapters include more than a dozen case studies with transcripts and commentary. Readers will learn how to use an adapted model of Remen's healing circle for preparing patients for surgery, and guided imagery and other approaches are presented for enhancing palliative care. Extensive appendixes provide a wide variety of valuable tools that psychotherapists can use with clients concerned with end-of-life issues.

This book explores the concept of relational care, what it feels like for older people and for carers, why it makes life happier and how those involved in residential or community care can make it work. Relational care is gaining traction as its benefits to individuals and society become recognised. This accessible book, based on real-life models and in-depth interviews, explores fresh ways that relational care can be facilitated in a variety of settings. It looks at practice in terms of team management, support for care workers, technology, design and architecture, intergenerational and multidisciplinary models, and their implications for resilience, wellbeing, policy and future funding. Chapters are arranged by theme and provide descriptions, learning points and resources for each model, as well as incorporating a wealth of interviews giving insights into the lived experience of relational care. This is a lively book full of realistic ideas and information for everyone who wants to find out more about, access or implement the best in care - the best for older people, their families, care workers, management and society.

This book explores the concept of relational care, what it feels like for older people and for carers, why it makes life happier and how those involved in residential or community care can make it work. Relational care is gaining traction as its benefits to individuals and society become recognised. This accessible book, based on real-life models and in-depth interviews, explores fresh ways that relational care can be facilitated in a variety of settings. It looks at practice in terms of team management, support for care workers, technology, design and architecture, intergenerational and multidisciplinary models, and their implications for resilience, wellbeing, policy and future funding. Chapters are arranged by theme and provide descriptions, learning points and resources for each model, as well as incorporating a wealth of interviews giving insights into the lived experience of relational care. This is a lively book full of realistic ideas and information for everyone who wants to find out more about, access or implement the best in care - the best for older people, their families, care workers, management and society.

This issue of Medical Clinics, guest edited by Dr. Eric Widera, is devoted to Palliative Care. Articles in this important issue include: Hospice and Palliative Care: An Overview; Goals of Care Conversations in Palliative Care: A Practical Guide; The Art and Science of Prognostication in Palliative Care; Recognizing and Managing Polypharmacy in Advanced Illness; Pain Management in those with Serious Illness; Management of Grief, Depression, and Suicidal Thoughts in those with Serious Illness; Management of Respiratory Symptoms in those with Serious Illness; Management of Gastrointestinal Symptoms in Advanced Illness; Management of Urgent Medical Conditions at the End of Life; Delirium at the End of Life; Options of Last Resort: Palliative Sedation, Physician Aid in Dying and Voluntary Cessation of Eating and Drinking; Cannabis for Symptom Management; and Self-care of Physicians Caring for Patients with Serious Illness.

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.

Death and Dying is an important core text for students and professionals interested in developing a holistic understanding of death and dying. Chapters are replete with case studies, activities, key point boxes, and other features that enable readers to develop a sociologically informed understanding of the broad range of complex issues that underpin death and dying. Written by two established and highly respected experts in the field, it offers a thoroughgoing account of a wide range of social aspects of death and dying, filling gaps left by the traditionally narrow focus of the existing literature. By drawing the suggested sociological perspectives and highlighting the role of social policy, the authors put forward a fresh perspective of the field of thanatology. This book is a major contribution in progressing knowledge and understanding of dying and death for students and professionals in counseling, health and human services.

This book draws together the learning of a wide range of social workers and other professionals engaged in end of life care who recognise that dying is essentially a social experience and want to tailor a personal, professional and societal response accordingly. Through a systemic lens, the book explores the nature and experience of living and dying in the UK today, then considers ways in which social workers and others may want to work with people who are affected by a diagnosis of a life-threatening condition. The contributors offer rich and contemporary perspectives on death, dying and loss, reflective of their different approaches and interests. The insights of the book are timely, given the growing levels and changing nature of needs for people who are coming to the end of their life in the UK and beyond, and the related requirements for compassionate, personalised and holistic care within the increasingly professionalised arena of health and social care. This book will be of interest to social work practitioners, students, and others committed to psychosocial support of people who are dying or bereaved, and who want to consider how to provide this support most effectively. Professionals who are interested in working alongside social workers to deliver high quality end of life care will also find this publication useful. This book was originally published as a special issue of the Journal of Social Work Practice.

The Dying Patient in Psychotherapy is a powerful account of love and death within a psychotherapeutic relationship. The narrative traces one man's journey in psychotherapy and that of the analyst who accompanies him. The full-length description of an analysis demonstrates the developmental path of an erotic transference from its origins in infancy, through fantasies of sex and violence to mature erotic intimacy. The countertransference is considered with exceptional honesty as the analysis intensifies following the diagnosis of a life-threatening illness. A series of dreams rich in symbolic imagery traces the psychological situation as death approaches. A precursor to Schaverien's acclaimed book Boarding School Syndrome, the single case study demonstrates the enduring impact of early boarding. This second edition also includes an updated literature review, and new material regarding training and supervision, making it a valuable resource for training institutions. The Dying Patient in Psychotherapy will be essential reading for psychoanalysts, psychotherapists, counsellors, arts therapists and all professionals working with the dying. The poignant story will also engage the general reader, curious about the process of psychotherapy.

This issue of Primary Care: Clinics in Office Practice, guest edited by Drs. Alan R. Roth, Peter A. Selwyn, and Serife Eti, is devoted to Palliative Care. Articles in this important issue include: Introduction to Hospice and Palliative Care; Hospice for the Primary Care Physician; Pain Assessment and Management; Non-Pain Symptom Management; Communication Skills: Delivering Bad News, Conducting a Goals of Care Family Meeting, and Advance Care Planning; Psychosocial Issues and Bereavement; Ethical and Legal Considerations in End of Life Care; Cultural, Religious, and Spiritual Issues in Palliative Care; Palliative Care Approach to Chronic Diseases (CHF/COPD/ESLD/ESRD); Palliative Care in HIV/AIDS; Palliative Care in the Elderly (Dementia, Neurodegenerative Disorders, Functional Decline/Frailty); and Pediatric Palliative Care.

There have been impressive improvements in the diagnosis and treatment of cancer in recent decades. In economically advantaged countries with well-developed healthcare systems over 50% of all cancer patients achieve long term survival and are probably cured. Not only has survival improved radically for cancer patients but also there has been an increasing focus on the quality of patient's lives, on improving the patient experience of care and on developing effective support for the very many cancer survivors. Despite the progress in cancer treatment, unfortunately a substantial number of cancer patients will still ultimately die of their disease. For many this will follow periods of successful treatment which results in good remissions and good quality of life. Helping patients to make the right choices about their care towards the end of their lives is one of the greatest and most challenging responsibilities of all healthcare professionals. Legal change on the provision of assisted dying by healthcare professionals has occurred in a substantial number of jurisdictions. This work brings together contributions on end of life choices from experienced professionals from oncology disciplines, palliative care, law, nurses and professions allied to medicine. The goals are: * To better inform cancer care professionals and the wider community about developments in choices in end of life care for cancer patients internationally. * To better answer questions from patients and respond to requests from patients, including questions about and requests for assisted dying in countries where it is legal to do so. * To have a balanced and well informed dialogue about choices available to patients without developing a formal policy position on change in law. * To provide a basis of information for future educational activities.

Given that treatment with curative intent is possible in only one-half of cancer victims, and that such treatment frequently fails, the majority of patients with cancer will require relief of symptoms and signs caused by their disease. In this book, the specific contribution of radiation therapy to palliation is considered within the context of multidisciplinary management. Individual chapters are devoted to palliative radiation therapy for primary tumours and metastases at different sites. The management of pain is discussed, and chapters are also devoted to end of life care, the management of complications of radiation therapy, and useful medications. This book will prove useful and interesting not only to radiation oncologists but also to medical students of all ages and to doctors from all disciplines who are concerned with the relief or prevention of suffering in patients with cancer.

Increasing attention is being paid to the needs of cancer patients who present acutely with issues relating to their diagnosis an management, complications of their cancer, complications arising from their treatment, or who require appropriate symptom control or palliative care. Recent years have seen substantial service development to ensure acute oncology is appropriately provided, to improve outcomes and wellbeing of patients. A team of experts in cancer care have completely revised and updated the previous edition of this book to produce a template that can be used by any professional involved in the planning and delivery of acute oncology care around the world. This title is formally supported by the Association of Cancer Physicians (ACP). This highly patient-centred, readable text will be of value to clinicians and healthcare professionals, healthcare strategic and operations managers, and doctors in training, in their daily work.

Perinatal hospice is a novel form of care for an unborn child who has been diagnosed with a significantly life-limiting condition. In this book, Aaron D. Cobb develops a virtue-based defense of the value of perinatal hospice. He characterizes its promotion and provision as a common project of individuals, local communities, and institutions working together to provide exemplary care. Engaging with important themes from the work of Alasdair MacIntyre and Robert Adams, he shows how perinatal hospice manifests virtues crucial to meeting the needs of families in these difficult circumstances. As a work of applied virtue ethics, this book has important normative, social, and political implications for the creation and development of structured programs of care. It grounds the view that communities ought (i) to devote resources to ensure that these programs are widely available and (ii) to develop social structures that promote awareness of and accessibility to these forms of care. A Virtue-Based Defense of Perinatal Hospice will be of interest to philosophers working in bioethics and applied virtue ethics, as well as scholars in the fields of neonatology, nursing, palliative and hospice care, and counseling who are interested in the study of perinatal hospice.

The International Handbook of Art Therapy in Palliative and Bereavement Care offers a multicultural and international perspective on how art therapy can be of help to individuals, groups, families, communities, and nations facing death and dying as well as grief and loss. Over 50 art therapists from around the world write about the transforming power of art therapy in the lives of those facing terminal illness, dementia, loss, and grief. They offer practical descriptions and techniques for working with adults and children to guide professionals, including those new to using art therapy and creative approaches in end-of-life care services. This international handbook is essential reading for arts therapists, social workers, medical personnel, faith leaders, and psychologists interested in a collaborative and accessible approach to working with patients and families affected by loss.

This is the first book to explore how religion, belief and spirituality are negotiated in hospice care. Specifically, it considers the significant place that spiritual care has in hospice care and claims that the changing role of religion and belief in society highlights the need to re-examine how such identities are integrated in professional practice. Using religious literacy as a framework, the author explores how healthcare professionals in hospice care respond to religion, belief and spiritual identities of service users. Part 1 provides a comprehensive account of the content and history of the place of religion, belief and spirituality in hospice care. Part 2 examines how these topics are negotiated in hospice care by looking at three key areas: environment, professional practice and organisation. Part 3 proposes a religious literacy model applicable to hospice care and explores implications for practice and policy. Lastly, the author identifies future trends in research, policy and practice. Drawing on a range of theories and concepts and proposing a working model that can impact the training of future and current professionals, Religious Literary in Hospice Care should be considered essential reading for students, researchers and practitioners.

Palliative Care Within Mental Health: Ethical Practice explores the comprehensive concerns and dilemmas that occur surrounding people experiencing mental health problems and disorders. Working beyond narrow, stereotypical definitions of palliative care as restricted to terminal cancer patients, this balanced and thought-provoking volume examines the many interrelated issues that face the individual, families, and caregivers, setting the groundwork for improved, ethical relationships and interventions. Chapters by experts and experienced practitioners detail the challenges, concerns, and best practices for ethical care and responses in a variety of individual and treatment contexts. This is an essential and thoughtful new resource for all those involved in the fast-developing field of palliative mental health.

Life at Home for People with a Dementia provides an evidence-based and readable account of improving life at home for people with a dementia and their families. There are estimated to be 47 million people with a dementia worldwide, the majority of whom will live, or want to live, in their own home. Yet there is a major shortcoming in available knowledge on what life is like for people with a dementia living at home. Most research focuses on care in hospitals or care homes, and takes a medical perspective. This book bridges this gap in knowledge by providing a comprehensive and critical overview of the best available evidence on enabling people with a dementia to live well at home from the viewpoint of those living with the condition, and in the context of global policy drivers on ageing and health, as well as technological advances. The book includes chapters on citizenships - that is, the diversity of people living with a dementia - enabling life at home, rethinking self-management, the ethics and care of people with a dementia at home, technological care and citizenship, and sharing responsibilities. It concludes with a care manifesto in which we set out a vision for improving life at home for people with a dementia that covers the areas of professional practice, education and care research. By covering a wide range of interrelated topics to advance understanding and practice as to how people with a dementia from diverse backgrounds can be supported to live well at home, this book provides a synthesised, critical and readable understanding of the complexities and risks involved.

The majority of doctors and nurses involved in specialist palliative care reject the legalisation of physician assisted suicide (PAS). This book explores the reasons why the healthcare professionals who have the most experience of caring for dying patients should object to a change in the law. Debate about euthanasia and PAS often arises in response to a well publicised tragic case of unrelieved suffering. Such heart rending stories do not reflect the fact that the majority of people dying have a dignified death. There is a marked disparity between medical intuitions and the philosophers' arguments about euthanasia and PAS. It seems that part of the moral constitution of a doctor is a commitment not to intend the death of a patient and to protect them from harm. The perspective of those who are privileged to care for thousands of dying patients and their families should inform the debate about PAS.This book will enable those who are not working within palliative care to gain an insight into the scope of this speciality and to understand why legalisation of PAS should be resisted to maintain and improve care of dying patients.

This book provides healthcare professionals with a practice theory for the care and management of patients who have been diagnosed with cancer. It explores what patients experience and how healthcare professionals can assist them in dealing with their uncertainty and fear as well as planning for the future. Unique to the book is its explication of the emerging theory, 'The Omnipresence of Cancer', which is set in the context of a discussion of earlier theories also concerned with cancer care. Chapters demonstrate how 'The Omnipresence of Cancer' has been developed, validated through research and being further tested in relation to cancer care. In particular, a chapter on philosophical reflections using theory to produce knowledge for practice is included. Each chapter provides essential background, a synthesis of the current state of knowledge, and practice examples associated with cancer care. The combination of theoretical reflection and practice examples is designed to promote comprehension and guidance on implementation of the theory, as well as recommendations for practice. This book will be of significant interest to healthcare students and professionals working in the field of cancer care and oncology, particularly healthcare professionals working in advanced practice roles and nurse educators. It is also anticipated that professionals working in pastoral care, occupational therapy, social work and radiography will be interested in this book.

The third edition of Hospice and Palliative Care is the essential guide to the hospice and palliative care movement both within the United States and around the world. Chapters provide mental-health and medical professionals with a comprehensive overview of the hospice practice as well as discussions of challenges and the future direction of the hospice movement. Updates to the new edition include advances in spiritual assessment and care, treatment of prolonged and complicated grief, provision of interdisciplinary palliative care in limited-resource settings, significant discussion of assisted suicide, primary healthcare including oncology, and more. Staff and volunteers new to the field along with experienced care providers and those using hospice and palliative care services will find this essential reading.