Medical futility is a controversial issue not only in its definition but also in its application. There are few books on the subject, and those in existence mostly focus on the situation in the United States. This title, however, provides extensive international perspectives on medical futility.This book will benefit healthcare professionals as well as health policy makers around the world. It allows them to see how different countries approach the issue of medical futility and their experiences in dealing with this issue. The complexity of the issue, and in particular how some countries innovatively address it in an ethically sound manner, is clearly presented.

There are few enough studies of the needs of dying people in the Western world, but no accessible studies of the needs of dying people in Asian cultures. Now, in this pioneering work, Dr Mui Hing June Mak shows us how a Good Death expresses itself in Hong Kong, and also how this ideal varies and is modified in other Asian societies as this is observed in their own, often inaccessible literature. The author offers a comprehensive review of the literature on dying conduct and needs from several Asian perspectives, and also provides a perceptive analysis of the lessons to be learnt from her qualitative study which employed a 'Grounded Theory' methodology to understand the experiences and end-of-life needs of cancer patients in hospice care in Hong Kong. A relation-based theory, Harmonious Death, is developed. She also makes several suggestions to translate these theoretical concepts into practice. Dr Mak brings to her words not only the disciplined eye of a hospice clinician and academic but also a compassionate insight derived from her direct personal experiences. Close, personal relationship with three dying people were formative of her current research and professional interests, and also the driving concern in ensuring that the voices of all the participants in her study are heard clearly, sympathetically, and poignantly. Audience: The book will be of interest to teachers, students and professionals across the whole range of health and social care and social work, particularly those in palliative or hospice settings, as well as well as those with an interest in behavioural and social sciences, anthropology, philosophy, thanatology, not to mention the humanities. Contents: Foreword by Professor Allan Kellehear . literature review . Western and Chinese perspectives on death and dying . the research study . elements of a Good Death in Chinese culture: awareness of death; maintaining hope; freedom from pain and suffering; maintaining social relations; experiencing personal control; preparation and bidding farewell; accepting the timing of one's death A Harmonious Death, The Good Death models . Conclusions and recommendations for hospice philosophy, education, research and health policy

Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment explores the pressures and challenges facing hospice and aims to produce new studies and educational materials on hospice ethics to help professionals in the field. Many of the tensions felt by caregivers and practitioners in hospice stem from uncertainty about the ethical mission of hospice and the ethical dilemmas arising in practice. This volume, a result of The Hastings Center and the Hospice Foundation of America s project on Ethical and Policy Issues in Hospice Care, addresses these issues in a clear, accessible way.Ethics in Hospice Care outlines the economic, social, and cultural challenges facing hospice care in a changing society and a changing health care environment. Issues of concern include: financial pressures as policymakers limit Medicare spending organizational pressures as hospice organizations enter a variety of new relationships with managed care organizations, home health agencies, and hospitals cultural and social challenges as Americans wrestle with moral and legal issues of death and dying and physician-assisted suicide the rapid and unplanned growth of the movement--from a single hospice in 1973 to over 2500 todayWhile primarily for practicing hospice professionals, Ethics in Hospice Care is vital reading for everyone concerned with assisted suicide, patients'rights, quality of life, managed care, physician referral, professional development, pain management, quality of care, and ethics committees.

"I just wish I had armfuls of time." These are the words of a four year old facing a life-threatening illness. This text portrays the psychological experience of such children, who are irreversibly changed from the moment of diagnosis. Barbara Sourkes is a psychologist who specializes in psychotherapy with children who have cancer and other serious diseases. In the account, she describes how she works with these children, using drawings, soft toys and dolls, stories and real medical instruments to allow them to communicate their experience of the illness, the treatment they undergo, their relationship with their families, and their feelings of grief and loss in coming to terms with the prospect of death. Making use of the words of children, offering interpretations and practical advice, this is a book that should be useful reading for those concerned with the care of terminally ill children.

This educational workbook helps people who build compassionate relationships with dying people. Accompanied by its trainer's guide, it presents a comprehensive, sequential learning program for caregivers in non-medical capacities covering everything from self-understanding to spiritual issues, listening skills and expressive activities, developing the skills, awareness and resilience needed for this privileged and sensitive role. The program includes a variety of learning experiences, including large and small group activities, discussion, close reading, creative writing, self exploration, and skill development and practice. This is an invaluable resource for small groups of individuals who wish to volunteer in hospice or palliative care settings. A copy of the guide for trainers is included in each pack of workbooks, and is also freely available online. 'The best resource I have seen to guide teachers and learners in this complex training process. I predict that those of you who try it with your staffs and trainees will find that it bears fruit both for your patients and their families, but also for the sustenance and personal development of the staff members themselves.' Timothy Quill, M.D., in his Foreword

Death strips away all of the superficial and mundane details of living and leaves behind life's bare essentials. Death is inevitable in life. It knows no boundaries. It knows no skin color, no financial or social standing. It knows nothing but itself. The paradox of Dying Declarations: Notes from a Hospice Volunteer is in its warm affirmation of life through the 'dying declarations' of patients who are peering into the cold face of death. The author reveals personal experiences about life, death, and the courage to strip away the unimportant aspects of life to make way for a clearer understanding on just what is truly important. Simple, moving stories invigorate and spark insightswhile discussing all aspects of hospice volunteering. By facing death on a regular basis, one can no longer maintain a tight grip on the masks, games, and trivialities that one uses to hide from truth. The person who looks death in the eye becomes more honest, grateful, compassionate, and humble. In Dying Declarations: Notes from a Hospice Volunteer, the author shares his experiences and the lessons he learned from the dying while working as a hospice volunteer. The stories, rather than being sad and depressing, present the author's hospice experience as being some of the most personally uplifting and enriching experiences of his life. In Dying Declarations: Notes from a Hospice Volunteer you will learn: about training for hospice work why hospice volunteers are at times more beneficial to the well-being of dying patients than family, clergy, or medical personnel the three basic tasks for a hospice volunteer how children and dogs can be beneficial for patients the impact that a dying patient can have on the life of a hospice volunteer words of wisdom about living life, directly from hospice patients Dying Declarations: Notes from a Hospice Volunteer will inspire and enlighten hospice volunteers, nurses, physicians, clergy, social workers or anyone who works for hospice or provides end-of-life care.

This book provides a clear approach to establishing a user involvement system in a healthcare organisation and its potential impact on cancer services. Using a tool kit style approach drawing on examples of successful past projects and case studies to provide evidence of good practice it describes how to plan and implement different stages of user involvement enabling organisations to draw on user experience and expertise to evaluate develop and improve the quality of service that they provide. Members of regional cancer networks multidisciplinary cancer care teams and all those involved in the NHS cancer services will find this toolkit interesting reading.

This is a comprehensive account of the psychology of death and bereavement, which places the subject within the contexts of the major world religions and their associated mourning and funeral customs. Clearly written, well referenced and carefully organized, the book examines the thinking of Freud and Jung and of modern psychiatrists, and also discusses those aspects of death - bereavement visions, euthanasia, grief for a pet and suicide - which are not covered elsewhere.The second edition has enabled the contents to be updated and enlarged. There are five new chapters, including one dealing with the scientific assessment of death: another looks at the psychological insights provided by Shakespeare, whilst a third deals with the beliefs and customs of minority groups - the Bahais, Jehovah's Witnesses, Mormons, Quakers, Spiritualists and Seventh-day Adventists. The text is highly accessible and uses case histories to bridge the gap between theory and experience in an novel and creative way.

Deckhead: An important examination of the theological, spiritual and ethical issues surrounding death.

What do faithful living and faithful dying mean as we near life's end? With all the technology and choices available to us today, making decisions about the end of life grows ever more difficult. As a result of all the theological and ethical issues that have arisen around the dying process in recent years, the 72nd General Convention of the Episcopal Church created a task force to study and report on these concerns. This is the report of the End-of-Life Task Force. In it, the Task Force responds to the broad range of theological, ethical, pastoral and policy issues that are generated by the need to provide loving and fitting care at the end of life.

Intended as a teaching document, Faithful Living, Faithful Dying will be useful as a discussion tool for the church, for individuals facing difficult decisions, for professionals, such as clergy and health care providers, and for those who make public policy.

Taking as its focus a highly emotive area of study, The Dying Process draws on the experiences of daycare and hospice patients to provide a forceful new analysis of the period of decline prior to death.
Placing the bodily realities of dying very firmly centre stage and questioning the ideology central to the modern hospice movement of enabling patients to 'live until they die', Julia Lawton shows how our concept of a 'good death' is open to interpretation. Her study examines the non-negotiable effects of a patient's bodily deterioration on their sense of self and, in so doing, offers a powerful new perspective in embodiment and emotion in death and dying.
A detailed and subtle ethnographic study, The Dying Process engages with a range of deeply complex and ethically contentious issues surrounding the care of dying patients in hospices and elsewhere.

The fifth edition of this seminal reference and text in palliative care nursing helps the practitioner and student offer comprehensive, targeted interventions responsive to the needs of palliative and hospice patients and families. Based on the best level of evidence available, reference to clinical practice guidelines, and palliative care order sets to address critical symptoms, the knowledge presented in this edition supports compassionate, timely, appropriate and cost-effective care to achieve quality health outcomes for diverse palliative care populations across the illness trajectory. Noteworthy features of the new edition include broadening population health management by helping the reader to identify patterns and connections within and across population and utilize information to respond to the needs of populations. This strategy allows the reader to apply strategies that are consistent with IHI's Triple Aim that includes Improving the patient experience of care, Improving the health of populations and reducing the per capita cost of health care. Every Chapter in Sections 1, 2, and 3 includes an Evidence Based Box with a current study including a commentary written by someone from a discipline other than nursing or by an interdisciplinary team.

Christopher Kerr is a hospice doctor. All of his patients die. Yet he has tended thousands of patients who, in the face of death, speak of love, meaning and grace. They reveal that there is hope beyond cure as they transition to focus on personal meaning. In this extraordinary and beautiful book, Dr. Kerr shares his patients' stories and his own research pointing to death as not purely the end of life, but as a final passage of humanity and transcendence. Drawing on interviews with over 1,200 patients and more than a decade of quantified data , Dr. Kerr reveals why pre-death dreams and visions are remarkable events that bring comfort and exemplify human resilience. These are not regular dreams. Described as "more real than real," they frequently include loved ones long gone and mark the transition from distress to acceptance. These end-of-life experiences help patients restore meaning, make sense of the dying process and assist in reclaiming it as an experience in which they have a say. They also benefit the bereaved who get relief from seeing their loved ones pass with a sense of calm closure. Beautifully written with astonishing stories, this book, at its heart, celebrates the power to reclaim how we die, while soothing the bereaved who witness their loved ones go with unqualified grace.

Hospice Care and Cultural Diversity captures the richness and differences that make up the United States and its culture. This book shows you the complex issues arising from work with patients of a different culture and encourages research in hospices which support culturally innovative programs. Many people are individually knowledgeable and culturally sensitive, but few hospices have systematically planned for service to culturally diverse groups. This volume identifies who is implementing organizational programs of cultural sensitivity and acknowledges the efforts of those individuals working to make hospice accessible to everyone.Hospice Care and Cultural Diversity contains original research, personal insights, and overviews to help you understand what is being done in the field. Specifically, chapters discuss: National Hospice Organization activities, goals, and recommended actions death and dying from a Native American perspective breaking barriers to hospice for African Americans a case study of the development of a culturally sensitive treatment plan in pre-hospice south Texas caregiving norms surrounding dying and use of hospice services among Hispanic American elderly cultural considerations surrounding childhood bereavement among Cambodians in the U.S. one hospice's experience in identifying and meeting the needs of ethnic minority patientsPeople from many different cultures are eager to share their customs, practices, and beliefs. They want hospice providers to understand their culture, and they want their community served by hospice. The only book of its kind, Hospice Care and Cultural Diversity is a valuable reference and source of ideas for anyone interested in the delivery of hospice services. From students to experts, you will find much information to help make hospice care accessible and comfortable for all groups of people.

Palliative medicine is the medical care provided for people who have a life limiting illness or condition. It encompasses both the physical symptoms a person may experience but also the psychosocial, emotional, and ethical issues that may arise. Now in its fourth edition, Palliative Medicine: A Case-Based Manual walks clinicians through the management of the most common situations found in palliative medicine, from diagnosis and managing symptoms through to grief and bereavement. Using real patient case scenarios and an easy-to-read question and answer format, it gives students and medical professionals an accessible, evidence-based entryway to gain the skills and knowledge needed to provide high quality palliative and end of life care to patients and their families. This new edition has been fully updated to cover the latest guidance, including new chapters dedicated to medical cannabis, opioids, grief and bereavement, and wider issues including palliative care in the community, structurally vulnerable populations, and public health. Written by over 50 experienced palliative care clinicians and educators, this book will be a welcome guide for palliative care workers, medical and nursing students, and medical professionals of any specialty where palliative needs might arise.

'Warm, wise and practical' Cressida Cowell, MBE An invaluable reference for parents of sick or hospitalised children by an experienced and eminent psychologist. To many parents, it is hard to imagine a more upsetting reality than one where their child is hospitalised, severely sick, or terminally ill. In When Your Child is Sick, psychologist Joanna Breyer distils decades of experience working with sick children and their families into a comprehensive guide for navigating the uncharted and frightening terrain. She provides expert advice to guide them through the hospital setting, at-home care, and long-term outcomes. Breyer's actionable techniques and direct advice will help parents feel more in-control of a circumstance that has upended their life. She alerts parents to key personnel in the hospital, gives dialogue prompts to help parents ask for the help they need, addresses the needs of their other children at home, offers advice on how to best utilise friends and family who want to help, includes stories from other families who have been there, and teaches coping techniques to help both parents and children weather the stress of prolonged illness and even death. When Your Child is Sick is a valuable guide to managing the myriad practical and emotional complications of an impossible situation.

The needs of critically ill children are unique and highly specialized. "Paediatric Intensive Care Nursing" is an essential manual of care and an invaluable resource to all those involved in the care of critically ill children and young people. Covering all the key aspects of pediatric intensive care, it is a fully comprehensive textbook which provides an evidence-based and up-to-date guide for all nurses who work with critically ill children.

"Paediatric Intensive Care Nursing" is divided into four user-friendly sections: The first section looks at the general background of paediatric intensive careSection two employs a systems approach, with each chapter focusing on a specific disease and following the same framework. This includes treating children with cardiac conditions, acute neurological dysfunction, musculoskeletal injuries and gastrointestinal and endocrine conditionsSection three looks at the essential care of managing pain relief, transportation needs and treating woundsThe final section explores the holistic aspects of nursing - nutrition and fluid management, infection control issues, safeguarding children and spirituality and bereavement

Written by a team of experts in the field, "Paediatric Intensive Care Nursing" is indispensable reading for nurses and health care professionals working with critically ill children.

Dieses Buch fasst den aktuellen Forschungsstand zum Thema Cannabis zusammen. Hierfur wurden alle bedeutsamen, in den letzten 10 Jahren in deutscher und englischer Sprache publizierten Forschungsarbeiten systematisch recherchiert und ausgewertet. Dargestellt werden: - psychische, organische und soziale Risiken des Konsums pflanzlicher und synthetischer Cannabisprodukte zu Rauschzwecken, - Wirksamkeit, Vertraglichkeit und Sicherheit von Cannabisarznei bei organischen und psychischen Erkrankungen, - Motive und Erwartungen eines nichtarztlich verordneten Gebrauchs von Cannabis im Sinne einer Selbstmedikation. Die Expertise liefert einen umfassenden UEberblick uber die aktuelle Literatur. Sie bewertet das therapeutische Potenzial und die Risiken von Cannabis entsprechend internationaler methodischer Vorgaben der evidenzbasierten Medizin. Die Expertise dient somit als solides Nachschlagewerk. Ihr Auftraggeber war das Bundesministerium fur Gesundheit.

In this extraordinary book, Iona Heath draws on her experience as a general practitioner to select and comment on a collection of passages concerning death and dying, and to consider the essential nature of general practice. In Ways of Dying Heath illuminates the process for professionals and lay readers, and stimulates consideration of approaches to improved care at end of life. Her renowned work The Mystery of General Practice (which has been unavailable for some time), considers the complex character of this field, its core values and changing roles. The two extended essays cover important issues on the role of the healthcare professional in the care of the dying, the idea of life and death, and the essential nature of general practice. Matters of Life and Death offers inspiration for all doctors, especially those with an interest in medical humanities. It will also be of great interest to general readers interested in end of life matters, and the nature and art of medicine.

"Children's palliative care is an evolving specialty and as such our knowledge base cannot remain static. This book constantly challenges the reader to critically analyze their own practices and beliefs within an evidence-based framework and as such makes a valuable contribution to the growing body of knowledge on this important subject." - Susan Fowler-Kerry, in the Foreword. This book caters for readers from different working environments and levels of experience. It is ideal for paediatric nurses with no specialist palliative care knowledge, and also for palliative care nurses with no specialist paediatric experience. Other healthcare professionals and therapists working with children, young people and their families will also find this book invaluable. It will also be ideal for undergraduate and postgraduate health and social care students, and professionals involved in children's hospices, community services and charity groups. "This book captures not just the rapidly evolving evidence base, but also as many current developments as possible and applies them in a meaningful way to the care of infants, children, and young people living with life-limiting illness, and their families. It offers an overview of contemporary issues and helps to stimulate the type of dialogue that can bring about the actions that will make a real difference for the children, young people and families in our care." - Rita Pfund, in the Preface.

This book explores the Care Trust concept promoted by central government for improving partnership working between health and social care. Using case studies and examples to raise current issues related to partnership working it explains how Care Trusts are bridging the gap between health and social care and considers how they are delivering more co-ordinated services and improved outcomes. All healthcare and social care professionals with responsibility for involved in or affected by the new partnership working arrangements will find this book useful reading.

'This book is a tribute to expert nursing. It should be seen as a celebration of all that is good in nursing. It also sets out the path for nursing that is centred on relationships - the essence of person-centred nursing is based on the quality of relationships both between nurse the client and others and also between nurses their colleagues and peers. Increasingly it is a challenge for nurses to hold on to humanistic care when we practice in a world of healthcare which is performance and fiscally driven. The concept of partnership and reciprocity runs through the book like a golden thread gleaming in a rich tapestry of person-centred practice expressed via the perspectives of the contributors. Expert practitioners working with people who have dementia have led the way in the development of person centred practice.' Pauline Ford Advisor in Gerontological Nursing Royal College of Nursing 'This book is a compendium of contemporary dementia care practice. It provides knowledge that is the foundation for a clear path to successful care outcomes. It clearly leaves no room for the ignorance that produced the uncertainty and inconsistency of past practices. If dementia can be likened to a journey of highs and lows this book shows us how to eliminate the negatives and accentuate the positives.' Bob Price Director Alzheimer Education Australia

'Wonderful, thoughtful, practical' - Cariad Lloyd, Griefcast 'Encouraging and inspiring' - Dr Kathryn Mannix, author of Amazon bestseller With the End in Mind End-of-life doula Anna Lyons and funeral director Louise Winter have joined forces to share a collection of the heartbreaking, surprising and uplifting stories of the ordinary and extraordinary lives they encounter every single day. From working with the living, the dying, the dead and the grieving, Anna and Louise reveal the lessons they've learned about life, death, love and loss. Together they've created a profound but practical guide to rethinking the one thing that's guaranteed to happen to us all. We are all going to die, and that's ok. Let's talk about it. This is a book about life and living, as much as it's a book about death and dying. It's a reflection on the beauties, blessings and tragedies of life, the exquisite agony and ecstasy of being alive, and the fragility of everything we hold dear. It's as simple and as complicated as that.

One of 17 titles in the 'Living Therapy' series, Counselling For Progressive Disdability addresses issues that arise when coming to terms with a progressive disability.

The first part focuses specifically on the emotional and psychological impact of being diagnosed with a disabling condition. The second part deals specifically with coming to terms with a worsening condition, the nature of pain and the prospect of having to accept the use of a wheelchair. Like all other titles in this series it includes a helpful overview of the person-centred approach to counselling and psychotherapy.