The delivery of good medical care often involves professionals
from various disciplines working together. Interdisciplinary health
care teams can be especially valuable in managing patients with
complex medical and social needs, such as older persons in
hospital, community, or home settings. Such teams, however, can
also complicate or even create problems because of their diverse
views and responsibilities. Ethical Patient Care: A Casebook for
Geriatric Health Care Teams is designed to teach effective and
responsible group decision making to clinicians working in teams to
treat older patients.
The editors use the case study method to present ethical
dilemmas that team members encounter in the management of geriatric
patients. Patients with multiple chronic conditions so often
require the care of more than one medical specialist, and in the
introductory chapters the editors suggest ways to resolve conflicts
among patients, health care professionals, and the institutions
that support them, including hospitals, HMOs, insurance companies,
and the government. The book is then divided into four sections,
each dealing with one angle of the team-care picture. The first
section treats the diverse ethical imperatives of various
professionals, conflicts among disciplinary approaches, and and
varying attitudes toward end-of-life- decision making. Section two
focuses on the patient and covers patient confidentiality, family
decisionmaking and interaction with the healthcare team, issues of
patient and team nonadherence to the care plan, and elder abuse and
neglect. Section three examines the emerging difficulties of
decentralized health care in settings such as hospitals, nursing
homes, and the home, including clinician accountability and how
ethical dilemmas differ across settings. Section four discusses the
problems arising from the increasing responsibility of clinicians
to manage costs and serve the interests of hospitals and insurers.
Ethical Patient Care is a valuable resource for bioethicists,
gerontologists, and the physicians, nurses, social workers, and
therapists who care for aging persons.
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