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Palliative Care and Ethics (Paperback)
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Palliative Care and Ethics (Paperback)
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Hospice is the premiere end of life program in the United States,
but its requirement that patients forgo disease-directed therapies
and that they have a prognosis of 6 months or less means that it
serves less than half of dying patients and often for very short
periods of time. Palliative care offers careful attention to pain
and symptom management, added support for patients and families,
and assistance with difficult medical decision making alongside any
and all desired medical treatments, but it does not include a
comprehensive system of care as is provided by hospice. The
practice of palliative care and hospice is filled with sometimes
overt (requests for hastened death in an environment where such
acts are legally prohibited) and other times covert (the delay in
palliative care referral because the health care team believes it
will undermine disease directed treatment) ethical issues. The
contributors to this volume use a series of case presentations
within each chapter to illustrate some of the palliative care and
hospice challenges with significant ethical dimensions across the
three overarching domains: 1) care delivery systems; 2) addressing
the many dimensions of suffering; and 3) difficult decisions near
the end of life. The contributors are among the most experienced
palliative care, hospice and ethics scholars in North America and
Western Europe. Each has been given relatively free reign to
address what they feel are the most pressing ethical challenges
within their domain, so a wide range of positions and vantage
points are represented. As a result, the volume provides a very
diverse ethical exploration of this relatively young field that can
deepen, stretch, and at times confront any simple notion of the
challenges facing patients, their families, professional
caregivers, and policy makers.
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