In few places in American society are adults so dependent on others as in nursing homes. Minimizing this dependency and promoting autonomy has become a major focus of policy and ethics in gerontology. Yet most of these discussions are divorced from the day-to-day reality of long-term care and are implicitly based on concepts of autonomy derived from acute medical care settings. Promoting autonomy in long-term care, however, is a complex task which requires close attention to everyday routines and a fundamental rethinking of the meaning of autonomy.
This timely work is based on an observational study of two different types of settings which provide long-term care for the elderly. The authors offer a detailed description of the organizational patterns that erode autonomy of the elderly. Their observations lead to a substantial rethinking of what the concept of autonomy means in these settings. The book concludes with concrete suggestions on methods to increase the autonomy of elderly individuals in long-term care institutions.

Informed consent - as an ethical ideal and legal doctrine - has been the source of much concern to clinicians. Drawing on a diverse set of backgrounds and two decades of research in clinical settings, the authors - a lawyer, a physician, a social scientist, and a philosopher - help clinicians understand and cope with their legal obligations and show how the proper handling of informed consent can improve , rather than impede, patient care. Following a concise review of the ethical and legal foundations of informed consent, they provide detailed, practical suggestions for incorporating informed consent into clinical practice. This completely revised and updated edition discusses how to handle informed consent in all phases of the updated edition discusses how to handle informed consent in all phases of the doctor-patient relationship, use of consent forms, patients' refusals of treatment, and consent to research. It comments on recent laws and national policy, and addresses cutting edge issues such as fulfilling physician obligations under managed care. This clear and succinct book contains a weath of information that will not only help clinicians meet the legal requirements of informed consent and understand its ethical underpinnings, but also enhance their ability to deal with their patients more effectively. It will be of value to all those working in areas where issues of informed consent are likely to arise, including medicine, biomedical research, mental health care, nursing, dentistry, biomedical ethics, and law.