The Patient in the Family diagnoses the ways in which the worlds of home and hospital misunderstand each other. The authors explore how medicine, through its new reproductive technologies, is altering the structure of families, how families can participate more fully in medical decision-making, and how to understand the impact on families when medical advances extend life but not vitality.

Mental illness is the poor, and somehow "damaged," cousin to physical ailments in the eyes of too many in our society. Compare the difference in how people would respond to someone who had fallen and broken their leg on the street, to how most react to those mentally ill among us, on those same streets, who spend their winters on steam grates and forage for food in dumpsters. " Rationing Sanity "is a provocative analysis of the mental health care system in the United States, dealing with issues of justice and access to mental health care.

How should a decent society, affluent but facing many serious calls on its resources, best care for citizens afflicted with severe and persistent mental illnesses? James Lindemann Nelson brings together, for the first time, scholars of the ethics of mental health care and top managed care policy analysts to address this crucial problem. "Rationing Sanity" integrates those perspectives with the thoughtful practice-based experience of physicians well versed in the actual care of people with emotional and behavioral problems. Over a period of years, the contributors met face-to-face to engage each other on the ethics of managed mental health care -- the result is a unique, collaborative effort that provides a wealth of important new insights on not only how Americans can readjust their attitudes toward the mentally ill -- but also how we may find more just and humane treatment for those afflicted.

Caring for a loved one who is terminally ill can be tremendously stressful under any circumstances. If that person has a degenerative and dementing disease such as Alzheimer's, and is unable to participate in decisions regarding his or her care, the stress is that much greater. When it comes to making those difficult moral and ethical decisions which will preserve the dignity and integrity of the patient while also maintaining the caregiver's own selfhood, this is the book that can help.

How much should the patient be told? How strongly should he be urged to plan for his own future? Is it ever right to lie to the patient about her condition? When is it right to place your loved one in a nursing home--and not feel guilty about it? How do different family members arrive at agreement among themselves in each of these situations?

Authors and bioethicists James and Hilde Lindemann Nelson have written an invaluable step-by-step guide to tackling these and other difficult decisions. Using their extensive research on moral issues in health care, the Nelsons create hypothetical scenarios that demonstrate some of the most common situations caregivers will have to face during every stage of the illness, and show by example how they can make the right choices for themselves, the patient, and the rest of the family. This invaluable information, combined with a state-by-state and city-by-city guide to agencies and support groups offering practical assistance, as well as a list of suggested reading on the subject, make this book unique--and the most complete source of advice available.


From the Hardcover edition.