Decisions about life-sustaining treatment are often ethically challenging for patients, surrogate decision-makers, and health care professionals. Providing safe, effective, and compassionate care near the end of life is a priority for health care organizations. In times of uncertainty, crisis, or reflection, and in efforts to improve health care for seriously ill patients, guidelines can help. This is the first updated, expanded edition of The Hastings Center's 1987 Guidelines on the Termination of Life-Sustaining Treatment and Care of the Dying, which shaped the ethical and legal framework for decision-making on treatment and end-of-life care in the United States. The new edition, the product of an authoritative consensus process, incorporates 25 years of research, innovation, and developments in law and policy. It summarizes the current framework for making good decisions about treatment and care and identifies educational and organizational goals for health care systems. It covers care planning, decision-making for adults and for children, care transitions, the determination of death, and the policies and processes that support good care at the bedside. It also addresses the psychological and social dimensions of care near the end of life, with attention to effective communication with patients and loved ones and among team members. This book is written for physicians, nurses, and other clinicians in hospitals, nursing homes, home care, and hospice. It is structured for ease of reference during difficult clinical situations and includes extensive practical recommendations supported by print and online resources. This book is also essential reading for clinical ethicists, ethics committee members, health lawyers, and medical and nursing directors. As the U.S. confronts the challenges of health care reform, an aging population, increasing technological capacity to extend life, and serious cost implications, The Hastings Center Guidelines are invaluable to educators, scholars, and policymakers.

Decisions about life-sustaining treatment are often ethically challenging for patients, surrogate decision-makers, and health care professionals. Providing safe, effective, and compassionate care near the end of life is a priority for health care organizations. In times of uncertainty, crisis, or reflection, and in efforts to improve health care for seriously ill patients, guidelines can help. This is the first updated, expanded edition of The Hastings Center's 1987 Guidelines on the Termination of Life-Sustaining Treatment and Care of the Dying, which shaped the ethical and legal framework for decision-making on treatment and end-of-life care in the United States. The new edition, the product of an authoritative consensus process, incorporates 25 years of research, innovation, and developments in law and policy. It summarizes the current framework for making good decisions about treatment and care and identifies educational and organizational goals for health care systems. It covers care planning, decision-making for adults and for children, care transitions, the determination of death, and the policies and processes that support good care at the bedside. It also addresses the psychological and social dimensions of care near the end of life, with attention to effective communication with patients and loved ones and among team members. This book is written for physicians, nurses, and other clinicians in hospitals, nursing homes, home care, and hospice. It is structured for ease of reference during difficult clinical situations and includes extensive practical recommendations supported by print and online resources. This book is also essential reading for clinical ethicists, ethics committee members, health lawyers, and medical and nursing directors. As the U.S. confronts the challenges of health care reform, an aging population, increasing technological capacity to extend life, and serious cost implications, The Hastings Center Guidelines are invaluable to educators, scholars, and policymakers.

How work gets done in complex health care systems is ethically important. When health care professionals and other staff are pressured to improvise, fix structural problems, or comply with competing policies, the uncertainty and distress they experience have potential consequences for patients, families, colleagues, and the system itself. This book presents a new theory of health care ethics that is grounded in the nature of health care work and how it is shaped by the ever-changing conditions of complex systems, in particular, problems of safety and harm. By exploring workarounds and other improvised practices in complex health care systems that are difficult for professionals to talk about openly, yet have unclear effects, including their value or risk to patients, this book offers a realistic look at our changing health care system and how we can improve the way we manage moral problems arising in the care of the sick. Berlinger argues that health care ethics in complex and changing health care systems should reflect the moral complexity of health care work, analyze common ethical challenges with reference to behaviors and pressures driven by the system itself, and support opportunities for health care professionals and staff at all levels to reflect on the problems they face and to take part in social change. The book's chapters include frameworks for looking at ethical challenges in health care as problems of safety and harm with consequences for patients. Are Workarounds Ethical? is designed to support clinician education in medicine, nursing, and interdisciplinary contexts and recommend methods for integrating ethics, safety, and justice in practice.

The first comprehensive resource for spiritual and pastoral caregivers—a vital resource for clergy, seminarians, chaplains, pastoral counselors and caregivers of all faith traditions. This essential resource integrates the classic foundations of pastoral care with the latest approaches to spiritual care. It is specifically intended for professionals who work or spend time with congregants in acute care hospitals, behavioral health facilities, rehabilitation centers and long-term care facilities. Offering the latest theological perspectives and tools, along with basic theory and skills from the best pastoral and spiritual care texts, research and concepts, the contributors to this resource are experts in their fields, and include eight current or past presidents of the major chaplaincy organizations. Contributors include: Rev. Nancy K. Anderson • Rev. Dr. Willard W. C. Ashley, Sr. • Dr. Nancy Berlinger • Rev. W. L. (Bill) Bross • Rev. Robin C. Brown-Haithco • Rabbi Zahara Davidowitz-Farkas • Paula DeAngelo • Chaplain D. W. Donovan • Dr. George Fitchett • Rev. Bill Gaventa • Rabbi H. Rafael Goldstein • Chaplain Dr. Daniel Grossoehme • Sr. Norma Gutierrez • Rev. George Handzo • Rev. Curtis W. Hart • Rev. Brian Hughes • Rev. Dr. Martha R. Jacobs • Chaplain Gerald L. Jones • Rev. Robert A. Kidd • Rev. Yoke Lye Kwong • Rev. Michele J. Guest Lowery • Rev. Marcia Marino • Rev. Lynne M. Mikulak • Rev. Nancy Osborne • Rev. Jon Overvold • Rev. Brent Peery • Chaplain Linda F. Piotrowski • Rev. David B. Plummer • Rabbi Stephen B. Roberts • Rev. Dr. Glenn A. Robitaille • Chaplain Timothy G. Serban • Bishop Dr. Teresa E. Snorton • Rev. Dr. Dane R. Sommer • Rabbi Dr. Shira Stern • Rev. Jo Clare Wilson • Rev. Sue Wintz

Medical error is a leading problem of health care in the United States. Each year, more patients die as a result of medical mistakes than are killed by motor vehicle accidents, breast cancer, or AIDS.

While most government and regulatory efforts are directed toward reducing and preventing errors, the actions that should follow the injury or death of a patient are still hotly debated. According to Nancy Berlinger, conversations on patient safety are missing several important components: religious voices, traditions, and models.

In After Harm, Berlinger draws on sources in theology, ethics, religion, and culture to create a practical and comprehensive approach to addressing the needs of patients, families, and clinicians affected by medical error. She emphasizes the importance of acknowledging fallibility, telling the truth, confronting feelings of guilt and shame, and providing just compensation. After Harm adds important human dimensions to an issue that has profound consequences for patients and health care providers.