Rethinking Palliative Care


Book Description

The author argues for the de-institutionalisation of palliative care and the development of an alternative framework for the institutional approaches found in hospices, palliative care units and community-based palliative care services.




Rethinking Aging


Book Description

For those fortunate enough to reside in the developed world, death before reaching a ripe old age is a tragedy, not a fact of life. Although aging and dying are not diseases, older Americans are subject to the most egregious marketing in the name of "successful aging" and "long life," as if both are commodities. In Rethinking Aging, Nortin M. Hadler examines health-care choices offered to aging Americans and argues that too often the choices serve to profit the provider rather than benefit the recipient, leading to the medicalization of everyday ailments and blatant overtreatment. Rethinking Aging forewarns and arms readers with evidence-based insights that facilitate health-promoting decision making. Over the past decades, Hadler has established himself as a leading voice among those who approach the menu of health-care choices with informed skepticism. Only the rigorous demonstration of efficacy is adequate reassurance of a treatment's value, he argues; if it cannot be shown that a particular treatment will benefit the patient, one should proceed with caution. In Rethinking Aging, Hadler offers a doctor's perspective on the medical literature as well as his long clinical experience to help readers assess their health-care options and make informed medical choices in the last decades of life. The challenges of aging and dying, he eloquently assures us, can be faced with sophistication, confidence, and grace.




Health Promoting Palliative Care


Book Description

Health promotion has traditionally focused on illness prevention, targeting the fit and well. But what about those who live with life-threatening or terminal illness? Health -Promoting Palliative Care proposes a model of care that goes beyond simply providing care in the final stages of lifeand draws on critical and participatory principles from both palliative care and health promotion. Emphasising early intervention and a social approach to the problems and experiences of dying, it encourages service providers, family members, and the dying themselves to seek ways to promoteemotional, social, and spiritual well-being, as well as physical health. The book begins by looking at the ways in which health promotion can be introduced to palliative care. It goes on to outline the goals and practice principles of a health promoting palliative care. Later chapters addresspractice strategies relevant to health and death education, social supports, interpersonal reorientation, and environmental and policy development. Health Promoting Palliative Care is a valuable, practical, and accessible resource for practitioners working alone or in health care institutions, forstudents of the health sciences, social work, or pastoral care, and for those working in policy areas.




That Good Night


Book Description

"A ... memoir about how the essential parts of one young woman's early life--her mother's work as a surgeon and her spiritual practice--led her to become a doctor and to question the premise that medicine exists to prolong life at all costs."--




Extreme Measures


Book Description

For readers of Being Mortal and Modern Death, an ICU and Palliative Care specialist offers a framework for a better way to exit life that will change our medical culture at the deepest level In medical school, no one teaches you how to let a patient die. Jessica Zitter became a doctor because she wanted to be a hero. She elected to specialize in critical care—to become an ICU physician—and imagined herself swooping in to rescue patients from the brink of death. But then during her first code she found herself cracking the ribs of a patient so old and frail it was unimaginable he would ever come back to life. She began to question her choice. Extreme Measures charts Zitter’s journey from wanting to be one kind of hero to becoming another—a doctor who prioritizes the patient’s values and preferences in an environment where the default choice is the extreme use of technology. In our current medical culture, the old and the ill are put on what she terms the End-of-Life Conveyor belt. They are intubated, catheterized, and even shelved away in care facilities to suffer their final days alone, confused, and often in pain. In her work Zitter has learned what patients fear more than death itself: the prospect of dying badly. She builds bridges between patients and caregivers, formulates plans to allay patients’ pain and anxiety, and enlists the support of loved ones so that life can end well, even beautifully. Filled with rich patient stories that make a compelling medical narrative, Extreme Measures enlarges the national conversation as it thoughtfully and compassionately examines an experience that defines being human.




Rethinking Health Care Ethics


Book Description

​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.




When Children Die


Book Description

The death of a child is a special sorrow. No matter the circumstances, a child's death is a life-altering experience. Except for the child who dies suddenly and without forewarning, physicians, nurses, and other medical personnel usually play a central role in the lives of children who die and their families. At best, these professionals will exemplify "medicine with a heart." At worst, families' encounters with the health care system will leave them with enduring painful memories, anger, and regrets. When Children Die examines what we know about the needs of these children and their families, the extent to which such needs areâ€"and are notâ€"being met, and what can be done to provide more competent, compassionate, and consistent care. The book offers recommendations for involving child patients in treatment decisions, communicating with parents, strengthening the organization and delivery of services, developing support programs for bereaved families, improving public and private insurance, training health professionals, and more. It argues that taking these steps will improve the care of children who survive as well as those who do notâ€"and will likewise help all families who suffer with their seriously ill or injured child. Featuring illustrative case histories, the book discusses patterns of childhood death and explores the basic elements of physical, emotional, spiritual, and practical care for children and families experiencing a child's life-threatening illness or injury.




Tackling Chronic Disease in Europe


Book Description

Chronic conditions and diseases are the leading cause of mortality and morbidity in Europe, accounting for 86% of total premature deaths, and research suggests that complex conditions such as diabetes and depression will impose an even greater health burden in the future - and not only for the rich and elderly in high-income countries, but increasingly for the poor as well as low- and middle-income countries. The epidemiologic and economic analyses in the first part of the book suggest that policy-makers should make chronic disease a priority. This book highlights the issues and focuses on the strategies and interventions that policy-makers have at their disposal to tackle this increasing challenge. Strategic discussed in the second part of this volume include (1) prevention and early detection, (2) new provider qualifications (e.g. nurse practitioners) and settings, (3) disease management programmes and (4) integrated care models. But choosing the right strategies will be difficult, particularly given the limited evidence on effectiveness and cost-effectiveness. In the third part, the book therefore outlines and discusses institutional and organizational challenges for policy-makers and managers: (1) stimulating the development of new effective pharmaceuticals and medical devices, (2) designing appropriate financial incentives, (3) improving coordination, (4) using information and communication technology, and (5) ensuring evaluation. To tackle these challenges successfully, key policy recommendations are made.




Rethinking Suicide


Book Description

"When I joined the Air Force in 2005, hostilities in Iraq were escalating, resulting in more frequent and longer deployments for just about everyone serving in the military, including psychologists. Soon thereafter, the suicide rate among military personnel also started to rise, especially in the Army and Marine Corps. During the first few years of that upward trend, the general sense was that the military was just having a few "bad years." In 2008, however, the age- and gender-adjusted Army and Marine suicide rates surpassed the U.S. general population rate. By the time I deployed to Iraq in February 2009, the military suicide rate had been rising steadily for three consecutive years; the initial assumption that we were simply experiencing a few bad years had dissolved, and an uncomfortable recognition that we had a clear problem on our hands had taken hold"--




With the End in Mind


Book Description

For readers of Atul Gawande and Paul Kalanithi, a palliative care doctor's breathtaking stories from 30 years spent caring for the dying. Modern medical technology is allowing us to live longer and fuller lives than ever before. And for the most part, that is good news. But with changes in the way we understand medicine come changes in the way we understand death. Once a familiar, peaceful, and gentle -- if sorrowful -- transition, death has come to be something from which we shield our eyes, as we prefer to fight desperately against it rather than accept its inevitability. Dr. Kathryn Mannix has studied and practiced palliative care for thirty years. In With the End in Mind , she shares beautifully crafted stories from a lifetime of caring for the dying, and makes a compelling case for the therapeutic power of approaching death not with trepidation, but with openness, clarity, and understanding. Weaving the details of her own experiences as a caregiver through stories of her patients, their families, and their distinctive lives, Dr. Mannix reacquaints us with the universal, but deeply personal, process of dying. With insightful meditations on life, death, and the space between them, With the End in Mind describes the possibility of meeting death gently, with forethought and preparation, and shows the unexpected beauty, dignity, and profound humanity of life coming to an end.