This is a comprehensive analysis of ethical topics in palliative care, combining clinical experience and philosophical rigor. A broad array of topics are explored from historical, legal, clinical, and ethical perspectives, offering both the seasoned clinician and interested lay reader a thorough examination of the complex ethical issues facing patients suffering from life-threatening illness.

Ethics in Hospice Care: Challenges to Hospice Values in a Changing Health Care Environment explores the pressures and challenges facing hospice and aims to produce new studies and educational materials on hospice ethics to help professionals in the field. Many of the tensions felt by caregivers and practitioners in hospice stem from uncertainty about the ethical mission of hospice and the ethical dilemmas arising in practice. This volume, a result of The Hastings Center and the Hospice Foundation of America’s project on Ethical and Policy Issues in Hospice Care, addresses these issues in a clear, accessible way.Ethics in Hospice Care outlines the economic, social, and cultural challenges facing hospice care in a changing society and a changing health care environment. Issues of concern include: financial pressures as policymakers limit Medicare spending organizational pressures as hospice organizations enter a variety of new relationships with managed care organizations, home health agencies, and hospitals cultural and social challenges as Americans wrestle with moral and legal issues of death and dying and physician-assisted suicide the rapid and unplanned growth of the movement--from a single hospice in 1973 to over 2500 todayWhile primarily for practicing hospice professionals, Ethics in Hospice Care is vital reading for everyone concerned with assisted suicide, patients’rights, quality of life, managed care, physician referral, professional development, pain management, quality of care, and ethics committees.

Hospice and Palliative Care for Companion Animals: Principles and Practice offers the first comprehensive reference to veterinary hospice and palliative care, with practical guidance and best practices for caring for sick and dying animals. Presents the first thorough resource to providing veterinary hospice and palliative care Offers practical guidance and best practices for caring for sick and dying animals Provides an interdisciplinary team approach, from a variety of different perspectives Gives concrete advice for easing pets more gently through their final stage of life Includes access to a companion website with client education handouts to use in practice

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Symptom control, management of psychosocial and spiritual concerns, decision-making consistent with values and goals, and care of the imminently dying that is appropriate and sensitive are among the critical issues in palliative care. This book explores progress made and future goals.

This book on the history of palliative care, 1500-1970 traces the historical roots of modern palliative care in Europe to the rise of the hospice movement in the 1960s. The author discusses largely forgotten premodern concepts like cura palliativa and euthanasia medica and describes, how patients and physicians experienced and dealt with terminal illness. He traces the origins of hospitals for incurable and dying patients and follows the long history of ethical debates on issues like truth-telling and the intentional shortening of the dying patients’ lives and the controversies they sparked between physicians and patients. An eye opener for anyone interested in the history of ethical decision making regarding terminal care of critically ill patients.

This scholarly book enables health care professionals to appropriately address hospice patients’and families’concerns about nutrition and hydration. Nutrition and Hydration in Hospice Care is a comprehensive resource that provides hands-on practical information that readers can use in everyday hospice practice. The chapters identify problems, solutions, and ethical issues of nutrition and hydration in hospice care.The contributing authors provide the way for health care professionals, especially those in nursing, dietary, and pharmacy units, to jointly and effectively manage troublesome symptoms and ethical issues. The following topics are included in the scope of coverage: nutrition/hydration needs during end-stage disease nursing and dietary roles in identifying nutrition/hydration problems and implementing treatment how needs of dying children and adults are different legal and ethical dilemmas of withholding or withdrawing nutrition and hydration appropriate and inappropriate uses of enteral and parenteral nutrition support during end-stage diseases food service considerations in inpatient hospice facilities appetite stimulant use in palliative careBecause Nutrition and Hydration in Hospice Care is comprehensive, all members of hospice staffs can find practical information to use each day. The authors cover issues not found in other books for nurses, dietitians, pharmacists, and physicians. They will find the information ready to apply at their work settings.

The practice of palliative care and hospice is filled with overt and sometimes covert ethical challenges. These challenges are addressed by leading international palliative care and hospice scholars under three main domains: care delivery systems; addressing the many dimensions of suffering; and difficult decisions near the end of life.

Narrative medicine, an interdisciplinary field that brings together the studies of literature and medicine, offers both a way of understanding patient identity and a method for developing a clinician’s responsiveness to patients. While recognizing the value of narrative medicine in clinical encounters, including the ethical aspects of patient discourse, Tara Flanagan examines the limits of narrative practices for patients with cognitive and verbal deficits. In Narrative Medicine in Hospice Care: Identity, Practice, and Ethics through the Lens of Paul Ricoeur, Flanagan contends that the models of selfhood and care found in the work of Ricoeur can offer a framework for clinicians and caregivers regardless of the verbal and cognitive capabilities of a patient at the end of life. In particular, Ricoeur’s concept of patient identity connects with the narrative method of life review in hospice and offers an opportunity to address the religious and spiritual dimensions of the patient experience.

"All of us working in palliative care would benefit from reading this book as it exposes assumptions derived from the treatment mostly of cancer patients and encourages us to review our thoughts on the intrinsic value of all life, however opaque." -- Palliative Medicine.