The philosophy of palliative care: critique and reconstruction
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| Main Authors: | , |
|---|---|
| Format: | Book |
| Language: | English |
| Published: |
Oxford [u.a.]
Oxford Univ. Press
2006
|
| Edition: | 1. publ. |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Item Description: | Includes bibliographical references and index |
| Physical Description: | XIV, 236 S. |
| ISBN: | 0198567367 9780198567363 |
Staff View
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| 245 | 1 | 0 | |a The philosophy of palliative care |b critique and reconstruction |c Fiona Randall ; R. S. Downie |
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| 264 | 1 | |a Oxford [u.a.] |b Oxford Univ. Press |c 2006 | |
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| 650 | 7 | |a Palliatieve behandeling |2 gtt | |
| 650 | 4 | |a Ethik | |
| 650 | 4 | |a Philosophie | |
| 650 | 4 | |a Palliative treatment |x Philosophy | |
| 650 | 4 | |a Palliative treatment |x Moral and ethical aspects | |
| 650 | 4 | |a Palliative Care |x ethics | |
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Contents
List of abbreviations xv
Part 1: Framework and concepts
1 Roots, traditions, and philosophy 3
Introduction and aims 3
1.1 Roots and traditions 5
1.2 Two traditions of health care 7
1.3 Consumerism in health care 9
1.4 Critique 10
1.5 A'philosophy'of palliative care 10
1.6 The normative function of a philosophy of palliative care 12
1.7 Theoretical questions 13
1.8 Practical questions: ethics 14
1.9 Paradoxes in palliative care 19
1.10 Conclusions 21
References 22
2 Quality of life 25
Introduction 25
2.1 The use of the term 'quality of life' 27
2.1.1 Qualities, evaluations, and definability 27
2.1.2 The global sense of quality of life 29
2.1.3 Health related quality of life 31
2.2 Assessment and measurement of quality of life 35
2.2.1 Theory of measurement and quality of life 35
2.2.2 Weighting and summing scale items 40
2.2.3 Utility rating scales 42
2.2 A Should quality of life be represented as
numerical data? 43
2.3 Decision making for individual patients 44
2.4 Quality of life as the goal of palliative care? 48
2.5 Conclusions 49
References 50
xii | CONTENTS
3 Autonomy, dignity, respect, and the patient centred
approach 53
Introduction 53
3.1 Autonomy, dignity, and respect in Kant 53
3.2 Developing Kant's ideas: a bad way and a good way 55
3.3 Truth telling, information giving, dignity, and autonomy 56
3.4 Consent, autonomy, and dignity 59
3.5 Professionalism, and consent as patient self determination 61
3.6 Consumerism, patient self determination, and consent 62
3.7 Human Rights, consent, and patient self determination 64
3.8 Patient centredness, consent, and self determination 65
3.9 Dignity and self determination 67
3.10 The analysis of dignity 69
3.11 Conclusions 72
References 73
4 Relatives 75
Introduction 75
4.1 Patient, family, and conflict of interest 78
4.1.1 Conflicts over confidentiality 80
4.1.2 Conflicts over place of care and death 80
4.1.3 Conflicts over time of death 82
4.2 Bereavement care: benefit or harm? 84
A3 Cost effectiveness of benefit to relatives 88
4.4 The nature and extent of obligations to relatives 90
4.5 Conclusions 92
References 92
Part 2: Interventions, effectiveness, and cost
5 Control of symptoms and prolongation of life 97
Introduction 97
5.1 Relief of physical symptoms and improvement of function 98
5.2 Treatments which may prolong life 100
5.2.1 Prolonging death or prolonging life? 100
5.2.2 Withholding and withdrawing
life prolonging treatment 104
5.3 Treatments which may hasten death 106
5.3.1 Not hastening death or not intending
to hasten death? 107
5.3.2 Killing versus letting die: the issue of causation 108
5.3.3 Intending versus foreseeing death 111
5.3.4 Double effect 112
5.3.5 Euthanasia and letting die 115
5.4 The roles and responsibilities of patients and professionals 117
5.5 Conclusions 122
References 123
CONTENTS | xiii
6 Resuscitation and advance statements 125
Introduction 125
6.1 CPR: a life prolonging treatment 126
6.2 CPR compared with other life prolonging treatments 128
6.2.1 The'nothing to lose'argument 129
6.2.2 The 'symbolic value' argument 131
6.2.3 The'low cost'argument 132
6.3 CPR decisions and competent patients 133
6.4 CPR decisions and incompetent patients 136
6.5 Positive recommendations for CPR decision making 136
6.6 Advance statements 138
6.7 Arguments in favour of advance statements 138
6.7.1 Giving patients what they want 138
6.7.2 Facilitating best interests judgements 139
6.7.3 Making life easier for the family 140
6.7 A Avoiding waste of resources 140
6.8 Arguments against advance statements 141
6.8.1 Difficulties of interpretation and enactment 141
6.8.2 Best interests and the duties of doctors 142
6.8.3 Advance statements and family problems 145
6.8.4 Advance statements and resources 145
6.8.5 Additional problems 146
6.9 Advance statements and the philosophy of palliative care 146
6.10 Conclusions 147
References 147
7 Assessment and treatment of psychosocial and
spiritual problems 149
Introduction 149
7.1 Psychosocial and spiritual problems as health
care responsibility 149
7.1.1 The patient professional relationship 151
7.1.2 Effect of the recommended relationship
on the patient 154
7.1.3 The effect of the recommended relationship
on the professional 160
7.1.4 Benefits versus harms of the relationship 162
7.1.5 An alternative: the client counsellor relationship 165
(a) Empathy 169
(b) Respect 172
(c) Genuineness 173
7.2 Psychosocial and spiritual care: an alternative approach 175
7.3 Conclusions 179
References 179
Xiv | CONTENTS
8 Resource allocation 183
Introduction 183
8.1 Needs assessment 184
8.2 Efficiency 189
8.3 Conclusions 194
References 194
Part 3: Critique and reconstruction:
some suggestions for a better way
9 Critique and reconstruction: some suggestions
for a better way 199
Introduction 199
9.1 Palliative care as a specialty 199
9.2 The Asklepian model of holistic care 201
9.2.1 Asklepian attention 201
9.2.2 Asklepian attention and Hippocratic observation 203
9.3 Asklepian acceptance and spirituality 205
9.4 Honest hope 209
9.5 Personal and professional development 213
9.6 Teams 218
9.7 The desirability of a philosophy of palliative care 219
9.8 Towards a new philosophy 220
9.9 A new philosophy statement 224
References 225
Index 227 |
| adam_txt |
Contents
List of abbreviations xv
Part 1: Framework and concepts
1 Roots, traditions, and philosophy 3
Introduction and aims 3
1.1 Roots and traditions 5
1.2 Two traditions of health care 7
1.3 Consumerism in health care 9
1.4 Critique 10
1.5 A'philosophy'of palliative care 10
1.6 The normative function of a philosophy of palliative care 12
1.7 Theoretical questions 13
1.8 Practical questions: ethics 14
1.9 Paradoxes in palliative care 19
1.10 Conclusions 21
References 22
2 Quality of life 25
Introduction 25
2.1 The use of the term 'quality of life' 27
2.1.1 Qualities, evaluations, and definability 27
2.1.2 The global sense of quality of life 29
2.1.3 Health related quality of life 31
2.2 Assessment and measurement of quality of life 35
2.2.1 Theory of measurement and quality of life 35
2.2.2 Weighting and summing scale items 40
2.2.3 Utility rating scales 42
2.2 A Should quality of life be represented as
numerical data? 43
2.3 Decision making for individual patients 44
2.4 Quality of life as the goal of palliative care? 48
2.5 Conclusions 49
References 50
xii | CONTENTS
3 Autonomy, dignity, respect, and the patient centred
approach 53
Introduction 53
3.1 Autonomy, dignity, and respect in Kant 53
3.2 Developing Kant's ideas: a bad way and a good way 55
3.3 Truth telling, information giving, dignity, and autonomy 56
3.4 Consent, autonomy, and dignity 59
3.5 Professionalism, and consent as patient self determination 61
3.6 Consumerism, patient self determination, and consent 62
3.7 Human Rights, consent, and patient self determination 64
3.8 Patient centredness, consent, and self determination 65
3.9 Dignity and self determination 67
3.10 The analysis of dignity 69
3.11 Conclusions 72
References 73
4 Relatives 75
Introduction 75
4.1 Patient, family, and conflict of interest 78
4.1.1 Conflicts over confidentiality 80
4.1.2 Conflicts over place of care and death 80
4.1.3 Conflicts over time of death 82
4.2 Bereavement care: benefit or harm? 84
A3 Cost effectiveness of benefit to relatives 88
4.4 The nature and extent of obligations to relatives 90
4.5 Conclusions 92
References 92
Part 2: Interventions, effectiveness, and cost
5 Control of symptoms and prolongation of life 97
Introduction 97
5.1 Relief of physical symptoms and improvement of function 98
5.2 Treatments which may prolong life 100
5.2.1 Prolonging death or prolonging life? 100
5.2.2 Withholding and withdrawing
life prolonging treatment 104
5.3 Treatments which may hasten death 106
5.3.1 Not hastening death or not intending
to hasten death? 107
5.3.2 Killing versus letting die: the issue of causation 108
5.3.3 Intending versus foreseeing death 111
5.3.4 Double effect 112
5.3.5 Euthanasia and letting die 115
5.4 The roles and responsibilities of patients and professionals 117
5.5 Conclusions 122
References 123
CONTENTS | xiii
6 Resuscitation and advance statements 125
Introduction 125
6.1 CPR: a life prolonging treatment 126
6.2 CPR compared with other life prolonging treatments 128
6.2.1 The'nothing to lose'argument 129
6.2.2 The 'symbolic value' argument 131
6.2.3 The'low cost'argument 132
6.3 CPR decisions and competent patients 133
6.4 CPR decisions and incompetent patients 136
6.5 Positive recommendations for CPR decision making 136
6.6 Advance statements 138
6.7 Arguments in favour of advance statements 138
6.7.1 Giving patients what they want 138
6.7.2 Facilitating best interests judgements 139
6.7.3 Making life easier for the family 140
6.7 A Avoiding waste of resources 140
6.8 Arguments against advance statements 141
6.8.1 Difficulties of interpretation and enactment 141
6.8.2 Best interests and the duties of doctors 142
6.8.3 Advance statements and family problems 145
6.8.4 Advance statements and resources 145
6.8.5 Additional problems 146
6.9 Advance statements and the philosophy of palliative care 146
6.10 Conclusions 147
References 147
7 Assessment and treatment of psychosocial and
spiritual problems 149
Introduction 149
7.1 Psychosocial and spiritual problems as health
care responsibility 149
7.1.1 The patient professional relationship 151
7.1.2 Effect of the recommended relationship
on the patient 154
7.1.3 The effect of the recommended relationship
on the professional 160
7.1.4 Benefits versus harms of the relationship 162
7.1.5 An alternative: the client counsellor relationship 165
(a) Empathy 169
(b) Respect 172
(c) Genuineness 173
7.2 Psychosocial and spiritual care: an alternative approach 175
7.3 Conclusions 179
References 179
Xiv | CONTENTS
8 Resource allocation 183
Introduction 183
8.1 Needs assessment 184
8.2 Efficiency 189
8.3 Conclusions 194
References 194
Part 3: Critique and reconstruction:
some suggestions for a better way
9 Critique and reconstruction: some suggestions
for a better way 199
Introduction 199
9.1 Palliative care as a specialty 199
9.2 The Asklepian model of holistic care 201
9.2.1 Asklepian attention 201
9.2.2 Asklepian attention and Hippocratic observation 203
9.3 Asklepian acceptance and spirituality 205
9.4 Honest hope 209
9.5 Personal and professional development 213
9.6 Teams 218
9.7 The desirability of a philosophy of palliative care 219
9.8 Towards a new philosophy 220
9.9 A new philosophy statement 224
References 225
Index 227 |
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| index_date | 2024-07-02T13:57:01Z |
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| spelling | Randall, Fiona Verfasser aut The philosophy of palliative care critique and reconstruction Fiona Randall ; R. S. Downie 1. publ. Oxford [u.a.] Oxford Univ. Press 2006 XIV, 236 S. txt rdacontent n rdamedia nc rdacarrier Includes bibliographical references and index Filosofische aspecten gtt Palliatieve behandeling gtt Ethik Philosophie Palliative treatment Philosophy Palliative treatment Moral and ethical aspects Palliative Care ethics Philosophy, Medical Palliativtherapie (DE-588)4115490-3 gnd rswk-swf Medizinische Ethik (DE-588)4074672-0 gnd rswk-swf Palliativtherapie (DE-588)4115490-3 s Medizinische Ethik (DE-588)4074672-0 s DE-604 Downie, Robert S. Verfasser aut HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014635019&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Randall, Fiona Downie, Robert S. The philosophy of palliative care critique and reconstruction Filosofische aspecten gtt Palliatieve behandeling gtt Ethik Philosophie Palliative treatment Philosophy Palliative treatment Moral and ethical aspects Palliative Care ethics Philosophy, Medical Palliativtherapie (DE-588)4115490-3 gnd Medizinische Ethik (DE-588)4074672-0 gnd |
| subject_GND | (DE-588)4115490-3 (DE-588)4074672-0 |
| title | The philosophy of palliative care critique and reconstruction |
| title_auth | The philosophy of palliative care critique and reconstruction |
| title_exact_search | The philosophy of palliative care critique and reconstruction |
| title_exact_search_txtP | The philosophy of palliative care critique and reconstruction |
| title_full | The philosophy of palliative care critique and reconstruction Fiona Randall ; R. S. Downie |
| title_fullStr | The philosophy of palliative care critique and reconstruction Fiona Randall ; R. S. Downie |
| title_full_unstemmed | The philosophy of palliative care critique and reconstruction Fiona Randall ; R. S. Downie |
| title_short | The philosophy of palliative care |
| title_sort | the philosophy of palliative care critique and reconstruction |
| title_sub | critique and reconstruction |
| topic | Filosofische aspecten gtt Palliatieve behandeling gtt Ethik Philosophie Palliative treatment Philosophy Palliative treatment Moral and ethical aspects Palliative Care ethics Philosophy, Medical Palliativtherapie (DE-588)4115490-3 gnd Medizinische Ethik (DE-588)4074672-0 gnd |
| topic_facet | Filosofische aspecten Palliatieve behandeling Ethik Philosophie Palliative treatment Philosophy Palliative treatment Moral and ethical aspects Palliative Care ethics Philosophy, Medical Palliativtherapie Medizinische Ethik |
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