End of life choices: consensus and controversy
Gespeichert in:
| Hauptverfasser: | , |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Oxford [u.a.]
Oxford Univ. Press
2010
|
| Ausgabe: | 1. ed. |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIII, 220 S. 24 cm |
| ISBN: | 9780199547333 0199547335 |
Internformat
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Datensatz im Suchindex
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| adam_text |
Titel: End of life choices
Autor: Randall, Fiona
Jahr: 2009
Contents
List of abbreviations and acronyms xv
Introduction xvii
Part 1
1 Patient choice and consent 3
1.1 Choice: the traditional concept 4
1.2 Consumer choice, the free market and the health service 6
1.3 Some problems with consumerism in end of life care 7
1.3.i Competition 8
1.3.N Prevention from harm 10
1.3.iii Alternatives 11
1.3.iv Responsibility 12
1.3.V Money 73
1.4 Implications of a system for end of life care based
on consumerism 13
1.4.i Consent 13
1.4.H The concept of a profession 14
1,4.iii Motivation 15
1.4.iv The art of dying lost by consumerism 16
1.5 The roots of the choice agenda 17
1.6 Conclusions 19
References 20
2 Choice and best interests: clinical decision-making in end
of life care 23
2.1 Understanding the clinical problem 24
2.2 Selecting the treatment options which offer a prospect of
net benefit 25
2.3 Assessment of capacity 28
X CONTENTS
2.4 Making the final decision with patients who have capacity:
consent 32
2.4.i How much information? 33
2.4.ii The continuing request for what is clinically
inappropriate 40
2.4.iii A right to consent or a duty to do so? 41
2.5 Making the final decision: patients without capacity 41
2.6 Conclusions 46
References 46
3 Three logical distinctions in decision-making 49
3.1 Intended and foreseen consequences: doctrine of double effect 49
3.2 Acts and omissions 52
3.3 Killing and letting die 54
3.4 Conclusions 59
References 59
4 Choice and best interests: life-prolonging treatments 61
4.1 Preliminary issues of ethical importance 62
4.2 Understanding the clinical problem 67
4.3 Selecting treatment options that offer a prospect of
net benefit 67
4.4 Making the final decision with patients who have capacity 70
4.4.i Disclosure of information 70
4.4.ii Patients requesting clinically inappropriate treatments 75
4.4.iii Reviewing the decision 76
4.4.iv Life-prolonging treatments and advance care planning 77
4.5 Making the final decision: patients without capacity 77
4.5.i Special features of decision-making regarding
life-prolonging treatment 78
4.5.ii Consulting the patient 79
4.5.iii Consulting those close to the patient 79
4.5.iv The basis of the final decision 80
4.5.V Reviewing the decision 81
4.6 Conclusions 81
References 82
CONTENTS xi
5 Choice and best interests: symptom control and the maintenance
of function 85
5.1 The basis of most moral problems in symptom control 85
5.2 Moral problems of symptom control in patients with capacity 86
5.3 Moral problems of symptom control in patients who lack
capacity 90
5.3.i Moral problems when the patient is imminently dying 90
5.3.ii Moral problems when the patient is not imminently
dying 93
5.4 Conclusions 96
References 97
6 Choice and best interests: sedation to relieve otherwise intractable
symptoms (terminal sedation) 99
6.1 Identifying the problems 99
6.2 What makes the analysis difficult 100
6.2.i Lack of a clear definition of 'terminal sedation' 100
6.2.ii Lack of clarity about the fundamental moral concepts of
intention, outcome and causality in decision-making about
sedation 102
6.2.iii Artificial hydration 103
6.3 Clinical circumstances where there is consensus 103
6.4 Clinical circumstances which are controversial 105
6.5 Solution to the problems via the doctrine of double effect 112
6.6 Solution via professional guidelines 113
6.7 Anticipating loss of capacity 114
6.8 Conclusions 115
References 275
Conclusions to Part 1 117
Part 2
Introduction to Part 2: controversies 119
7 Choice and advance care planning (ACP): definition, professional
responsibilities 121
7.1 National guidance on ACP 124
7.2 Who should have the discussion with the patient? 725
xii CONTENTS
7.3 When should ACP be instigated? 126
7.4 Information needed by patients for ACP regarding future
treatment 128
7.5 Professional responsibility for establishing validity and
applicability 130
7.6 Importance of recording and review 134
7.7 Responsibility for taking advance statements into account in best
interests judgements 235
7.8 Ethically important common misunderstandings 135
7.8.i Failure to distinguish ACP from other forms of care
planning 136
7.8.ii Failure to recognize importance of voluntariness 136
7.8.iii Failure to recognize the patient's right to confidentiality 137
7.8.iv Failure to obtain the patient's permission to record the
outcome of the ACP discussion 138
7.8.V Misunderstandings regarding the function of advance
statements, advance care plans in best interests
judgements 138
7.9 Support for ACP, advance statements 139
7.10 ACP: an intervention with a limited UK evidence base 140
7.11 Cardiopulmonary resuscitation and ACP 142
7.12 Conclusions 143
References 144
8 Preferred place of care and death 747
8.1 The national context 147
8.2 Ethical problems arising from the preferred place of care and
death policy 149
8.2.i Voluntariness in ACP and care planning generally 149
8.2.ii Pressure on patients to express achievable preferences 150
8.2.iii Effects on decision-making for patients who lack
capacity 152
8.2.iv Audit 153
8.2.V The role of family members 154
8.2.vi Use of resources 156
8.3 ACP and preferred place of care and death: should we be asking a
different question? 162
8.4 Conclusions 163
References ]63
CONTENTS xiii
9 Choice, assisted suicide and euthanasia 165
9.1 The argument from'moral equivalence' 166
9.2 The argument from the 'right to die' 169
9.2.i A'right to die'? 170
9.2.ii Human rights and the'right to die' 173
9.3 The argument from dignity 176
9.3.i The analysis of dignity 176
9.3.M Dignity, assisted suicide and euthanasia 178
9.4 A simple argument and a simple reply 179
9.5 Conclusions 181
References 182
10 Best interests: extended senses 185
10.1 'Best interests'extended to'whole person'or'holistic'care 186
10.2 Meaning and dignity at the end of life 195
10.3 Best interests and relatives 198
10.3.i The nature and extent of obligations to relatives 200
10.3.ii Bereavement care: benefit or harm? 202
10.3.iii Cost-effectiveness of benefit to relatives 205
10.4 Conclusions 206
References 207
General conclusions 211
Index 215 |
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| spelling | Randall, Fiona Verfasser aut End of life choices consensus and controversy Fiona Randall ; R. S. Downie 1. ed. Oxford [u.a.] Oxford Univ. Press 2010 XIII, 220 S. 24 cm txt rdacontent n rdamedia nc rdacarrier Decision Making Palliative Care ethics Palliative treatment Terminal Care ethics Terminal care Sterbebegleitung (DE-588)4466515-5 gnd rswk-swf Ethik (DE-588)4015602-3 gnd rswk-swf Sterbehilfe (DE-588)4077877-0 gnd rswk-swf Palliative treatment. Terminal care. Sterbehilfe (DE-588)4077877-0 s Ethik (DE-588)4015602-3 s DE-604 Sterbebegleitung (DE-588)4466515-5 s b DE-604 Downie, R. S. 1933- Verfasser (DE-588)134130448 aut HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=018705661&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Randall, Fiona Downie, R. S. 1933- End of life choices consensus and controversy Decision Making Palliative Care ethics Palliative treatment Terminal Care ethics Terminal care Sterbebegleitung (DE-588)4466515-5 gnd Ethik (DE-588)4015602-3 gnd Sterbehilfe (DE-588)4077877-0 gnd |
| subject_GND | (DE-588)4466515-5 (DE-588)4015602-3 (DE-588)4077877-0 |
| title | End of life choices consensus and controversy |
| title_auth | End of life choices consensus and controversy |
| title_exact_search | End of life choices consensus and controversy |
| title_full | End of life choices consensus and controversy Fiona Randall ; R. S. Downie |
| title_fullStr | End of life choices consensus and controversy Fiona Randall ; R. S. Downie |
| title_full_unstemmed | End of life choices consensus and controversy Fiona Randall ; R. S. Downie |
| title_short | End of life choices |
| title_sort | end of life choices consensus and controversy |
| title_sub | consensus and controversy |
| topic | Decision Making Palliative Care ethics Palliative treatment Terminal Care ethics Terminal care Sterbebegleitung (DE-588)4466515-5 gnd Ethik (DE-588)4015602-3 gnd Sterbehilfe (DE-588)4077877-0 gnd |
| topic_facet | Decision Making Palliative Care ethics Palliative treatment Terminal Care ethics Terminal care Sterbebegleitung Ethik Sterbehilfe |
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