图书简介
A book for nurses, doctors and all who provide end of life care, this essential volume guides readers through the ethical complexities of such care, including current policy initiatives, and encourages debate and discussion on their controversial aspects. dived into two parts, it introduces and explains clinical decision making-processes about which there is broad consensus, in line with guidance documents issued by WHO, BMA, GMC, and similar bodies. The changing political and social context where ’patient choice’ has become a central idea, and the broadened scope of potients’ best interests, have added to the complexity of decision-making in end of life care. The authors discuss issues widely encountered by GPs, nurses, and hospital clinicians. These include patient choice, consent, life-prolonging treatment, and symptom relief including sedation. Part rwo explores the more controversial current end of life care initiatives, such as advance care planning preferred place of care and death, euthanais and assited suicide, extended ideas of ’best interests’, and the view that there are therapeutic duties to the relatives of Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of comsumerist choice, they reject its place in the health service, proposing a a realistic, fair, humane and widely adoptable system of end of life care
Part 1; Introduction; 1 Patient choice and consent; 2 Choice and best interests: clinical decision-making in end of life care; 3 Three logical distinctions in decision-making; 4 Choice and best interests: life-prolonging treatments; 5 Choice and best interests: symptom control and the maintenance of function; 6 Choice and best interests: sedation to relieve otherwise intractable symptoms (terminal sedation); Conclusions to Part 1; Part 2 - Controversies; Introduction; 7 Choice and advance care planning: definition, professional responsibility; 8 Preferred place of care and death; 9 Choice, assisted suicide and euthanasia; 10 Best interests: extended senses; General conclusions
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