Caring for Patients at the End of Life: Facing an Uncertain Future Together

Paperback | March 15, 2001

byTimothy E. Quill

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In Caring for Patients at the End of Life: Facing an Uncertain Future Together, Dr. Quill uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section one utilizes the near deathexperiences of two patients to explore values underlying medical humanism, and then presents the case of "Diane" to explore the fundamental clinical commitments of partnership and non-abandonment. Section two explores, illustrates, and provides practical guidance for clinicians, patients, andfamilies about critical communication issues including delivering bad news, discussing palliative care, and exploring the wish to die. In section three, difficult ethical and policy challenges inherent in hospice work, including the rule of double effect, terminal sedation, and physician-assistedsuicide, are explored using a mix of real cases and an analysis of underlying clinical, ethical, and policy issues. In a final chapter, Dr. Quill discusses the tragic death of his brother which occurred as this book was being completed, and how his family made the most emotionally challengingdecisions of their lives. Dr. Quill exposes readers to an internally consistent and practical way of thinking by simultaneously embracing the potential of palliative care, and also acknowledging that it has limitations. His philosophy of offering forthright discussions with patient and family, mutual decision-making,ensuring medical and palliative care expertise and of committing to see the dying process through to the patient's death is vividly illustrated.

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From the Publisher

In Caring for Patients at the End of Life: Facing an Uncertain Future Together, Dr. Quill uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section one utilizes the near deathexperiences of two patients to explore values underl...

Timothy E. Quill is at University of Rochester School of Medicine and Dentistry, Rochester, NY.

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Format:PaperbackPublished:March 15, 2001Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0195139402

ISBN - 13:9780195139402

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Table of Contents

I. Underlying Values and Assumptions1. Same Old Seventeen Dollar Lamps2. Humanistic End of Life Care3. Death and Dignity: A Case of Individualized Decision Making4. Partnership in the Care of the Dying5. Non-abandonment: A Central Obligation of PhysiciansII. The Medical Interview: A Critical Clinical Tool6. Delivering Bad News7. Discussing Palliative Care with Patients8. Palliative Care for Patients with Severe Dementia: A Consensus-Based Approach to Decision-Making9. Doctor, I want to die! Will you help me?III. Difficult Clinical and Ethical Issues10. Hospice and Palliative Care: Clinical, Ethical and Policy Challenges11. The Rule of Double Effect: A Critique of its Role in End of Life Decision Making12. Palliative Options of Last Resort: A Comparison of Practices, Justifications, and Safeguards13. End of Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and PracticesEpilogue: All About My Brother

Editorial Reviews

"I was extraordinarily impressed with Dr. Quill's writing skills, as well as his approach to the decision making around palliative care. It is wonderfully written, vivid with examples, useful work tips and strategies, and cerebral and analytical when it deals with complicated ethical andpolicy issues. Reading this made some of my recent interactions with patients go better. I learned from Dr. Quill, and you will too. I recommend the book very highly to anyone who teaches about palliative care."--Journal of Palliative Medicine, November, 2002