Palliative Care and Ethics

Paperback | February 11, 2016

EditorTimothy E. Quill, Franklin G. Miller

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Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliativecare offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it does not include a comprehensive system of care as is provided by hospice. Thepractice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directedtreatment) ethical issues. The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering;and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges withintheir domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families,professional caregivers, and policy makers.

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Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliativecare offers careful attention to pain and symp...

Timothy E. Quill is a Professor of Medicine, Psychiatry, Medical Humanities and Nursing at the University of Rochester School of Medicine where he directs their Palliative Care Division. He is a board member and the immediate past president of the American Academy of Hospice and Palliative Medicine. He was the lead physician plaintif...

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Format:PaperbackDimensions:322 pages, 9.09 × 6.1 × 0.91 inPublished:February 11, 2016Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0190604441

ISBN - 13:9780190604448

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"This outstanding essay collection, edited by Quill (Univ. of Rochester) and Miller (National Institutes of Health), provides a survey of the clinical and ethical dilemmas clinicians face in palliative care contexts, mainly, but not exclusively, at life's end. The volume helpfully providesperspectives from the diverse disciplines represented in a contemporary palliative care team, general physicians, psychiatrists, nurses, etc. and the diverse locations in which palliative care takes place, from in-home hospice to inpatient hospital settings." --Choice