Patient-Centred Ethics and Communication at the End of Life / Edition 1

by David Jeffrey

Overview

This book provides the best information available on the ways priorities are currently set for health care around the world. It describes the methods now used in the six countries leading the process, and contrasts the differences between them. It shows how, except in the UK, frameworks have now been developed to set priorities. Making Choices for Health Care sets forth the key issues that need to be tackled in the years ahead. Descriptions of the leading trends are accompanied by suggestions to resolve outstanding difficulties. Topics include: the need for national research and development funding for new treatments, ways to shift resources permanently towards prevention and chronic care, and how DALYs may replace QALYs. While the concepts and values underlying priority setting have been discussed elsewhere, Making Choices for Health Care highlights real current practice. It is a vital tool for policy-makers, health care managers, clinicians, patient organizations, academics, and executives in pharmaceutical and medical supply industries.

Product Details

ISBN-13:	9781857756210
Publisher:	Taylor & Francis
Publication date:	12/01/2005
Pages:	144
Product dimensions:	6.70(w) x 9.60(h) x 0.60(d)

Table of Contents

Contents: Part 1: Ethics, communication and palliative care: what is palliative care? I want to hold your hand. A good death. Why ethics? Why won’t you listen to me? Part 2: Death, dying and dilemmas. ‘What are you going to do next?’.. When cancer comes back. ‘What would you do?’ Informed consent. ‘There is nothing more I can do’ Stopping active treatment. ‘Am I not worth treating?’ Do not attempt resuscitation orders. ‘Water, water everywhere’ Feeding and fluids at the end of life. ‘Help me to die’ Euthanasia. Part 3: Good Practice: Patient’s choice. Communicating in multidisciplinary teams. Education, ethics and communication skills. The ‘good’ doctor.

Editorial Reviews

Reviewer: Nalini I Rattan, BA, MA (Alzheimer Society of Canada)
Description: This book describes the significance and effectiveness of communication between the doctor and patient in a healthcare setting. It provides recommendations on the ways in which difficult discussions can be addressed with the patient that can be beneficial to physicians and healthcare workers.
Purpose: The purpose is to improve understanding of end-of-life issues and to promote effective communication in order to improve the care of dying patients. These are worthy objectives as end-of-life decisions can be difficult for the patient and family members. Therefore, the use of effective communication can allow well informed decisions to be made while bringing comfort to the individual and loved ones. The book meets the author's objectives as it clearly discusses various communication strategies that could be considered when dealing with end-of-life matters.
Audience: This book is written for physicians and healthcare workers, providing suggestions to practitioners on ways communication can be effectively initiated and used to bring comfort and understanding to the patient and loved ones. The author hopes that this book will be of interest to patients and their families as well as healthcare workers. However, it focuses mainly on healthcare workers, providing suggestions for how physicians can approach clinical discussions with patients as opposed to ways in which patients can approach physicians. The author was a general practitioner for 20 years, currently chairs an ethics committee for the Association for Palliative Medicine for Great Britain and Ireland, and works as a consultant in palliative medicine in Roxbhurghe House, Dundee.
Features: The author covers various scenarios which focus on cancer patients dealing with end of life decisions. He first looks at how effective communication can assist patients in finding comfort with the concept of death as opposed to being afraid of dying and of leaving loved ones. He addresses dilemmas that must be confronted when cancer recurs and notes that the word "cure" should not be used loosely by physicians. Doctor-patient confidentiality is considered as well as the ethical dilemma when loved ones don't want the patient to know a diagnosis. The book also covers euthanasia and how it is essential to maintain open and effective communication in an honest and virtuous manner as much as is possible. The best part of this book is the way the case scenarios help readers apply the author's recommendations to a clinical situation. The focus is on communication with patients and loved ones in each of these scenarios. A shortcoming of this book is that there are no statistics on how effective communication or the recommendations of the author have improved healthcare overall, or doctor-patient relationships in particular. Although a section is dedicated to handling the delivery of bad news about a parent when children are present, the issue of addressing difficult news with children who are cancer patients is not considered.
Assessment: This book provides valuable recommendations and suggestions for healthcare workers on how to improve communication with patients in a healthcare setting. Establishing a trusting and honest relationship with patients is imperative and essential for the well-being of the individuals involved, especially since the life of the patient ultimately lies in the hands of the physician. The book is comprehensive and easy to read. It addresses an area of healthcare that is essential in making doctor-patient relationships a success.

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