Results for 'end‐of‐life care'

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  1.  29
    The Morality of Experience Machines for Palliative and End of Life Care.Dan Weijers - 2017 - In Mark Silcox (ed.), Experience Machines: The Philosophy of Virtual Worlds. Rowman & Littlefield. pp. 183-201.
    Experience machines, popularized in print by Robert Nozick and on the screen by the Wachowskis’ film The Matrix, provide highly or perfectly realistic experiences that are more pleasant and less painful than those generated in real life.1 The recent surge in virtual reality and neuro-prosthetic technologies is making the creation of real-world experience machines seem inevitable and perhaps imminent.2 Given the likelihood of the near-future availability of such machines, it behooves ethicists to consider the moral status of their potential uses. (...)
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  2.  18
    Ethics and End of Life Care: The Liverpool Care Pathway and the Neuberger Review.Anthony Wrigley - 2015 - Journal of Medical Ethics 41 (8):639-643.
    The Liverpool Care Pathway for the Dying has recently been the topic of substantial media interest and also been subject to the independent Neuberger Review. This review has identified clear failings in some areas of care and recommended the Liverpool Care Pathway be phased out. I argue that while the evidence gathered of poor incidences of practice by the Review is of genuine concern for end of life care, the inferences drawn from this evidence are inconsistent (...)
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  3.  51
    The Importance of Patient–Provider Communication in End-of-Life Care.Timothy R. Rice, Yuriy Dobry, Vladan Novakovic & Jacob M. Appel - 2012 - Journal of Bioethical Inquiry 9 (4):439-441.
    Successful formulation and implementation of end-of-life care requires ongoing communication with the patient. When patients, for reasons of general medical or psychiatric illness, fail to verbally communicate, providers must be receptive to messages conveyed through alternate avenues of communication. We present the narrative of a man with schizophrenia who wished to forgo hemodialysis as a study in the ethical importance of attention to nonverbal communication. A multilayered understanding of the patient, as may be provided by both behavioral and motivational (...)
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  4.  24
    A Legal and Ethical Analysis of the Effects of Triggering Conditions on Surrogate Decision-Making in End-of-Life Care in the US.J. Clint Parker & Daniel S. Goldberg - 2016 - HEC Forum 28 (1):11-33.
    The central claim of this paper is that American states’ use of so-called “triggering conditions” to regulate surrogate decision-making authority in end-of-life care leaves unresolved a number of important ethical and legal considerations regarding the scope of that authority. The paper frames the issue with a case set in a jurisdiction in which surrogate authority to withdraw life-sustaining treatment is triggered by two specific clinical conditions. The case presents a quandary insofar as the clinical facts do not satisfy the (...)
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  5.  25
    I Could Never Quite Get It Together: Lessons for End-of –Life Care in Harold Pinter’s The Caretaker. [REVIEW]Ewan Jeffrey & David Jeffrey - 2012 - Journal of Medical Humanities 33 (2):117-126.
    Pinter’s play The Caretaker explores interpersonal tensions relating to terminal illness. This paper interrogates notions of care, suffering, ownership, dignity and the consequences of active intervention and inaction in two key sections of the play: Aston’s monologue concerning his own brutal treatment (active intervention) and Davies’s final rejection by the brothers who fail to provide accommodation and care (inaction). This interprofessional analysis combines theatrical and clinical perspectives to create insights which can enhance empathy improve decision-making in end of (...)
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  6.  35
    Challenges in End-of-Life Decisions in the Intensive Care Unit: An Ethical Perspective. [REVIEW]Hanne Irene Jensen, Jette Ammentorp, Helle Johannessen & Helle Ørding - 2013 - Journal of Bioethical Inquiry 10 (1):93-101.
    When making end-of-life decisions in intensive care units (ICUs), different staff groups have different roles in the decision-making process and may not always assess the situation in the same way. The aim of this study was to examine the challenges Danish nurses, intensivists, and primary physicians experience with end-of-life decisions in ICUs and how these challenges affect the decision-making process. Interviews with nurses, intensivists, and primary physicians were conducted, and data is discussed from an ethical perspective. All three groups (...)
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  7.  22
    Quality End‐of‐Life Care.Kerry W. Bowman, Douglas K. Martin & Peter A. Singer - 2000 - Journal of Evaluation in Clinical Practice 6 (1):51-61.
  8.  27
    Ethical Obligations and Clinical Goals in End-of-Life Care: Deriving a Quality-of-Life Construct Based on the Islamic Concept of Accountability Before God.Aasim Padela & Afshan Mohiuddin - 2015 - American Journal of Bioethics 15 (1):3-13.
    End-of-life medical decision making presents a major challenge to patients and physicians alike. In order to determine whether it is ethically justifiable to forgo medical treatment in such scenarios, clinical data must be interpreted alongside patient values, as well as in light of the physician's ethical commitments. Though much has been written about this ethical issue from religious perspectives , little work has been done from an Islamic point of view. To fill the gap in the literature around Islamic bioethical (...)
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  9.  25
    Questions and Answers on the Belgian Model of Integral End-of-Life Care: Experiment? Prototype?Jan L. Bernheim, Wim Distelmans, Arsène Mullie & Michael A. Ashby - 2014 - Journal of Bioethical Inquiry 11 (4):507-529.
    This article analyses domestic and foreign reactions to a 2008 report in the British Medical Journal on the complementary and, as argued, synergistic relationship between palliative care and euthanasia in Belgium. The earliest initiators of palliative care in Belgium in the late 1970s held the view that access to proper palliative care was a precondition for euthanasia to be acceptable and that euthanasia and palliative care could, and should, develop together. Advocates of euthanasia including author Jan (...)
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  10.  26
    Ethical Challenges in End-of-Life Care for GLBTI Individuals.Colleen Cartwright - 2012 - Journal of Bioethical Inquiry 9 (1):113-114.
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  11.  60
    Three Myths in End-of-Life Care.Dominic Wilkinson - 2013 - Journal of Medical Ethics 39 (6):389-390.
    Huang and colleagues provide some intriguing insights into the attitudes about end of life care of practising Taiwanese neonatal doctors and nurses.1 There are some similarities with surveys from other parts of the world. Most Taiwanese neonatologists and nurses agreed that it was potentially appropriate to withhold or limit treatment for infants who were dying. A very high proportion was opposed to active euthanasia of such infants. But there were also some striking differences. Only 21% of Taiwanese doctors ‘agreed’ (...)
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  12.  95
    The Role of Doctors' Religious Faith and Ethnicity in Taking Ethically Controversial Decisions During End-of-Life Care.C. Seale - 2010 - Journal of Medical Ethics 36 (11):677-682.
    Background and Aims The prevalence of religious faith among doctors and its relationship with decision-making in end-of-life care is not well documented. The impact of ethnic differences on this is also poorly understood. This study compares ethnicity and religious faith in the medical and general UK populations, and reports on their associations with ethically controversial decisions taken when providing care to dying patients. Method A postal survey of 3733 UK medical practitioners, of whom 2923 reported on the (...) of their last patient who died. Findings Specialists in care of the elderly were somewhat more likely to be Hindu or Muslim than other doctors; palliative care specialists were somewhat more likely to be Christian, religious and ‘white’ than others. Ethnicity was largely unrelated to rates of reporting ethically controversial decisions. Independently of speciality, doctors who described themselves as non-religious were more likely than others to report having given continuous deep sedation until death, having taken decisions they expected or partly intended to end life, and to have discussed these decisions with patients judged to have the capacity to participate in discussions. Speciality was independently related to wide variations in the reporting of decisions taken with some intent to end life, with doctors in ‘other hospital’ specialities being almost 10 times as likely to report this when compared with palliative medicine specialists, regardless of religious faith. Conclusions Greater acknowledgement of the relationship of doctors' values with clinical decision-making is advocated. (shrink)
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  13.  28
    End-of-Life Care and Pragmatic Decision Making: A Bioethical Perspective.D. Micah Hester - 2009 - Cambridge University Press.
    Every one of us will die, and the processes we go through will be our own - unique to our own experiences and life stories. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions, healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so (...)
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  14.  63
    American Sign Language and End-of-Life Care: Research in the Deaf Community. [REVIEW]Barbara Allen, Nancy Meyers, John Sullivan & Melissa Sullivan - 2002 - HEC Forum 14 (3):197-208.
    We describe how a Community-Based Participatory Research (CBPR) process was used to develop a means of discussing end-of-life care needs of Deaf seniors. This process identified a variety of communication issues to be addressed in working with this special population. We overview the unique linguistic and cultural characteristics of this community and their implications for working with Deaf individuals to provide information for making informed decisions about end-of-life care, including completion of health care directives. Our research and (...)
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  15.  57
    Internists' Attitudes Towards Terminal Sedation in End of Life Care.L. C. Kaldjian - 2004 - Journal of Medical Ethics 30 (5):499.
    Objective: To describe the frequency of support for terminal sedation among internists, determine whether support for terminal sedation is accompanied by support for physician assisted suicide , and explore characteristics of internists who support terminal sedation but not assisted suicide.Design: A statewide, anonymous postal survey.Setting: Connecticut, USA.Participants: 677 Connecticut members of the American College of Physicians.Measurements: Attitudes toward terminal sedation and assisted suicide; experience providing primary care to terminally ill patients; demographic and religious characteristics.Results: 78% of respondents believed that (...)
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  16.  34
    Causation and Intent: Persistent Conundrums in End-of-Life Care.Ben A. Rich - 2007 - Cambridge Quarterly of Healthcare Ethics 16 (1):63-73.
    In a recent special supplement to the Hastings Center Report entitled “Improving End-of-Life Care—Why Has It Been So Difficult?” Robert Burt wrote the following in an essay ominously entitled “The End of Autonomy”: No one should be socially authorized to engage in conduct that directly, purposefully, and unambiguously inflicts death, whether on another person or on oneself. Decisions that indirectly lead to death should be acted upon only after a consensus is reached among many people. No single individual should (...)
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  17. Death with Dignity is Impossible in Contemporary Japan: Considering Patient Peace of Mind in End-of-Life Care.A. Asai, K. Aizawa, Y. Kadooka & N. Tanida - 2012 - Eubios Journal of Asian and International Bioethics 22 (2):49-52.
    Currently in Japan, it is extremely difficult to realize the basic wish of protecting personal dignity at the end of life. A patient’s right to refuse life-sustaining treatment has not been substantially warranted, and advance directives have not been legally enforceable. Unfortunately, it is not until the patient is moribund that all concerned parties start to deliberate on whether or not death with dignity should be pursued. Medical intervention is often perceived as a worthwhile goal to not only preserve life, (...)
     
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  18.  88
    Precedent Autonomy, Advance Directives, and End-of-Life Care.John Davis - 2007 - In Bonnie Steinbock (ed.), The Oxford Handbook of Bioethics. Oxford University Press.
    Bioethicists are widely agreed that patients have a right of self-determination over how they are treated. Our duty to respect this is said to be based on the principle of respect for autonomy. In end-of-life care the patient may be incompetent and unable to exercise that right. One solution is to exercise it in advance. Advance directives, which include living wills and powers of attorney for health care, enable people to decide what medical treatment they will receive later, (...)
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  19.  63
    Futility, Autonomy, and Cost in End-of-Life Care.Mary Ann Baily - 2011 - Journal of Law, Medicine and Ethics 39 (2):172-182.
    This paper uses the controversy over the denial of care on futility grounds as a window into the broader issue of the role of cost in decisions about treatment near the end of life. The focus is on a topic that has not received the attention it deserves: the difference between refusing medical treatment and demanding it. The author discusses health care reform and the ethics of cost control, arguing that we cannot achieve universal access to quality (...) at affordable care without better public understanding of the moral legitimacy of taking cost into account in health care decisions, even decisions at the end of life. (shrink)
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  20.  36
    Prognosis Terminal: Truth-Telling in the Context of End-of-Life Care.Ben A. Rich - 2014 - Cambridge Quarterly of Healthcare Ethics 23 (2):209-219.
    Recent contributions to the medical literature have raised yet again the issue of whether the term “terminal” is an intelligible one and whether there is a consensus view of its meaning that is sufficient to justify or even require its use in discussing end-of-life care and treatment options with patients. Following a review of the history and development of informed consent, persistent problems with the communication of prognosis and the breaking of bad news are analyzed. The author argues that (...)
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  21. Is the Legalization of Physician-Assisted Suicide Compatible with Good End-of-Life Care?Michael B. Gill - 2009 - Journal of Applied Philosophy 26 (1):27-45.
    abstract Many have held that there is some kind of incompatibility between a commitment to good end-of-life care and the legalization of physician-assisted suicide. This opposition to physician-assisted suicide encompasses a cluster of different claims. In this essay I try to clarify some of the most important of these claims and show that they do not stand up well to conceptual and empirical scrutiny.
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  22.  58
    Do the Ward Notes Reflect the Quality of End-of-Life Care?D. P. Sulmasy, M. Dwyer & E. Marx - 1996 - Journal of Medical Ethics 22 (6):344-348.
    OBJECTIVES: To study the accuracy of reviewing ward notes (chart review) as a measure of the quality of care rendered to patients with "Do Not Resuscitate" (DNR) orders. DESIGN: We reviewed the charts of 19 consecutive, competent inpatients with DNR orders for evidence that the staff addressed a broad range of patient care needs called Concurrent Care Concerns (CCCs), such as withholding treatments other than resuscitation itself, and attention to patient comfort needs. We then interviewed the patient, (...)
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  23.  29
    Bioethics, Cultural Differences and the Problem of Moral Disagreements in End-Of-Life Care: A Terror Management Theory.M. -J. Johnstone - 2012 - Journal of Medicine and Philosophy 37 (2):181-200.
    Next SectionCultural differences in end-of-life care and the moral disagreements these sometimes give rise to have been well documented. Even so, cultural considerations relevant to end-of-life care remain poorly understood, poorly guided, and poorly resourced in health care domains. Although there has been a strong emphasis in recent years on making policy commitments to patient-centred care and respecting patient choices, persons whose minority cultural worldviews do not fit with the worldviews supported by the conventional principles of (...)
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  24.  9
    Situating Requests for Medical Aid in Dying Within the Broader Context of End-of-Life Care: Ethical Considerations.Lori Seller, Marie-Ève Bouthillier & Veronique Fraser - 2019 - Journal of Medical Ethics 45 (2):106-111.
    BackgroundMedical aid in dying was introduced in Quebec in 2015. Quebec clinical guidelines recommend that MAiD be approached as a last resort when other care options are insufficient; however, the law sets no such requirement. To date, little is known about when and how requests for MAiD are situated in the broader context of decision-making in end-of-life care; the timing of MAiD raises potential ethical issues.MethodsA retrospective chart review of all MAiD requests between December 2015 and June 2017 (...)
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  25.  24
    The POLST (Physician Orders for Life-Sustaining Treatment) Paradigm to Improve End-of-Life Care: Potential State Legal Barriers to Implementation.Susan E. Hickman, Charles P. Sabatino, Alvin H. Moss & Jessica Wehrle Nester - 2008 - Journal of Law, Medicine and Ethics 36 (1):119-140.
    The Physician Orders for Life-Sustaining Treatment Paradigm is designed to improve end-of-life care by converting patients' treatment preferences into medical orders that are transferable throughout the health care system. It was initially developed in Oregon, but is now implemented in multiple states with many others considering its use. An observational study was conducted in order to identify potential legal barriers to the implementation of a POLST Paradigm. Information was obtained from experts at state emergency medical services and long-term (...)
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  26.  43
    Evaluation of End of Life Care in Cancer Patients at a Teaching Hospital in Japan.Y. Tokuda - 2004 - Journal of Medical Ethics 30 (3):264-267.
    Objectives: To analyse the decision making for end of life care for patients with cancer at a teaching hospital in Japan at two periods 10 years apart.Design and setting: Retrospective study conducted in a 550 bed community teaching hospital in Okinawa, Japan.Patients: There were 124 terminally ill cancer patients admitted either in 1989 and 1999 for end of life care with sufficient data to permit analysis.Main measurements: Basic demographic data, notification to the patient that he or she had (...)
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  27.  6
    Relational Autonomy: What Does It Mean and How is It Used in End-of-Life Care? A Systematic Review of Argument-Based Ethics Literature.Carlos Gómez-Vírseda, Yves de Maeseneer & Chris Gastmans - 2019 - BMC Medical Ethics 20 (1):1-15.
    Respect for autonomy is a key concept in contemporary bioethics and end-of-life ethics in particular. Despite this status, an individualistic interpretation of autonomy is being challenged from the perspective of different theoretical traditions. Many authors claim that the principle of respect for autonomy needs to be reconceptualised starting from a relational viewpoint. Along these lines, the notion of relational autonomy is attracting increasing attention in medical ethics. Yet, others argue that relational autonomy needs further clarification in order to be adequately (...)
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  28.  16
    French District Nurses' Opinions Towards Euthanasia, Involvement in End-of-Life Care and Nurse Patient Relationship: A National Phone Survey.M. Bendiane, A. Galinier, R. Favre, C. Ribiere, J.-M. Lapiana, Y. Obadia & P. Peretti-Watel - 2007 - Journal of Medical Ethics 33 (12):708-711.
    Objectives: To assess French district nurses’ opinions towards euthanasia and to study factors associated with these opinions, with emphasis on attitudes towards terminal patients.Design and setting: An anonymous telephone survey carried out in 2005 among a national random sample of French district nurses.Participants: District nurses currently delivering home care who have at least 1 year of professional experience. Of 803 district nurses contacted, 602 agreed to participate .Main outcome measures: Opinion towards the legalisation of euthanasia , attitudes towards terminal (...)
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  29.  75
    Proxy, Health, and Personal Care Preferences: Implications for End-of-Life Care.Peter J. Aikman, Elaine C. Thiel, Douglas K. Martin & Peter A. Singer - 1999 - Cambridge Quarterly of Healthcare Ethics 8 (2):200-210.
    The Institute of Medicine's report, the American Medical Association's project, the Open Society Institute's and the initiative sponsored by the Robert Wood Johnson Foundation have focused attention on improving the care of dying patients. These efforts include advance care planning and the use of written advance directives. Although previous studies have provided quantitative descriptions of patient preferences for life-sustaining treatment, including those documented in written ADs, to our knowledge open-ended written preferences have not been studied. Studies of these (...)
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  30.  28
    End-of-Life Care in The Netherlands and the United States: A Comparison of Values, Justifications, and Practices.Timothy E. Quill & Gerrit Kimsma - 1997 - Cambridge Quarterly of Healthcare Ethics 6 (2):189-.
    Voluntary active euthanasia and physician-assisted suicide remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In (...)
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  31.  72
    Terminal Sedation: An Emotional Decision in End-of-Life Care.S. N. Etkind - 2012 - Journal of Medical Ethics 38 (8):508-509.
    A patient with end-stage motor neurone disease was admitted for hospice care with worsening bulbar symptoms. Although he initially walked onto the ward he became very distressed and asked for sedation. After much discussion, this man was deeply sedated, and after some harrowing days, died. Was it right to provide terminal sedation? What should the threshold be for such treatment? How should our personal reservations affect how we approach the distressed patient in an end-of-life situation?
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  32.  14
    End-of-Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices.Timothy E. Quill & Gerrit Kimsma - 1997 - Cambridge Quarterly of Healthcare Ethics 6 (2):189-204.
    Voluntary active euthanasia and physician-assisted suicide remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In (...)
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  33.  33
    End-of-Life Care: A Philosophical or Management Problem?Daniel Callahan - 2011 - Journal of Law, Medicine and Ethics 39 (2):114-120.
    End-of-life care became an important issue in the late 1960s and early 1970s. It was in great part driven by complaints about the care of the dying: lack of patient autonomy, indifferent or insensitive physicians, and inadequate pain control. The main task of those who worked to improve the situation centered on changing each of those variables, assuming that would do the job. But it has worked to a moderate extent only and the problem is not fully solved. (...)
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  34.  20
    Documented Consent Process for Implantable Cardioverter-Defibrillators and Implications for End-of-Life Care in Older Adults.A. Niewald, J. Broxterman, T. Rosell & S. Rigler - 2013 - Journal of Medical Ethics 39 (2):94-97.
    Implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients at risk for life-threatening heart arrhythmias, and their use is increasingly common. However, these devices also confer risk for delivery of unexpected painful shocks during the dying process, thus reducing the quality of palliative care at the end of life. This scenario can be avoided by ICD deactivation in appropriate circumstances but patients will remain unaware of this option if not informed about it. It is not known how often end-of-life (...)
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  35.  32
    Making the Case for Talking to Patients About the Costs of End-of-Life Care.Greer Donley & Marion Danis - 2011 - Journal of Law, Medicine and Ethics 39 (2):183-193.
    Costs at the end of life disproportionately contribute to health care costs in the United States. Addressing these costs will therefore be an important component in making the U.S. health care system more financially sustainable. In this paper, we explore the moral justifications for having discussions of end-of-life costs in the doctor-patient encounter as part of an effort to control costs. As health care costs are partly shared through pooled resources, such as insurance and taxation, and partly (...)
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  36.  75
    Medical Futility at the End of Life: The Perspectives of Intensive Care and Palliative Care Clinicians.R. J. Jox, A. Schaider, G. Marckmann & G. D. Borasio - 2012 - Journal of Medical Ethics 38 (9):540-545.
    Objectives Medical futility at the end of life is a growing challenge to medicine. The goals of the authors were to elucidate how clinicians define futility, when they perceive life-sustaining treatment (LST) to be futile, how they communicate this situation and why LST is sometimes continued despite being recognised as futile. Methods The authors reviewed ethics case consultation protocols and conducted semi-structured interviews with 18 physicians and 11 nurses from adult intensive and palliative care units at a tertiary hospital (...)
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  37. From Birth to Death? A Personalist Approach to End-of-Life Care of Severely Ill Newborns.Chris Gastmans, Gunnar Naulaers, Chris Vanhole & Yvonne Denier - 2013 - Christian Bioethics 19 (1):7-24.
    In this paper, a personalist ethical perspective on end-of-life care of severely ill newborns is presented by posing two questions. (1) Is it ethically justified to decide not to start or to withdraw life-sustaining treatment in severely ill newborns? (2) Is it ethically justified, in exceptional cases, to actively terminate the life of severely ill newborns? Based on five values—respect for life and for the dignity of the human person, quality of life, respect for the process of dying, relational (...)
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  38.  59
    Defining End-of-Life Care From Perspectives of Nursing Ethics.S. Izumi, H. Nagae, C. Sakurai & E. Imamura - 2012 - Nursing Ethics 19 (5):608-618.
    Despite increasing interests and urgent needs for quality end-of-life care, there is no exact definition of what is the interval referred to as end of life or what end-of-life care is. The purpose of this article is to report our examination of terms related to end-of-life care and define end-of-life care from nursing ethics perspectives. Current terms related to end-of-life care, such as terminal care, hospice care, and palliative care, are based on (...)
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  39.  18
    Physician-Hastened Death and End-of-Life Care: Development of a Community-Wide Consensus Statement and Guidelines.Steve Heilig & Robert V. Brody - 1998 - Cambridge Quarterly of Healthcare Ethics 7 (2):223-225.
    In mid-1996, the United States Supreme Court agreed to hear arguments and rule on two lower court cases that would, if upheld, legalize physician-assisted suicide in twelve states, including California. At about the same time, at a national meeting dealing with this controversial topic, several participants from the San Francisco Bay Area got together to ask, Based on the old principle of the suggestion was made that the local ethics committee network might be interested in developing guidelines for the (...) of patients at the end of life in the unlikely event that laws would change by Supreme Court action. Thus the coordinator of the Bay Area Network of Ethics Committees (BANEC) and several BANEC members began to discuss this question. (shrink)
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  40.  41
    Moral Obligations of Nurses and Physicians in Neonatal End-of-Life Care.Elizabeth Gingell Epstein - 2010 - Nursing Ethics 17 (5):577-589.
    The aim of this study was to explore the obligations of nurses and physicians in providing end-of-life care. Nineteen nurses and 11 physicians from a single newborn intensive care unit participated. Using content analysis, an overarching obligation of creating the best possible experience for infants and parents was identified, within which two categories of obligations (decision making and the end of life itself) emerged. Obligations in decision making included talking to parents and timing withdrawal. End-of-life obligations included providing (...)
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  41.  43
    Existential Loneliness and End-of-Life Care: A Systematic Review.Eric J. Ettema, Louise D. Derksen & Evert van Leeuwen - 2010 - Theoretical Medicine and Bioethics 31 (2):141-169.
    Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (...)
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  42.  6
    A Legal and Ethical Analysis of the Effects of Triggering Conditions on Surrogate Decision-Making in End-of-Life Care in the US.Daniel Goldberg & J. Clint Parker - 2016 - HEC Forum 28 (1):11-33.
    The central claim of this paper is that American states’ use of so-called “triggering conditions” to regulate surrogate decision-making authority in end-of-life care leaves unresolved a number of important ethical and legal considerations regarding the scope of that authority. The paper frames the issue with a case set in a jurisdiction in which surrogate authority to withdraw life-sustaining treatment is triggered by two specific clinical conditions. The case presents a quandary insofar as the clinical facts do not satisfy the (...)
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  43.  18
    Parting: A Handbook for Spiritual Care Near the End of Life.Jennifer Sutton Holder - 2004 - University of North Carolina Press.
    At times we may be called to be companions on a journey we would rather not take--the journey of a loved one toward the end of life. For those who choose to serve as close companions of terminally ill relatives or friends, Parting offers the collective wisdom of people from many cultures and faith traditions as a "travel guide" for meaningful companionship--helping someone toward a peaceful transition from this life. Sections of the book discuss how to cross the bridge from (...)
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  44.  4
    End-of-Life Care in a Nursing Home: Assistant Nurses’ Perspectives.Bodil Holmberg, Ingrid Hellström & Jane Österlind - 2019 - Nursing Ethics 26 (6):1721-1733.
    Background: Worldwide, older persons lack access to palliative care. In Sweden, many older persons die in nursing homes where care is provided foremost by assistant nurses. Due to a lack of beds, admission is seldom granted until the older persons have complex care needs and are already in a palliative phase when they move in. Objective: To describe assistant nurses’ perspectives of providing care to older persons at the end of life in a nursing home. Research (...)
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  45. The Impact of Roman Catholic Moral Theology on End-of-Life Care Under the Texas Advance Directives Act.David Zientek - 2006 - Christian Bioethics 12 (1):65-82.
    This essay reviews the Roman Catholic moral tradition surrounding treatments at the end of life together with the challenges presented to that tradition by the Texas Advance Directives Act. The impact on Catholic health care facilities and physicians, and the way in which the moral tradition should be applied under this statute, particularly with reference to the provision dealing with conflicts over end-of-life treatments, will be critically assessed. I will argue, based on the traditional treatment of end-of-life issues, that (...)
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  46.  42
    Using the Family Covenant in Planning End-of-Life Care: Obligations and Promises of Patients, Families, and Physicians.David J. Doukas - unknown
    Physicians and families need to interact more meaningfully to clarify the values and preferences at stake in advance care planning. The current use of advance directives fails to respect patient autonomy. This paper proposes using the family covenant as a preventive ethics process designed to improve end-of-life planning by incorporating other family members—as agreed to by the patient and those family members—into the medical care dialogue. The family covenant formulates advance directives in conversation with family members and with (...)
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  47.  54
    Liver Transplantation Using 'Donation After Circulatory Death' Donors: The Ethics of Managing the End-of-Life Care of Potential Donors to Achieve Organs Suitable for Transplantation.G. Moorlock, H. Draper & S. R. Bramhall - 2011 - Clinical Ethics 6 (3):134-139.
    The decline in organs donated after brain death has been countered by an increase in organs donated after circulatory death. Organs donated after circulatory death present an increased risk of complications for their eventual recipients when compared with organs donated after brain death, so the likelihood of successful transplantation is decreased. If organ donation is considered to be in the best interests of the patient, interventions that facilitate successful donation and transplantation might be permissible. This paper seeks to establish whether (...)
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  48.  18
    Ethical Practice in End-of-Life Care in Japan.Shigeko Izumi - 2010 - Nursing Ethics 17 (4):457-468.
    Nurses are obliged to provide quality nursing care that meets the ethical standards of their profession. However, clear descriptions of ethical practice are largely missing in the literature. Qualitative research using a phenomenological approach was conducted to explicate ethical nursing practice in Japanese end-of-life care settings and to discover how ethical practices unfold in clinical situations. Two paradigm cases and contrasting narratives of memorable end-of-life care from 32 Japanese nurses were used to reveal four levels of ethical (...)
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  49.  9
    Multi-Dimensional Approach to End-of-Life Care: The Welfare Model.Shin Wei Sim, Tze Ling Gwendoline Beatrice Soh & Lalit Kumar Radha Krishna - 2019 - Nursing Ethics 26 (7-8):1955-1967.
    Appropriate and balanced decision-making is sentinel to goal setting and the provision of appropriate clinical care that are attuned to preserving the best interests of the patient. Current family-led decision-making in family-centric societies such as those in Singapore and other countries in East Asia are believed to compromise these objectives in favor of protecting familial interests. Redressing these skewed clinical practices employing autonomy-based patient-centric approaches however have been found wanting in their failure to contend with wider sociocultural considerations that (...)
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  50.  4
    Comparison of Thai Older Patients’ Wishes and Nurses’ Perceptions Regarding End-of-Life Care.Manchumad Manjavong, Varalak Srinonprasert, Panita Limpawattana, Jarin Chindaprasirt, Srivieng Pairojkul, Thunchanok Kuichanuan, Sawadee Kaiyakit, Thitikorn Juntararuangtong, Kongpob Yongrattanakit, Jiraporn Pimporm & Jinda Thongkoo - 2019 - Nursing Ethics 26 (7-8):2006-2015.
    Background: Achieving a “good death” is a major goal of palliative care. Nurses play a key role in the end-of-life care of older patients. Understanding the perceptions of both older patients and nurses in this area could help improve care during this period. Objectives: To examine and compare the preferences and perceptions of older patients and nurses with regard to what they feel constitutes a “good death.” Research design: A cross-sectional study. Participants and research context: This study (...)
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