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Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life: Revised and Expanded Second Edition 2nd Revised edition [Mīkstie vāki]

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(, Hastings Center, Yale University School of Nursing, USA), (, University of Minnesota, USA), (, Center for Humans and Nature, Yale University School of Public Health, USA)
  • Formāts: Paperback / softback, 264 pages, height x width x depth: 175x249x15 mm, weight: 454 g
  • Izdošanas datums: 20-Jun-2013
  • Izdevniecība: Oxford University Press Inc
  • ISBN-10: 0199974551
  • ISBN-13: 9780199974559
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Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life: Revised and Expanded Second Edition 2nd Revised editionPalielināt
  • Formāts: Paperback / softback, 264 pages, height x width x depth: 175x249x15 mm, weight: 454 g
  • Izdošanas datums: 20-Jun-2013
  • Izdevniecība: Oxford University Press Inc
  • ISBN-10: 0199974551
  • ISBN-13: 9780199974559
Citas grāmatas par šo tēmu:
Permanent link: https://www.kriso.lv/db/9780199974559.html
Keywords:
Decisions about life-sustaining treatment are often ethically challenging for patients, surrogate decision-makers, and health care professionals. Providing safe, effective, and compassionate care near the end of life is a priority for health care organizations. In times of uncertainty, crisis, or reflection, and in efforts to improve health care for seriously ill patients, guidelines can help.

This is the first updated, expanded edition of The Hastings Center's 1987 Guidelines on the Termination of Life-Sustaining Treatment and Care of the Dying, which shaped the ethical and legal framework for decision-making on treatment and end-of-life care in the United States. The new edition, the product of an authoritative consensus process, incorporates 25 years of research, innovation, and developments in law and policy. It summarizes the current framework for making good decisions about treatment and care and identifies educational and organizational goals for health care systems. It covers care planning, decision-making for adults and for children, care transitions, the determination of death, and the policies and processes that support good care at the bedside. It also addresses the psychological and social dimensions of care near the end of life, with attention to effective communication with patients and loved ones and among team members.

This book is written for physicians, nurses, and other clinicians in hospitals, nursing homes, home care, and hospice. It is structured for ease of reference during difficult clinical situations and includes extensive practical recommendations supported by print and online resources. This book is also essential reading for clinical ethicists, ethics committee members, health lawyers, and medical and nursing directors. As the U.S. confronts the challenges of health care reform, an aging population, increasing technological capacity to extend life, and serious cost implications, The Hastings Center Guidelines are invaluable to educators, scholars, and policymakers.

Recenzijas

Reports and publications from the Hastings Center have been influential in shaping and defining our professional attitudes to ethics of clinical care, particularly in regard to euthanasia and physician-assisted suicide (PAS) and other matters related to end-of-life care. This second edition of their Guidelines is very welcome and provides a clear and reasoned approach to the different clinical scenarios... It's a pleasure to read as the material is logically sequenced and each statement or recommendation is justified-you feel each bit has been thought through and care taken to write it clearly. If you have an interest in the ethical underpinnings of what we do, this book is for you. If you teach about ethics and clinical practice, or are responsible for it at your institution, this is required reading. * Roger Woodruff for IAHPC News, July 2013 * This groundbreaking expansion of the Guidelines incorporates research and innovation in clinical care, law, and policy. It is written for physicians, nurses, and other health care professionals and is structured for easy reference in difficult clinical situations. It supports the work of clinical ethicists, ethics committee members, health lawyers, clinical educators, scholars, and policymakers. It includes extensive practical recommendations. * Anticancer Research, August 2013 *

Preface to the Second Edition xiii
Contributors xvii
How These Guidelines Are Organized xxiii
Introduction 1(8)
The Function and Sources of These Ethics Guidelines
2(1)
Legal and Ethical Consensus Informing These Guidelines: Rights, Protections, and Key Philosophical Distinctions
3(6)
Part One Framework and Context
9(24)
Section 1 Ethics Goals for Good Care When Patients Face Decisions about Life-Sustaining Treatment or Approach the End of Life
11(8)
Section 2 Ethics Education Competencies for Health Care Professionals Caring for Patients Facing Decisions about Life-Sustaining Treatment or Approaching the End of Life
19(4)
Section 3 Organizational Systems Supporting Good Care and Ethical Practice
23(2)
Section 4 Social, Economic, and Legal Contexts
25(8)
A Social Context
25(3)
B Economic Context
28(3)
C State and Federal Context
31(2)
Part Two Guidelines on Care Planning and Decision-Making
33(96)
Section 1 Guidelines for Advance Care Planning and Advance Directives: Using Patient Preferences to Establish Goals of Care and Develop the Care Plan
35(8)
Section 2 Guidelines for the Decision-Making Process
43(24)
A Evaluating the Patient
44(2)
B Determining Decision-Making Capacity
46(2)
C Identifying the Key Decision-Maker
48(1)
D Surrogate Decision-Making
48(6)
E Making the Decision at Hand
54(5)
F Documenting the Decision
59(3)
G Implementing the Decision
62(1)
H Changing Treatment Decisions
63(1)
I Conflicts and Challenges Related to Treatment Decision-Making
63(4)
Section 3 Guidelines Concerning Neonates, Infants, Children, and Adolescents
67(22)
A General Guidelines for Pediatric Decision-Making Concerning the Use of Life-Sustaining Treatments
72(7)
B Guidelines for Decision-Making and Care Involving Nonviable Neonates and Neonates at the Threshold of Viability
79(3)
C Guidelines for Decision-Making about Life-Sustaining Treatment for Viable Neonates
82(1)
D Guidelines for Decision-Making about Life-Sustaining Treatment for Young Children
83(1)
E Guidelines for Decision-Making with Older Children
84(1)
F Guidelines for Decision-Making with Adolescents
85(1)
G Guidelines for Decision-Making by Mature Minors and Emancipated Minors
86(3)
Section 4 Guidelines for Care Transitions
89(16)
A General Guidelines for Hand-Offs between Professionals and Transfers Across Care Settings
90(2)
B Guidelines on Care Transitions for Nursing Home Residents
92(4)
C Guidelines on Portable Medical Orders
96(3)
D Guidelines on Discharge Planning and Collaboration with Nursing Homes, Home Care, Hospice, and Outpatient Care
99(3)
E Guidelines on Care Transitions for Patients Who Will Die in the Hospital
102(3)
Section 5 Guidelines for the Determination of Death
105(6)
A Procedural Guidelines for Making a Determination of Death and for Making a Declaration of Death
106(3)
B The Determination of Death: Continuing Ethical Debates
109(2)
Section 6 Guidelines for Institutional Policy
111(18)
A Guidelines on Ethics Services in Institutions Providing Care for Patients Facing Decisions about Life-Sustaining Treatment on Approaching the End of Life
112(4)
B Guidelines on Palliative Care Services
116(3)
C Guidelines Supporting Advance Care Planning
119(2)
D Guidelines Supporting Portable Medical Orders
121(1)
E Guidelines Supporting Care Transitions
122(2)
F Guidelines on the Role of Institutional Legal Counsel and Risk Management in Supporting Good Care
124(1)
G Guidelines on Conflict Resolution
125(4)
Part Three Communication Supporting Decision-Making and Care
129(68)
Section 1 Communication with Patients, Surrogates, and Loved Ones
131(8)
A Conducting a Family Conference When a Patient's Condition Is Deteriorating
132(3)
B Supporting the Decision-Maker When Loved Ones Disagree
135(1)
C Discussing Values Concerning Nutrition and Hydration
136(1)
D Using Electronic and Telephone Communications with Seriously Ill Patients or with Surrogates and Loved Ones
137(2)
Section 2 Communication and Collaboration with Patients with Disabilities
139(6)
A Life-Sustaining Treatments and Accommodation of Stable or Progressive Disabilities
140(1)
B Communication When a Patient's Disability Affects Speech
140(1)
C Communication When a Patient's Disability Affects Cognition
141(1)
D Communication and Collaboration with Recently Disabled Patients Concerning Life-Sustaining Treatments
142(3)
Section 3 Psychological Dimensions of Decision-Making about Life-Sustaining Treatment and Care Near the End of Life
145(10)
A Coping as a Factor in Treatment Decision-Making
146(1)
B Hope as a Factor in Treatment Decision-Making
146(2)
C Ambivalence, Denial, and Grief as Factors in Treatment Decision-Making
148(1)
D Existential Suffering as a Factor in Treatment Decision-Making
149(1)
E Spirituality and Religion as Factors in Treatment Decision-Making
149(1)
F Religious Objections During Treatment Decision-Making
150(1)
G Moral Distress as a Factor in Treatment Decision-Making
151(2)
H Integrating Bereavement Care for Loved Ones and Professionals into Care Near the End of Life
153(2)
Section 4 Decision-Making Concerning Specific Treatments and Technologies
155(32)
A Forgoing Life-Sustaining Treatments: Ethical and Practical Considerations for Clinicians
155(2)
B Brain Injuries and Neurological States
157(4)
C Mechanical Ventilation
161(4)
D Cardiopulmonary Resuscitation and Cardiac Treatments
165(4)
E Dialysis
169(2)
F Nutrition and Hydration
171(3)
G Chemotherapy and Other Cancer Treatments
174(4)
H Routine Medications, Antibiotics, and Invasive Procedures
178(3)
I Blood Transfusion and Blood Products
181(2)
J Palliative Sedation
183(4)
Section 5 Institutional Discussion Guide on Resource Allocation and the Cost of Care
187(10)
A Developing a Practice of Discussing Resource Allocation and the Cost of Care: Six Strategies
188(4)
B Discussing Uncompensated Care for Patients Without Insurance
192(5)
Notes 197(6)
Glossary 203(4)
Cited Legal Authorities 207(2)
Selected Bibliography 209(24)
Index 233
Nancy Berlinger is a Research Scholar at The Hastings Center and teaches ethics in master's and doctoral programs at the Yale University School of Nursing. She directed the Hastings Center project that produced the revised edition of the Guidelines and is also the author of After Harm: Medical Error and the Ethics of Forgiveness (Johns Hopkins University Press, 2005). Her research and publications include topics in end-of-life care, palliative care, chronic illness, patient safety, and health policy. She serves on the bioethics committee at Montefiore Medical Center, Bronx, New York and is involved in clinician education in the New York area, nationally, and internationally.





Bruce Jennings is Director of Bioethics at the Center for Humans and Nature and teaches ethics at the Yale School of Medicine. He has published widely on ethical issues in end-of-life treatment decision making and palliative care. He has served on the Board of Directors of the National Hospice and Palliative Care Organization (NHPCO) and on numerous hospital ethics committees in the New York metropolitan area.





Susan M. Wolf is McKnight Presidential Professor of Law, Medicine & Public Policy at the University of Minnesota, as well as Founding Chair of the University's Consortium on Law and Values in Health, Environment & the Life Sciences, and a Faculty Member in the Center for Bioethics. She is an elected Member of the National Academy of Science's Institute of Medicine, elected Fellow of the AAAS, and elected Fellow of The Hastings Center. She directed the Hastings Center project that produced the first edition of the Guidelines in 1987, and was principal author of that work.