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This volume explores the debate over medically futile treatment in the ICU, where the urgency to resolve it amounts yearly. Dr. Kelly presents an introduction to the arguments over medically futile treatment in the United States. Then, three fictitious patients arrive in turn at the ICU, each critically ill but with a different degree of promise. A panel of experienced critical care physicians from around the world offer their assessments and propose management based on resources they routinely have before describing what they would do with unlimited resources.
For over thirty years, David F. Kelly has worked with medical practitioners, students, families, and the sick and dying to confront the difficult and often painful issues that concern medical treatment at the end of life. In this short and practical book, Kelly shares his vast experience, providing a rich resource for thinking about life's most painful decisions. Kelly outlines eight major issues regarding end-of-life care as seen through the lens of the Catholic medical ethics tradition. He looks at the distinction between ordinary and extraordinary means; the difference between killing and allowing to die; criteria of patient competence; what to do in the case of incompetent patients; the meaning and use of advance directives; the morality of hydration and nutrition; physician-assisted suicide and euthanasia; and medical futility. Kelly's analysis is sprinkled with significant legal decisions and, throughout, elaborations on how the Catholic medical ethics tradition—as well as teachings of bishops and popes—understands each issue. He provides a helpful glossary to supplement his introduction to the terminology used by philosophical health care ethics. Included in Kelly's discussion is his lucid description of why the Catholic tradition supports the discontinuation of medical care in the Terry Schiavo case. He also explores John Paul II's controversial papal allocution concerning hydration and nutrition for unconscious patients, arguing that the Catholic tradition does not require feeding the permanently unconscious. Medical Care at the End of Life addresses the major issues that inform this last stage of caregiving. It offers a critical guide to understanding the medical ethics and relevant legal cases needed for clear thinking when individuals are faced with those crucial decisions.
Talking to patients and their families about end-of-life issues can be difficult and stressful. This book looks at ways different cultures view death and then further explores how health care providers around the world communicate about such sensitive issues as withholding or withdrawing life support and discussing options when the outcome is uncertain. By offering a better understanding of cultural differences in attitudes about death and methods of communications about end-of-life issues, the coverage in this important book helps prepare healthcare practitioners to be better communicators – both within and outside of their own cultures.
A penetrating look at the values, systems, and life-and-death dramas in the world of the surgical intensive care unit.
Intensive care medicine is one of the fastest growing services provided by hospitals and perhaps one of the most expensive. Yet in response to the global financial crisis of the last few years, healthcare funding is slowing or decreasing throughout the world. How we manage health care resources in the intensive care unit (ICU) now and in a future that promises only greater cost constraints is the subject of this book, the third in an informal series of volumes providing a global perspective on difficult issues arising in the ICU. Taking 12 developed countries as their focus, leading experts provide a country-by-country analysis of current ICU resource allocation. A second group of experts use the chapters as a departure point to analyze current ICU resource allocation at the level of the global medical village. The process is repeated, but with an eye toward the future – first country by country, then at the global level – that takes into account initiatives and reforms now underway. A fictional healthcare plan, the “Fair & Equitable Healthcare Plan,” is put forth to address weaknesses in existing approaches, and healthcare experts and ethicists are invited to respond to its often provocative provisions. Itself structured as a dialogue, the book is an excellent way to start or to continue serious discussion about the allocation of ICU healthcare resources now and in the years ahead.
Designated a Doody's Core Title! At the intersection of health care delivery and practice there lies a large area of patient care with no manual: how to provide the best care to patients who have a critically low level of comprehension and literacy. Because all patients play a central role in the outcome of their own health care, competent health care becomes almost impossible for caregivers when the boundary of low literary skills is present. In a concise and well-written format you will learn: Common myths about low literacy Examples of low health care literacy How to recognize patients with low literacy Strategies to help patients with low literacy and reduce medical errors Cultural issues in health literacy Ways to create a patient-friendly office environment How to improve patient communication Guidelines to target and overcome common problems practitioners encounter This clear, well written book is packed with examples and tips and will serve as a much needed guide for primary care providers, nurse practitioners, hospital administrators, and others who are looking for ways to improve their communication with patients and provide the most beneficial health care to their low-literacy patients.

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