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End-of-Life Care and Pragmatic Decision Making provides a 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 should pay close attention to the narratives of patients and the communities they inhabit so that their dying processes embody their life stories.
Every one of us will die, and the processes we go through will be our own - unique to our own experiences and life stories. Hester argues that it is reasonable to reflect on what kinds of dying processes may be better or worse for us as we move toward our end. Such consideration, however, can raise troubling ethical concerns for patients, families, and healthcare providers. Even after forty years of concerted focus on biomedical ethics, these moral concerns persist in the care of lethally impaired, terminally ill, and injured patients.
Hester discusses three types of end-of-life patient populations - adults with decision-making capacity, adults without capacity, and children (with a specific focus on infants) - to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients.
1 Crito Revisited 1
2 Blindness, Narrative, and Meaning: Moral Living 13
3 Radical Experience and Tragic Duty: Moral Dying 41
4 Needing Assistance to Die Well: PAS and Beyond 59
5 Experiencing Lost Voices: Dying without Capacity 92
6 Dying Young: What Interests Do Children Have? 126
7 Caring for Patients: Cure, Palliation, Comfort, and Aid in the Process of Dying 156
Works Cited 163