Ethical Patient Care: A Casebook for Geriatric Health Care Teams

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The delivery of good medical care often involves professionals from various disciplines working together. Interdisciplinary health care teams can be especially valuable in managing patients with complex medical and social needs, such as older persons in hospital, community, or home settings. Such teams, however, can also complicate or even create problems because of their diverse views and responsibilities. Ethical Patient Care: A Casebook for Geriatric Health Care Teams is designed to teach effective and ...

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Overview

The delivery of good medical care often involves professionals from various disciplines working together. Interdisciplinary health care teams can be especially valuable in managing patients with complex medical and social needs, such as older persons in hospital, community, or home settings. Such teams, however, can also complicate or even create problems because of their diverse views and responsibilities. Ethical Patient Care: A Casebook for Geriatric Health Care Teams is designed to teach effective and responsible group decision making to clinicians working in teams to treat older patients.

The editors use the case study method to present ethical dilemmas that team members encounter in the management of geriatric patients. Patients with multiple chronic conditions so often require the care of more than one medical specialist, and in the introductory chapters the editors suggest ways to resolve conflicts among patients, health care professionals, and the institutions that support them, including hospitals, HMOs, insurance companies, and the government. The book is then divided into four sections, each dealing with one angle of the team-care picture. The first section treats the diverse ethical imperatives of various professionals, conflicts among disciplinary approaches, and and varying attitudes toward end-of-life- decision making. Section two focuses on the patient and covers patient confidentiality, family decisionmaking and interaction with the healthcare team, issues of patient and team nonadherence to the care plan, and elder abuse and neglect. Section three examines the emerging difficulties of decentralized health care in settings such as hospitals, nursing homes, and the home, including clinician accountability and how ethical dilemmas differ across settings. Section four discusses the problems arising from the increasing responsibility of clinicians to manage costs and serve the interests of hospitals and insurers. Ethical Patient Care is a valuable resource for bioethicists, gerontologists, and the physicians, nurses, social workers, and therapists who care for aging persons.

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Editorial Reviews

Journal of Interprofessional Care

This work is a must-read for geriatric health care team development. And it will be an essential, extremely useful addition to the bookshelf of anyone whose clinical practice or career focus is in geriatrics.

— Bethel Ann Powers

Health Progress

This is a very readable book on ways in which interdisciplinary teams can interact efficiently. The authors offer excellent comments on how to resolve conflicts between team members... I strongly recommend this book to those who wish to learn more about how to create highly functional interdisciplinary teams.

— John E. Morley

Doody's Review Service
Reviewer: Deborah Kuhn Bruley, MS, RN (University of Illinois at Chicago College of Nursing)
Description: This book uses case analyses to teach ethical geriatric care from an interdisciplinary team perspective. Most chapters include discussion questions or small group activities to assist learning.
Purpose: The book facilitates the education and training of healthcare professionals in the area of ethical geriatric care from an interdisciplinary perspective and approach. This interdisciplinary team approach is greatly needed in the current healthcare climate and is applicable to today's clinical practice. By gathering authors from many different disciplines and levels of healthcare, the authors have contributed greatly to our understanding of the theoretical and practical issues involved in supplying ethical geriatric care.
Audience: The entire healthcare team is targeted, including physicians, nurses, social workers, pharmacists, and other healthcare professionals. Throughout the book, these various professions are represented in authorship, examples, and references. Drawing from a large group of contributors, this book is applicable for all healthcare professions.
Features: The book provides an overview of ethical geriatric principles and how they apply in many different cases, with particular attention given to the results of their application for patients, families, healthcare professionals, and healthcare systems. By including discussion questions and small group activities with most chapters, educational activities are facilitated. However, inclusion of additional tables and graphs would have clarified some of the processes described in narrative.
Assessment: This is a wonderful addition to the libraries of both educators and clinicians. Its up-to-date examples of the complex issues involved in providing ethical geriatric care present thought-provoking educational material as well as guidance in providing interdisciplinary healthcare. Although examples are of geriatric cases, their applicability in discussing ethical healthcare for other populations can be easily seen. I know of no other book with this up-to-date, unique perspective on providing ethical patient care to elderly patients and their families.
Beatrice M. Robbins
This is a timely exploration of the ethical issues being encountered on a daily basis by geriatric practitioners. The combination of instructional chapters providing a theoretical framework with chapters outlining cases yields a very useful and practical text.
Peter V. Rabins
I know of no other volume that addresses the ethical issues raised by team care in such depth.
From The Critics
Designed to promote effective and responsible group decision-making for inter-disciplinary health care teams, this book uses case studies to illustrate ethical problems related to the management of geriatric patients. Specific methods are outlined for resolving conflicts between patients, health care professionals, and medical institutions. Seventeen chapters consider the role of professionals, the interests of care recipients, teamwork, and the impact of organization on team care. Annotation c. Book News, Inc., Portland, OR (booknews.com)

3 Stars from Doody
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Product Details

  • ISBN-13: 9780801867705
  • Publisher: Johns Hopkins University Press
  • Publication date: 1/28/2002
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 376
  • Product dimensions: 6.12 (w) x 8.98 (h) x 0.94 (d)

Meet the Author

Mathy D. Mezey, Ed.D., R.N., is Independence Foundation Professor of Nursing Education and Director of the John A. Hartford Foundation Institute for Geriatric Nursing Practice in the Division of Nursing at New York University. She and her coeditors directed efforts for the John A. Hartford Foundation's Geriatric Interdisciplinary Team Training (GITT) Program.

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Table of Contents

List of Contributors ix
Foreword xiii
Preface xv
I Introduction
1 An Introduction to Bioethics as It Relates to Teams and Geriatrics 3
2 Using This Book as a Teaching Tool 23
II Professionals
3 Ethics and Cultures of Care 41
4 Professional Attitudes Toward End-of-Life Decision Making 67
III Care Recipients
5 Protecting the Patient's Voice on the Team 83
6 Guarding Patients' Secrets: Clinicians' Responsibility to Protect Patient Confidentiality 102
7 Conflicting Interests: Dilemmas of Decision Making for Patients, Families, and Teams 119
8 Refusal to Comply: What to Do When the Interdisciplinary Team Plan Doesn't Work 136
9 Protecting Patients: The Special Case of Elder Abuse and Neglect 151
IV Teams and How They Work Across Health Care Settings
10 Using Ethics Consultation to Resolve Team Conflict 169
11 Avoiding the Dark Side of Geriatric Teamwork 187
12 Exploring Responsibility, Accountability, and Authority in Geriatric Team Performance 208
13 The Locus of Care and Its Effect on the Presentation of Ethical Conundrums 230
V Impact of the Organization on Team Care
14 Ethical Dilemmas of Team Decisions in a Cost-Conscious Environment 259
15 Duly Compensated or Compromised? Multiple Providers and Cross-Institutional Decision Making 277
16 Transitions from Setting to Setting along the Care Continuum: The Case for Megateams 295
17 Emerging Ethical Issues in Geriatric Team Care 317
Glossary 333
Index 343
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