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When Treatment Fails: How Medicine Cares for Dying Children

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Medical care of the terminally ill is one of the most emotionally fraught and controversial issues before the public today. As medicine advances and technologies develop, end-of-life care becomes more individualized and uncertain, guided less by science and more by values and beliefs. The crux of the controversy is when to withhold or withdraw curative treatments—when is enough, enough?
Political debates rage about when treatment is no longer effective; difficult cases are ...

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Overview

Medical care of the terminally ill is one of the most emotionally fraught and controversial issues before the public today. As medicine advances and technologies develop, end-of-life care becomes more individualized and uncertain, guided less by science and more by values and beliefs. The crux of the controversy is when to withhold or withdraw curative treatments—when is enough, enough?
Political debates rage about when treatment is no longer effective; difficult cases are contested in courts; and the media devour the most sensational aspects of end-of-life care. In all this excitement and controversy, what is sadly overlooked is the extreme pressure that care of the terminally ill puts on medical staff as they deal with patients and their families and make life-or-death decisions. That pressure—the psychological strain and continuing uncertainties—is magnified when the patients are children.
David Bearison looks at this controversial issue from the perspective of the medical staff caring for dying children. Not just doctors, but nurses and counselors as well. By capturing their stories—as no other book has, Bearison is able to move beyond broad, abstract ideas about end-of-life care to convey the situated contexts of such care, including the complications, disagreements, frustrations, confusions, and unexpected setbacks.
In addition to a discussion of questions surrounding whether to withhold or withdraw curative treatments, When Treatment Fails explores the crucial concerns of those medical practitioners who care for dying children: education and training, relation with one another, communicating with patients and families, and finally, coping and moving on. Ultimately, the threads connecting these themes are the great costs and rewards of this difficult work, and the lessons that can be drawn from the nitty-gritty experiences of medical practitioners who struggle to find the balance between trying to defeat death and trying to provide comfort.

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Editorial Reviews

Doody's Review Service
Reviewer: Richelle Monier, MD (Ochsner Clinic Foundation)
Description: This is a unique book written by a child psychiatrist that examines pediatric and end-of-life care from the perspective of the medical staff.
Purpose: The purpose is to more fully examine end-of-life care for children and their families. There are currently no other books examining this topic so extensively or with such a unique perspective. The book meets the author's objectives.
Audience: It is written for anyone who takes care of pediatric patients during the end of their life — especially pediatric hematologists/oncologists.
Features: This is a narrative of end-of-life issues for 20 pediatric patients from the perspective of various members of the medical team. It includes the staff's views/memories of specific patients as well as topics such as curative vs. palliative care and pain and suffering, as well as how patients and families reacted during this time period. David Bearison provides a very unique and innovative perspective in examining this complex issue.
Assessment: This book is truly unique in its evaluation of pediatric end-of-life care issues from the medical staff's perspective. It is of high quality and would be useful reading for all medical personnel involved in the care of a dying child.
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Product Details

  • ISBN-13: 9780195156126
  • Publisher: Oxford University Press, USA
  • Publication date: 2/9/2006
  • Pages: 312
  • Product dimensions: 9.30 (w) x 6.30 (h) x 1.10 (d)

Meet the Author

David J. Bearison's many positions include Professor of Developmental Psychology at the Graduate Center of the City University of New York, Adjunct Professor of Medical Psychology in Pediatrics and Psychiatry at the College of Physician and Surgeons of Columbia University, and Attending at the Children's Hospital of New York (CHONY), Columbia Presbyterian Medical Center. He is a member of the American Psychological Association's Task Force on End-of-Life Issues for Children and Adolescents. He lives with his wife, a pediatric oncologist, in New York City and Croton on Hudson, NY.

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Table of Contents

1. Pediatric End-of-Life Care
2. Narrative Theory, Medicine, and Methods
3. Twenty Stories About How Children Die
4. Withholding or Withdrawing Curative Treatments
5. Pain and Suffering
6. Staff Reacting
7. Patients and Families Reacting
8. Conclusions

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Sort by: Showing 1 Customer Reviews
  • Anonymous

    Posted November 8, 2007

    Why does anyone trust his opinion?

    I have met this man and I think he is a very strange individual. He is the last person to tell caring doctors how they should treat patients or how they should interact with patients. Doctors are doing just fine without him. Maybe there should be more strict professional standards for psychologists -- we would then see fewer authors like Dr. Bearison. I give the book two or three stars, but the man belongs very far away from terminally ill patients and their dedicated physicians.

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