The Oxford Handbook of Ethics at the End of Life

by Stuart J. Youngner, Robert M. Arnold

Overview

This handbook explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. In this period, technology has radically changed medical practices and the way we die as structures of power have been reshaped by the rights claims of African Americans, women, gays, students, and, most relevant here, patients. Respecting patients' values has been recognized as the essential moral component of clinical decision-making. Technology's promise has been seen to have a dark side: it prolongs the dying process. For the first time in history, human beings have the ability control the timing of death. With this ability comes a responsibility that is awesome and inescapable. How we understand and manage this responsibility is the theme of this volume. The book comprises six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II
focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues. Section IV discusses death and dying among various vulnerable populations such as the elderly and persons with disabilities. Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as a way to address the psychosocial and ethical problems of death and dying.

Product Details

ISBN-13:	9780199974412
Publisher:	Oxford University Press
Publication date:	10/11/2016
Series:	Oxford Handbooks
Pages:	488
Product dimensions:	9.90(w) x 7.10(h) x 1.50(d)

About the Author

Stuart J. Youngner is the Susan E. Watson Professor of Bioethics and Chair of the Department of Bioethics at Case Western Reserve University School of Medicine. He has written and spoken extensively about definitions of death, organ and tissue transplantation, end-of-life decisions, and clinical ethics consultation.

Robert M. Arnold, MD is Professor of Medicine, UPMC Montefiore Hospital

Table of Contents

Background: The Smell of Chlorine: Coming to Terms with Death (Stuart J. Youngner and Robert M. Arnold)
Section I: Clinical and Legal Issues
1. Legal Issues in Death and Dying: How Rights and Autonomy Have Shaped Clinical Practice (Alan Meisel)
2. "So what do you want us to do?" Patient's Rights, Unintended Consequences, and the Surrogate's Role (Mark Aulisio)
3. Death at the Beginning: The Neonatal Intensive Care Unit (Renee D. Boss)
4. Dying Children and the Kindness of Strangers (John D. Lantos)
5. Medical Futility and Physician Power (Douglas White, Thaddeus Pope)
6. Conscientious Objection (Mark R. Wicclair)
7. Continuous Sedation at the End of Life (Sigrid Stercks, Kasper Raus)
8. Fluids and Nutrition (Daniel Salmasy)
9. Disorders of Consciousness and Neuro-Palliative Care: Towards an Expanded Scope of Practice for the Field (Joseph Fins and Maria G. Master)
10. Ethical Issues in Prognosis and Prognostication (Alexander K. Smith, Paul Glare)
Section II: Theoretical, Cultural, and Psychosocial Issues
11. The Nature of Suffering (Eric J. Cassell)
12. On Our Difficulties Speaking To and About the Dying (David Barnard)
13. The Cost of Dying among the Elderly in the United States: Ethical Issues (Susannah Rose and Janelle Highland)
14. Death, Dying and the Disabled (Anita Silvers, Leslie Francis)
15. The Effect of Social Media on End-of-Life Decision Making (Jessica Berg)
16. Cultural Factors (Megan Crowley-Matoka)
17. Ethnicity as a Factor (Kimberly S. Johnson, Ramona L. Rhodes)
18. Reframing Care in End-of-Life Care: Helpful Themes from a Catholic-Christian Understanding of Death (Michael McCarthy, Mark Kuczewski)
Section III: Physician-Assisted Death
19. Physician-Assisted Death in the Netherlands (Gerrit Kimsma).
20. The Case Against Physician-Assisted Suicide and Euthanasia (Ira Byock)
21. Goodbye Thomas: The Case for Physician-Assisted Dying (Margaret P. Battin)
22. Depression and the Desire to Die Near the End of Life (Nathan Fairman, Scott A. Irwin)
Section IV: The Emergence of Palliative Care and Hospice
23. Hospice and Palliative Care: Developments, Differences and Challenges (David Clark)
24. Potential Perils to the Promise of Specialty Palliative Care (Robert Arnold)
25. The Social Marketing of Palliative Care in Public Policy (Rolfe Sean Morrison, Bridget Tracy)
26. Talking and Working with Dying Patients: True Grief and Loss (Lisa Humphrey)

Editorial Reviews

Reviewer: Kimbell Kornu, MD, PhD (Saint Louis University)
Description: This edited volume of essays covers a wide range of topics in the ethical dimensions of end-of-life care from a diversity of legal, philosophical, historical, and clinical perspectives.
Purpose: According to the editors, the purpose is to explore the "topic of death and dying during the fifty to sixty years spanning the late twentieth and early twenty-first centuries, primarily in the United States", paying close attention to understanding and managing the ethical responsibility of controlling the timing of death. A comprehensive, authoritative survey is needed to provide the historical and legal contexts for the ethical issues in end-of-life care as well as a critical assessment of the current debates and clinical practices. This book meets the stated purpose.
Audience: While the editors do not state this explicitly, the book is intended for graduate students and scholars in bioethics as well as clinicians in hospice and palliative medicine, critical care, pediatrics, geriatrics, and internal medicine. The editors and many of the authors are internationally renowned scholars and clinicians in ethics and end-of-life care.
Features: Four sections cover clinical and legal issues; theoretical, cultural, and psychosocial issues; physician-assisted death; and the emergence of palliative care and hospice. The strength of the book is the diversity of topics written by experts in their respective fields. The essays range from the practical for approaching the clinical situation, to the philosophical that provide arguments for and against physician-assisted suicide, to the historical and legal that represent the varied dimensions of pediatrics, disability, ethnicity, and culture. Not only are the essays succinct introductions to the topics, but many also advance the current debates. Particularly useful are an introductory discussion of social media in end-of-life decision-making, a Dutch perspective on physician-assisted suicide in the Netherlands, and cutting-edge discussions about the future of palliative care. The clinical essays offer helpful tables to summarize the material. Extensive bibliographies follow each essay for further reading. However, one glaring omission from this book is perinatal palliative care and hospice.
Assessment: This book helps address the need for an authoritative, advanced survey on the ethical issues of end-of-life care, particularly as technology continues to advance and palliative care becomes more widely recognized. Because of the breadth and depth of topics, it could serve as an up-to-date textbook on ethics at the end of life. Seasoned scholars, students needing an introduction to the issues, and clinicians seeking practical guidance all will find something useful to their work.

Doody's Review Service

"This book provides a varied and interesting compilation of chapters combining the ethical and historical legal landmarks that have shaped current policy and thinking on these issues. The chapters are neatly bounded allowing the reader to dip in and out according to their interests, while the span of topics is generally comprehensive, covering ethics in end of life care right from pre-natal through to gerontology. ... It is a worthy addition to the field." — Eleanor Wilson, Mortality

"This book helps address the need for an authoritative, advanced survey on the ethical issues of end-of-life care, particularly as technology continues to advance and palliative care becomes more widely recognized. Because of the breadth and depth of topics, it could serve as an up-to-date textbook on ethics at the end of life. Seasoned scholars, students needing an introduction to the issues, and clinicians seeking practical guidance all will find something useful to their work." -Doodys Health Science

From the Publisher