Clinical and Ethical Dilemmas in Palliative and End-of-Life Care
Clinical and Ethical Dilemmas in Palliative and End-of-Life Care
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Abstract
Like other case-based volumes in this series, this one provides frameworks to address therapeutic dilemmas that lead junior colleagues to improvise and consult their more seasoned ones. In an era of increasingly mechanistic understanding of illness that may progress to the terminal phase, never has adherence to the humane values underpinning care been more compelling yet challenging to provide. These challenges embroil patients, families, healthcare providers and healthcare systems, and range from efficient clinical practice to ethical issues. We have assembled a highly respected, interprofessional group of clinicians to identify and categorize common dilemmas, guiding their junior colleagues in the management of patients undergoing palliative and end-of-life care. Such mentorship has, from the dawn of organized healthcare, been integral to transforming biomedical knowledge into clinical wisdom.
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Front Matter
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Part I Dilemmas Related to Patients
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1
A Choice of Comfort Feeding
Wesley W. Boyette andM. Jennifer Cheng
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2
Patients Seeking Alternative Treatments for Cancer Pain
Steven Mach andSalahadin Abdi
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3
Delivering Difficult News as a Covering Provider
S. Ian Borison
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4
To Pray or Not to Pray: Is That the Question?
Marta Illueca
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5
Pain and Substance Use Disorder
Baraa O. Tayeb andAntje M. Barreveld
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6
Patient with a Low Respiratory Rate Receiving Opioids
Baraa O. Tayeb andAntje M. Barreveld
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7
Video Gaming and Virtual Reality in Pediatrics
Elizabeth Pasternak andPamela Ressler
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8
Native American Spirituality and Healing
Marta Illueca
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9
Dying Alone
Sharon Kim
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1
A Choice of Comfort Feeding
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Part II Dilemmas Related to Families
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10
Navigating Familial Conflict Regarding Information Sharing
Nafiisah B. M. H. Rajabalee andS. Ian Borison
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11
Dis/Continuing Transfusions in a 2-Year-Old Dying of Leukemia
Elizabeth Pasternak andPamela Ressler
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12
Managing Family Conflict
Betty R. Ferrell
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13
Dilemmas Related to Families
Anna Barreiro Albán andBeth B. Hogans
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14
Complicated Grief
Zhu Wang andSalahadin Abdi
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10
Navigating Familial Conflict Regarding Information Sharing
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Part III Dilemmas Related to Health Care Professionals
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15
Moral Distress by Staff: My Patient Is Suffering and “We Can’t Keep Torturing Them”
Anthony Eidelman andRegina M. Fink
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16
Work–Nonwork Life Fit: Tensions for Health Care Clinicians
Emily P. Guinee and others
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17
Burnout and Resilience
Jennifer Winegarden andYlisabyth Bradshaw
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18
Planning and Facing Retirement
Daniel B. Carr andStephen Gullo
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15
Moral Distress by Staff: My Patient Is Suffering and “We Can’t Keep Torturing Them”
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Part IV Dilemmas Related to the Health Care System
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19
Balancing Opioid Benefit and Risk for Subacute or Chronic Non-Cancer Pain
Scott A. Strassels andDaniel B. Carr
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20
The Emerging Role of Independent Patient Advocates
Shiella Dowlatshahi
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21
Managing Outpatient Workplace Violence
Pragya B. Gupta andDaniel B. Carr
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22
Maladaptive Team Dynamics
Moe Norton-Westbrook and others
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23
Allocation of Scarce Resources
Justin Price
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24
Introducing Novel Treatments and Navigating Institutional Policies
Jennifer Winegarden
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25
Racial Inequities in Health Care
Carmen Renee Green
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19
Balancing Opioid Benefit and Risk for Subacute or Chronic Non-Cancer Pain
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Part V Dilemmas Related to Ethical Issues
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26
Artificial Hydration and Nutrition at the End of Life
Carol Pilgrim andTamara Vesel
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27
Physician-Assisted Death
Sudha Chandrasekhar
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28
Decision-Making Around Dialysis Withdrawal
Mary K. Buss andTamara Vesel
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29
LGBTQ: To Disclose or Not to Disclose
Gabriel Lutz
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30
Can Minors Make Major Medical Decisions?
Sudha Chandrasekhar
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31
Surrogate Decision-Making
Margaret M. Mahon
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32
Approaching Palliative Sedation at the End of Life
Abigail Lebovitz andTamara Vesel
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33
Advance Care Planning
Nnamdi C. Iwuala andLauren Shaiova
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34
Substituted Judgment
Gabriel Lutz
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26
Artificial Hydration and Nutrition at the End of Life
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