| Descript |
1 online resource (268 pages) |
| Content |
text txt |
| Media |
computer c |
| Carrier |
online resource cr |
| Contents |
Cover -- Half-title page -- Title page -- Copyright page -- Dedication -- Contents -- Preface -- Acknowledgments -- 1 The Conundrum: How Much Medical Care Is 'Enough'? -- Life expectancy, health status and health care spending -- Quality and utilization of medical care at the end of life -- What is the goal and how might we get there? -- 2 The US Health Care 'System': The Good, the Bad, and the Probably Unfixable -- Health insurance and payment - the US 'system' -- Sources of health insurance coverage -- Health care payment, incentives for overutilization, and quality of care -- Health care access and payment - the Canadian system -- Health care access and payment - the National Health Service in the United Kingdom -- Health care as a right -- Informed consent and end-of-life law in the United States -- Informed consent and end-of-life law in Canada -- Informed consent and end-of-life law in the United Kingdom -- Assessing the possibility of future reform -- 3 Autonomy and Informed Consent in the Real World -- Pathways to death and decisional opportunities -- Autonomy and beneficence: Two fine words in search of meaning -- Autonomy in the Real World -- Informed consent law and practice - papering over poor communication -- The reality of physician-patient communication -- Yet another challenge: Statistics and innumeracy -- The allure of hope -- The impact of race and racism -- 'Doing everything' versus trying for 'just right' -- 4 The Denial of Death and Its Sequelae -- Cultural indicia of the fear of death -- The impact of death denial on life -- To be a rock and not to roll -- 5 Disorders of Consciousness and the Meaning of Life -- The permanent vegetative state -- Theresa Schiavo -- Anthony Bland -- Hassan Rasouli -- Some comparisons and observations -- Can we agree to disagree? -- 6 More Barriers to Good Communication. |
|
Communication avoidance and its causes -- Physician professional culture - the 'do everything' mentality -- By the way, a word about how physicians die -- Financial incentives and the business of medicine -- Liability fears -- Patients only die once -- 7 Palliative and Hospice Care: Misunderstandings and Lost Opportunities -- Rates of utilization -- The benefits of palliative and hospice care -- Structural barriers to access and utilization of palliative care and hospice -- Once again, honest communication really matters -- A 'better' death in Britain? -- Palliative and hospice care are medical care -- 8 Rational Apathy and the Role of Uncertainty -- Knightian uncertainty, clinical uncertainty, and cognitive biases -- Rational patient apathy -- Activist and passivist patients and physicians -- Portrait of an activist -- So, what now? -- 9 The Crucible: Making Decisions for Incapacitated Patients -- The basics of surrogate decision-making law and ethics -- Why surrogate decision-making is so difficult -- The limitations of advance directives -- The extra layers of clinical and ethical uncertainty -- Race and surrogate decision-making -- With caring comes courage -- 10 Resolving Conflicts at the End of Life -- The United States: Hospital ethics committees and judicial resolution -- Canada: Ontario's Consent and Capacity Board -- England and Wales: The Mental Capacity Act -- Patient preferences, with a dose of best interests -- 11 At the End of the Day -- The feasibility of system-wide changes -- Culture matters -- The communication conundrum -- Some promising developments -- Forcing physicians to have 'the talk' -- An opportunity for physicians -- It's all up to us -- 12 Coda -- Index. |
| ISBN |
9781108804608 (electronic bk.) |
|
9781108486804 |
|
