The Oxford Handbook of Ethics at the End of Life

ISBN : 9780199974412

Stuart J. Youngner; Robert M. Arnold
488 ページ
171 x 248 mm
Oxford Handbooks

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.


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)


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