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Highly commended in the basis of medicine category of the British Medical Association Book Awards 2010
End of life choices
Consensus and controversy
Fiona Randall and Robin Downie
240 pages
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234x156mm
978-0-19-954733-3
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Paperback
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08 October 2009
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- Provides a full analysis of the decision making process and makes clear the roles and responsibilities of professionals and patients in decision-making
- Explains the impact of the Mental Capacity Act on end of life care and makes clear that some common practices such as assessing quality of life are now illegal
- Discusses and explains good practice in sedation at the end of life
- Outlines the nature of advance care planning and makes clear the considerable ethical problems with this initiative, especially when it is concerned with preferred place of care and death
A book for nurses, doctors and all who provide end of life care, this essential volume guides readers through the ethical complexities of such care, including current policy initiatives, and encourages debate and discussion on their controversial aspects. dived into two parts, it introduces and explains clinical decision making-processes about which there is broad consensus, in line with guidance documents issued by WHO, BMA, GMC, and similar bodies. The changing political and social context where 'patient choice' has become a central idea, and the broadened scope of potients' best interests, have added to the complexity of decision-making in end of life care. The authors discuss issues widely encountered by GPs, nurses, and hospital clinicians. These
include patient choice, consent, life-prolonging treatment, and symptom relief including sedation. Part rwo explores the more controversial current end of life care initiatives, such as advance care planning preferred place of care and death, euthanais and assited suicide, extended ideas of 'best interests', and the view that there are therapeutic duties to the relatives of Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of comsumerist choice, they reject its place in the health service, proposing a a realistic, fair, humane and widely adoptable system of end of life care.
As knowledge of ethical theories is required in training courses, and the vocabulary of ethical
theory is widespread in current discussions a substantial appendix on ethical theories and terms is available online.
Written by the same authors as The Philosophy of Palliative Care: Critique and Reconstruction, which won the Medical Journalists' Association Specialits Book Award 2007, this new book for non-specialists is essential reading for all health care professionals involved in providing end of life care.Readership: Consultants (especially in medicine for the elderly and oncologists), SpRs in medicine for the elderly and palliative medicine, GPs interested in end of life care, nurse specialists in palliative care and medicine for the elderly and nurses doing degree courses relevant
to end of life care, Macmillan and Marie Curie organisations.
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Fiona Randall, Consultant in Palliative Medicine, Royal Bournemouth and Christchurch Hospitals Foundation Trust, UK, and Robin Downie, Honorary Professorial Research Fellow and Emeritus Professor of Moral Philosophy, University of Glasgow, Glasgow, UK
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"This book was a pleasure to read. As in their previous volumes, Randall and Downie have the ability to write clearly and to develop arguments that are logical and transparent, all of which is a refreshing departure from a lot of the stuff published on euthanasia and physician-assisted suicide ... The material in this book is well-presented and articulate. If you are going to delve into these matters only once this year, this should be the book." - IAHPC NL "A comprehensive exploration of the moral, ethical and medico-legal issues associated with palliative care. It is thought-provoking and provides guidance for many of the problems with which health professionals are faced in their daily work. At £29.95, this is an affordable
book which is relevant to anyone caring for patients in the terminal phase of their illness." - Urology News
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Part 1
Introduction
1: Patient choice and consent
2: Choice and best interests: clinical decision-making in end of life care
3: Three logical distinctions in decision-making
4: Choice and best interests: life-prolonging treatments
5: Choice and best interests: symptom control and the maintenance of function
6: Choice and best interests: sedation to relieve otherwise intractable symptoms (terminal sedation)
Conclusions to Part 1
Part 2 - Controversies
Introduction
7: Choice and advance care planning: definition, professional responsibility
8: Preferred place of care and death
9: Choice, assisted suicide and euthanasia
10: Best interests: extended senses
General conclusions
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The specification in this catalogue, including without limitation price, format, extent, number of illustrations, and month of publication, was as accurate as possible at the time the catalogue was compiled. Occasionally, due to the nature of some contractual restrictions, we are unable to ship a specific product to a particular territory. Jacket images are provisional and liable to change before publication.
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