Book

Caring for Patients at the End of Life

Timothy Quill

Published in print May 2001 | ISBN: 9780195139402
Published online November 2011 | e-ISBN: 9780199999859 | DOI: https://dx.doi.org/10.1093/acprof:oso/9780195139402.001.0001
Caring for Patients at the End of Life

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In this book, the author uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section One utilizes the near-death experiences of two patients to explore values underlying medical humanism, and then presents the case of “Diane” to explore the fundamental clinical commitments of partnership and non-abandonment. Section Two explores, illustrates, and provides practical guidance for clinicians, patients, and families about critical communication issues including delivering bad news, discussing palliative care, and exploring the wish to die. In Section Three, difficult ethical and policy challenges inherent in hospice work, including the rule of double effect, terminal sedation, and physician-assisted suicide, are explored using a mix of real cases and an analysis of underlying clinical, ethical, and policy issues. In the final chapter, the author discusses the tragic death of his brother, which occurred as this book was being completed, and how his family made the most emotionally challenging decisions of their lives. The author exposes readers to an internally consistent and practical way of thinking by simultaneously embracing the potential of palliative care, and also acknowledging that it has limitations. His philosophy of offering forthright discussions with patient and family, mutual decision making, ensuring medical and palliative care expertise, and committing to see the dying process through to the patient's death, is vividly illustrated.

Keywords: clinical experience; near-death experience; patients; values; medical humanism; partnership; non-abandonment; clinicians; bad news; palliative care

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Subjects: Palliative Medicine

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Table of Contents

Introduction: Challenges and Potential of End-of-Life Care in Caring for Patients at the End of Life

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Same Old Seventeen-Dollar Lamps in Caring for Patients at the End of Life

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Humanistic End-of-Life Care in Caring for Patients at the End of Life

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Partnerships in the Care of the Dying in Caring for Patients at the End of Life

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Nonabandonment: A Central Obligation of Physicians  in Caring for Patients at the End of Life

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Delivering Bad News in Caring for Patients at the End of Life

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Discussing Palliative Care with Patients in Caring for Patients at the End of Life

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“Doctor, I Want to Die! Will You Help Me?” in Caring for Patients at the End of Life

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