Palliative Care Ethics

Abstract
A book for nurses, doctors, and all who provide end-of-life care, this volume guides readers through the ethical complexities of such care, including policy initiatives, and encourages debate and discussion on their controversial aspects. Divided into two parts, it introduces and explains clinical decision-making processes about which there is broad consensus, in line with guidance documents issued by the WHO, the BMA, the GMC, and similar bodies. The changing political and social context, where ‘patient choice’ has become a central idea, and the broadened scope of patients' 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, which include patient choice; consent; life-prolonging treatment; and symptom relief, including sedation. Part Two explores the more controversial current end-of-life care initiatives, such as advance care planning, preferred place of care and death, euthanasia and assisted suicide, extended ideas of ‘best interests’, and the view that there are therapeutic duties to the relatives of patients. Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of consumerist choice, they reject its place in the health service, proposing a realistic, fair, humane and widely adoptable system of end-of-life care.

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