The Patient Self-Determination Act: Meeting the Challenges in Patient CareGeorgetown University Press, 18 jul 2001 - 364 páginas The Patient Self-Determination Act of 1990 required medical facilities to provide patients with written notification of their right to refuse or consent to medical treatment. Using this Act as an important vehicle for improving the health care decisionmaking process, Lawrence P. Ulrich explains the social, legal, and ethical background to the Act by focusing on well-known cases such as those of Karen Quinlan and Nancy Cruzan, and he explores ways in which physicians and other caregivers can help patients face the complex issues in contemporary health care practices. According to Ulrich, health care facilities often address the letter of the law in a merely perfunctory way, even though the Act integrates all the major ethical issues in health care today. Ulrich argues that well-designed conversations between clinicians and patients or their surrogates will not only assist in preserving patient dignity — which is at the heart of the Act—but will also help institutions to manage the liability issues that the Act may have introduced. He particularly emphasizes developing effective advance directives. Ulrich examines related issues, such as the negative effect of managed care on patient self-determination, and concludes with a seldom-discussed issue: the importance of being a responsible patient. Showing how the Patient Self-Determination Act can be a linchpin of more meaningful and effective communication between patient and caregiver, this book provides concrete guidance to health care professionals, medical ethicists, and patient-rights advocates. |
Índice
Decisional Capacity | 172 |
The Right to Refuse Treatment | 177 |
Demands for Treatment | 182 |
Clinical Futility | 187 |
An Integration of Ethical Issues | 197 |
Advance Directives | 219 |
The Social Justification for Advance Directives | 228 |
General Problems with Advance Directives | 233 |
The Social and Technological Background for the Patient SelfDetermination Act | 47 |
The Expectations of Healthcare | 48 |
The PhysicianPatient Relationship | 51 |
The Technological Pressures on Healthcare Delivery | 56 |
The Difficulty of Limiting Technology in Healthcare | 58 |
Healthcare Costs and the Demands of Justice | 61 |
The Human Context of the Patient SelfDetermination Act | 77 |
The Recognition of Human Finitude | 78 |
The Assertion of Personal Dignity | 88 |
The Role of the Virtues in Conducting the Moral Life | 99 |
The Institutional Context of the Patient SelfDetermination Act | 125 |
The Social Obligations of Institutions | 126 |
The Mission of the Institution | 130 |
Healthcare Institutions as Centers of Education | 135 |
The Ethical Foundations of the Patient SelfDetermination Act | 147 |
The Supporting Principles of Bioethics | 148 |
The Principle of Autonomy | 149 |
The Principle of Beneficence | 151 |
The Principle of Justice | 153 |
The Principle of Parentalism | 159 |
The Role of the Virtues in Clinical Decisions | 162 |
Informed Consent | 165 |
Advantages and Disadvantages of Advance Directives | 237 |
Writing an Advance Directive | 240 |
Content of Advance Directives | 244 |
Assistance in Writing Advance Directives | 248 |
The Roles of Healthcare Professionals | 269 |
Preparing the Professional | 270 |
The Role of the Physician | 271 |
The Role of Social Services and Chaplaincy | 276 |
The Role of Nursing | 281 |
Perspective | 284 |
The Role of the Responsible Patient | 293 |
The Moral Responsibility for Making Decisions | 295 |
Developing a Life of Virtue | 298 |
Essential Virtues of the Responsible Patient | 301 |
Being Informed | 303 |
Being Assertive | 305 |
Being Communicative | 308 |
Taking Risks | 310 |
Summary | 312 |
Conclusion | 321 |
325 | |
Otras ediciones - Ver todo
The Patient Self-Determination Act: Meeting the Challenges in Patient Care Lawrence P. Ulrich No hay ninguna vista previa disponible - 1999 |
The Patient Self-Determination Act: Meeting the Challenges in Patient Care Lawrence P. Ulrich No hay ninguna vista previa disponible - 1999 |
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