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Caring for Patients at the End of Life : Facing an Uncertain Future Together - Timothy E. Quill

Caring for Patients at the End of Life

Facing an Uncertain Future Together

Paperback Published: 1st April 2001
ISBN: 9780195139402
Number Of Pages: 264

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In Caring for Patients at the End of Life: Facing an Uncertain Future Together, Dr. Quill 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 a final chapter, Dr. Quill 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.
Dr. Quill 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 of committing to see the dying process through to the patient's death is vividly illustrated.

"Nothing is harder than communication with patients and families at the end of life. Nothing is more important to quality of care than effective communication. Nothing is better for teaching than personal narratives. Nobody puts all this together better than Tim Quill."--Christine K. Cassel, M.D., Professor and Chairman, The Henry L. Schwartz Department of Geriatrics and Adult Development, Mount Sinai School of Medicine "This book is fresh air for doctors who care for seriously ill patients. Dr. Quill brings the incredible privilege of being a doctor to life on the page. His book transcends the emotional pain and intimacy of accompanying our patients on their path, bringing a concise intellectual clarity and an organized approach to the complicated task of doctoring." -- Diane Meier, M.D., Director, Hertzberg Palliative Care Institute and Co-director, Center to Advance Palliative Care, Mount Sinai School of Medicine "To guide us in end-of-life care, no voice is more respected than Timothy Quill's. In this book, he brings to bear all of his experience, his wisdom and his sensitivity, to help readers through this most difficult of journeys." -- Sherwin Nuland, M.D., author of How We Die "Timothy Quill is a guiding light to the medical profession and to the rest of us who will eventually need help as life comes to its inevitable end. His ability to see how increased longevity has created not just medical dilemmas but complex emotional, spiritual, and familial concerns comes not a moment too soon. This book should be required reading in every medical school and for every doctor nationwide. It should also be a bedside companion for those at the end of life and for those who love them." -- Marilyn Webb, author of The Good Death: The New American Search to Reshape the End of Life "Material is presented from the dual perspective of the patient (or patient's family) and the physician, with illustrative cases. The uncommon depth with which the concepts in the book are addressed demonstrates the author's extensive clinical experience and intellectual reflection on the topic. Moral and legal controversies are well covered in cited references."--Annals of Internal Medicine, October 16, 2001 "Nothing is harder than communication with patients and families at the end of life. Nothing is more important to quality of care than effective communication. Nothing is better for teaching than personal narratives. Nobody puts all this together better than Tim Quill."--Christine K. Cassel, M.D., Professor and Chairman, The Henry L. Schwartz Department of Geriatrics and Adult Development, Mount Sinai School of Medicine "This book is fresh air for doctors who care for seriously ill patients. Dr. Quill brings the incredible privilege of being a doctor to life on the page. His book transcends the emotional pain and intimacy of accompanying our patients on their path, bringing a concise intellectual clarity and an organized approach to the complicated task of doctoring." -- Diane Meier, M.D., Director, Hertzberg Palliative Care Institute and Co-director, Center to Advance Palliative Care, Mount Sinai School of Medicine "To guide us in end-of-life care, no voice is more respected than Timothy Quill's. In this book, he brings to bear all of his experience, his wisdom and his sensitivity, to help readers through this most difficult of journeys." -- Sherwin Nuland, M.D., author of How We Die "Timothy Quill is a guiding light to the medical profession and to the rest of us who will eventually need help as life increased longevity has created not just medical dilemmas but complex emotional, spiritual, and familial concerns comes not a moment too soon. This book should be required reading in every medical school and for every doctor nationwide. It should also be a bedside companion for those at the end of life and for those who love them." -- Marilyn Webb, author of The Good Death: The New American Search to Reshape the End of Life "Overall, this is a helpful book on an important topic by a remarkably courageous and caring physician." --JAMA "A compelling narrative, a combination of case history and an analysis of the complex clinical , ethical, and policy issues that swirl around end-of-life care...Offers valuable guidelines for doctors, patients and families, discussing difficult subjects like delivering bad news, the challenges of hospice and palliative care, and the options available to dying patients."--The New York Times, October, 1, 2002 "The book illustrates wholly the key principles of holistic end-of-life care, and is an excellent read for any on the cutting edge of delivering palliative and end-of-life care."--Progress in Palliative Care, Vol. 10, Number 2, 2002 "The editing and republication of a dozen of his mostly co-authored papers over the previous decade comprises an impressive opus of thoughtful, compassionate, and practical commentary on the care of the dying patient. They are well worth reading...Dr. Quill's writing style is relaxed, conversational, clear, and rational. It comprises an important summary of the contributions to the compassionate care of dying patients made by Timothy Quill and his colleagues over the past decade."--Neurology Today, November 2002 "I was extraordinarily impressed with Dr. Quill's writing skills, as well as his approach to the decision making around palliative care. It is wonderfully written, vivid with examples, useful work tips and strategies, and cerebral and analytical when it deals with complicated ethical and policy issues. Reading this made some of my recent interactions with patients go better. I learned from Dr. Quill, and you will too. I recommend the book very highly to anyone who teaches about palliative care."--Journal of Palliative Medicine, November, 2002

I. Underlying Values and Assumptions 1: Same Old Seventeen Dollar Lamps 2: Humanistic End of Life Care 3: Death and Dignity: A Case of Individualized Decision Making 4: Partnership in the Care of the Dying 5: Non-abandonment: A Central Obligation of Physicians II. The Medical Interview: A Critical Clinical Tool 6: Delivering Bad News 7: Discussing Palliative Care with Patients 8: Palliative Care for Patients with Severe Dementia: A Consensus-Based Approach to Decision-Making 9: Doctor, I want to die! Will you help me? III. Difficult Clinical and Ethical Issues 10: Hospice and Palliative Care: Clinical, Ethical and Policy Challenges 11: The Rule of Double Effect: A Critique of its Role in End of Life Decision Making 12: Palliative Options of Last Resort: A Comparison of Practices, Justifications, and Safeguards 13: End of Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices Epilogue: All About My Brother

ISBN: 9780195139402
ISBN-10: 0195139402
Audience: Professional
Format: Paperback
Language: English
Number Of Pages: 264
Published: 1st April 2001
Publisher: Oxford University Press Inc
Country of Publication: US
Dimensions (cm): 23.42 x 15.42  x 1.8
Weight (kg): 0.38