decision making

risk on life …

September 4, 2012

in Spirituality

"The politics of death is bureaucracy, routine, rules, status quo. The politics of life is personal initiative, creativity, flair, dash, a little daring.   The politics of death is calculation, prudence, measured gestures. The politics of life is experience, spontaneity, grace, directness.   The politics of death is fear of youth. The politics of life […]

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Daniel Callahan and Peter Augustine Lawler discuss end-of-life care. More and more, our end-of-life care looks like the trench warfare of World War I: heavier and heavier economic and human costs with increasingly less ground being won. (Callahan) People today think of themselves less than ever as part of wholes greater than themselves—as part of […]

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principles …  Standard of Care … Know your medical facts – diagnosis – prognosis – treatment. Get second opinion … go to the literature.   Substituted judgment … “If for whatever reason you are unable to make your own medical decisions … Who should make them for you?”. Put yourself in the patient’s place – […]

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When confronting serious medical decisions our attitude should be one of openness and wonder in front of a Mystery greater than ourselves. We set aside preconceptions and attend to the person in need as well as those who are serving him (doctors, nurses, chaplains, others). As we journey together, we weigh the burdens and benefits […]

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Dan Sulmasy OFM MD PhD nicely summarizes the use of advance directives … “With so many possible treatments, studies now demonstrate that approximately 90 percent of hospitalized patients die after a decision to forgo a procedure that could have been tried. One of the burdens of contemporary medical technology accompanying its many benefits is the […]

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… the third section of Billings’ family meetings in the ICU setting. Do not feel you need to identify every management option. We do not have a responsibility to offer treatment options that will not benefit the patient. Asking, ‘‘What do you want us to do?’’ or ‘‘Do you want us to do everything?’’ requires the family to […]

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… when their loved one is seriously ill … assure their loved one is receiving high quality care provide appropriate information adequate time to share perspectives and concerns accurate information about prognosis empathic communication and support trust anticipatory grief and bereavement   from Billing’s End of Life Family Meeting Part I: Indications, Outcomes, and Family Needs […]

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progress …

September 1, 2011

in Bioethics,Spirituality

“We all want progress. But progress means getting nearer to the place where you want to be. And if you have taken a wrong turning, then to go forward does not get you any nearer. If you are on the wrong road, progress means doing an about turn and walking back to the right road; […]

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Palliative care focuses on improving a patient’s quality of life by managing pain and other distressing symptoms of a serious illness. Palliative care should be provided along with other medical treatments. Hospice is palliative care for patients in their last year of life. Hospice care can be provided in patients’ homes, hospice centers, hospitals, longterm […]

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… factors that influence decision makers’ perceptions of prognosis … Boyd et al sought to determine what sources of knowledge family members/decision makers use when determining the prognosis of their loved ones. “Less than 2% (3 of 179) of surrogates reported that their beliefs about the patients’ prognoses hinged exclusively on prognostic information provided to […]

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