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Hastings Center calls on health care professionals and organizations to meet standards for good care near the end of life
Date:5/7/2013

ent's values and preferences concerning different options for treatment and care. The guidelines offer a reliable framework for these discussions, and for education, policy-making, and redesign of care. They also encourage health care leaders and administrators to support better outcomes for patients by building more effective forms of care delivery and integrating care near the end of life into organizational safety and improvement initiatives."

The book separates fact from fiction, clarifying misperceptions that can lead to problems or conflict. For example, readers will learn why a physician's offer or a family's request to "do everything" for a patient is not an effective way to respect a patient's rights or to ensure that a patient receives good care. The publication also explains a patient's right to refuse life-sustaining treatment, with a clear description of how treatment refusal differs from physician-assisted suicide. It describes what all patients should expect, including pain and symptom relief and respect for their preferences in all treatment and care plans.

It offers guidance on how to avoid common communication problems when discussing different medical conditions. A section on brain injuries, for example, summarizes research findings on neurological states and their implications for prognosis and making decisions about care. How surrogates, families, and even clinicians understand neurological states "may be influenced by how terms such as 'coma' or 'brain dead' are used in everyday speech, by media coverage of high-profile cases, or by fictional portrayals of film or television characters who wake up from 'comas' after years or decades," the authors write, adding that health care professionals "should anticipate the need to define terms and correct misperceptions" when discussing these decisions.

The book gives extensive practical guidance on a range of topics, including advance care planning and advance directives, dete
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Contact: Susan Gilbert
gilberts@thehastingscenter.org
The Hastings Center
Source:Eurekalert

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