It deserves to be widely read and I hope it starts many a conversation. It is a rare balance of an interesting read with an incredible integration of factual information.
‘Death with Dignity’: Elevating Suicide Is Not the Solution
I intend to share it in my long term care circles A wonderful contribution! Every once in a long while a short, succinct book comes along that awakens our senses and motivates us to action. It cuts right to the chase to offer a new, innovative change for an old, outmoded rite of passage. This professional clinical guide presents nursing administrators and nurses in acute care agencies, nursing homes, hospice, and palliative care settings with detailed implementation strategies for accommodating dying persons and their loved ones as they make the transition from physical life.
It presents the need for and the development of the concept: Golden Room concept: a place for dying that facilitates a dignified, peaceful, and profound experience for dying persons and their loved ones. This book presents a practical solution on multiple levels that will benefit all involved-patient, family, nurses, administrators, policy makers, and insurance companies. It presents the theoretical frameworks for end-of-life care and how the Golden Room concept fits into these frameworks. She has authored or co-authored 18 books and scores of professional journal publications and chapters in text books.
In addition she has delivered scores of presentations and keynote addresses in numerous countries throughout the world. She is past president of the American Holistic Nurses' Association and is on the board of many organizations and journals.
Death by Poison Holistic “Dignity?”
She has been on the faculty of several prominent universities teaching in associate degree programs through coordinating graduate nursing programs. Convert currency.
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New Book. Shipped from UK. Established seller since Seller Inventory IQ More information about this seller Contact this seller. Delivered from our UK warehouse in 4 to 14 business days. Language: English. Brand new Book. I intend to share it in my long term care circles. Three other states have followed suit in the past 6 years. In , Washington enacted a measure that allows competent adults who have a life expectancy of 6 months or less due to a diagnosed medical condition to request and self-administer lethal medication.
Vermont adopted a comparable law in May Montana allows the practice through court precedent. Now, lawmakers in Pennsylvania, Massachusetts and Hawaii are considering similar bills that would legalize physician-assisted death. The legislative efforts have significant consequences for members of the health care community — particularly those who care for patients with cancer.
Patients who request prescriptions for lethal medication often are grateful to feel some control in an uncertain situation, regardless of whether the prescription is filled or ingested, said Elizabeth Trice Loggers, MD, PhD, of Seattle Cancer Care Alliance. HemOnc Today spoke with several clinicians to gauge their perceptions about this type of legislation, the medical and ethical dilemmas it raises, and whether physician-assisted death is necessary given the other options available to terminally ill patients.
Under legislation that allows physician-assisted death, patients with all terminal illnesses can request lethal medication. However, patients with cancer account for most cases. In the report, Loggers and colleagues outlined the experience of their comprehensive cancer center with regard to implementation of its Death with Dignity program. Most patients at Seattle Cancer Care Alliance who participated in the program were white, male and college-educated.
The most common reasons cited for participation were loss of autonomy However, the number of patients who self-administer lethal medication remains low, accounting for an estimated 0. Of the patients treated at the institution who inquired about Death with Dignity between March and December , only 40 More than one-third of patients Thirty patients Participation also is low in other states, according to Timothy E.
There is a lot of conversation about it, but relatively few patients actually follow through with it. In the review by Loggers and colleagues, 11 patients lived for more than 6 months after they obtained the lethal prescription. Proponents contend physician-assisted death may be a rational choice for patients who do not want to endure pain, distress or loss of quality of life — including states of being they find objectionable ie, dependency or inability to do the things they enjoy.
What I think is necessary is good palliative care. In , Quill was a part of a landmark court case — Vacco v. Quill — that focused on the right to die. They clearly have not interfered with the places that have legalized. Quill and colleagues mailed surveys to 3, physicians from 10 specialties most likely to receive requests for assisted death, including hematology-oncology, neurology, infectious disease and geriatrics.
End of Life: Nursing Solutions for Death with Dignity (Paperback) | Copperfield’s Books Inc.
Sixty-one percent of recipients responded. At the time of the survey, Results showed 3. Sixty-five percent of recipients participated in the survey, results of which were published in in The New England Journal of Medicine. Researchers received data about outcomes for of the patients who made those requests. Data showed physicians pursued at least one substantive palliative intervention — such as pain control, hospice referral or antidepressant medications — to 68 of the evaluable patients.
Loss of independence, poor quality of life and wanting to control circumstances of death were the most common reasons for requests for lethal prescriptions — all reasons not easily remediated by palliative care. None of the patients with documented symptoms of depression received a prescription for a lethal medication.
Nonetheless, most of the respondents reported that they had made efforts to improve their ability to recognize depression in terminally ill patients. The findings from Ganzini and colleagues demonstrate that the benefits of palliative interventions support the argument that all other strategies should be employed before physician-assisted death.
Physicians should use inquiries about physician-assisted death as opportunities to help patients learn about their options, including hospice and palliative care, Loggers said.
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Although nurses typically do not play a role in assisted deaths, they often are the ones in whom patients confide when they want to learn more about their options. In other words, do they really want to end their life, or are we missing something important? According to a study published in the Journal of Hospice and Palliative Nursing , little attention has been given to educating nurses about Death with Dignity laws — and, more importantly, the role they play in implementation.
The nurses who participated were licensed in Washington state and were members of the Washington State Nurses Association. In one respect, Death with Dignity laws are designed to make sure patients and providers are not making quick decisions. It often takes 4 to 6 weeks to go through the process. There are some thoughtful measures in place to make sure patients are screened and supported and are not making rash decisions. This does not lend itself to an imminent dying scenario.
This has caused a lot of distress for hospice nurses because, while they do not participate in the process, they are often asked about when the best timing is from the patient. This can be very hard for nurses.
We hope we have created a policy and program in which ethical concerns can be dealt with in a way that is positive for physicians, patients and their families. One component that remains up for debate is the language used to describe the legislation that allows physician-assisted death. With more states expected to adopt similar legislation, Ward said he is concerned that the movement will be more of a grand social experiment for which extremely limited and poorly developed data are being collected. By being simplistic, important pieces are often missed. Both of these legislative events leave all kinds of unanswered questions about what this means to both patients and to our society.
Death With Dignity National Center.