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Open Access

Abstract

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How Gay Men Prepare for Death
Type: Book
ISBN: 978-1-83909-587-0

Article
Publication date: 27 December 2021

Victoria Helmly, Marisol Garica, Brie Williams and Benjamin A. Howell

With a rapidly growing population of older adults with chronic illness in US prisons, the number of people who die while incarcerated is increasing. Support for patients’ medical…

Abstract

Purpose

With a rapidly growing population of older adults with chronic illness in US prisons, the number of people who die while incarcerated is increasing. Support for patients’ medical decision-making is a cornerstone of quality care for people at the end of life (EOL). This study aims to identify, describe, and analyze existing policies regarding EOL decision-making in U.S. Departments of Corrections.

Design/methodology/approach

This study performed an iterative content analysis on all available EOL decision-making policies in US state departments of corrections and the Federal Bureau of Prisons.

Findings

This study collected and reviewed available policies from 37 of 51 prison systems (73%). Some areas of commonality included the importance of establishing health-care proxies and how to transfer EOL decision documents, although policies differed in terms of which patients can complete advance care planning documents, and who can serve as their surrogate decision-makers.

Practical implications

Many prison systems have an opportunity to enhance their patient medical decision-making policies to bring them in line with community standard quality of care. In addition, this study was unable to locate policies regarding patient decision-making at the EOL in one quarter of US prison systems, suggesting there may be quality-of-care challenges around formalized approaches to documenting patient medical wishes in some of those prison systems.

Originality/value

To the best of the authors’ knowledge, this is the first content analysis of EOL decision-making policies in US prison systems.

Book part
Publication date: 22 February 2011

Katharina Heyer

This chapter examines disability rights movement's rejection of a right to physician-assisted suicide (PAS). Supporters of PAS frame the right to enlist a physician's help in…

Abstract

This chapter examines disability rights movement's rejection of a right to physician-assisted suicide (PAS). Supporters of PAS frame the right to enlist a physician's help in determining the nature and timing of one's death as a fundamental liberty interest and as a right to privacy. The disability opposition counters this with disparate impact and slippery slope arguments and stories of disability pride as a rhetorical rejection of a right it deems dangerous and discriminatory. In examining this clash of rights talk, this chapter analyzes the legal and political consequences of anti-rights rhetoric by a movement that is grounded in notions of autonomy and self-determination.

Details

Special Issue Social Movements/Legal Possibilities
Type: Book
ISBN: 978-0-85724-826-8

Article
Publication date: 1 June 2006

Jenny Billings

This study was undertaken in response to the audit requirements for the National Service Framework for Older People Standard 1 ‘Rooting Out Ageism’. The aim of this study was to…

Abstract

This study was undertaken in response to the audit requirements for the National Service Framework for Older People Standard 1 ‘Rooting Out Ageism’. The aim of this study was to identify and describe the nature of any age‐discriminatory practice in the clinical setting through the perceptions and experiences of staff working with older people.The study adopted a qualitative approach using focus group design. Six focus groups were conducted with 57 members of staff. An aim of the study method was to isolate consensus areas of ageist practice that would facilitate targeted intervention. To assist this, statements relating to common practice experiences were developed following the first two focus groups. This was used as a discussion tool for the subsequent groups.Perceived ageist practice could be grouped under the following themes:• access to services• communication and attitudes• treatment and care• the role of relatives• resources.On the basis of the findings, greater choice and control for older people need to be key features of the recommendations, through the development of a co‐ordinated development programme involving all stakeholders

Details

Quality in Ageing and Older Adults, vol. 7 no. 2
Type: Research Article
ISSN: 1471-7794

Abstract

Details

Postmodern Malpractice: A Medical Case Study in The Culture War
Type: Book
ISBN: 978-1-84950-091-3

Article
Publication date: 8 August 2008

Ash Samanta and Jo Samanta

The purpose of this paper is to provide a viewpoint on decision making in do not attempt resuscitation (DNAR) orders from the perspective of a competent patient who requests…

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Abstract

Purpose

The purpose of this paper is to provide a viewpoint on decision making in do not attempt resuscitation (DNAR) orders from the perspective of a competent patient who requests cardiopulmonary resuscitation (CPR) when their clinical prognosis is poor. This issue will be examined from the position of patient autonomy and self determination.

Design/methodology/approach

The literature is reviewed including academic commentary, case law and statute.

Findings

The paper finds that factors such as futility and quality of life that engage in DNAR considerations should be gauged from the patient's perspective. There is a definite argument for supporting a competent patient's positive autonomous choice for CPR. This should feature clearly within the framework of clinical governance.

Research limitations/implications

Presents a viewpoint designed to stimulate debate based on a contemporary perspective of patient autonomy.

Practical implications

End‐of‐life care is assuming a greater importance as evidenced by an increase in reported complaints. Decisions regarding CPR need to form part of the clinical governance agenda.

Originality/value

This paper provides an original viewpoint on the tension between a competent positive choice for CPR against opposing medical opinion, and argues for a resolution on a principled basis to protect patients from arbitrary decision making with regard to resuscitation.

Details

Clinical Governance: An International Journal, vol. 13 no. 3
Type: Research Article
ISSN: 1477-7274

Keywords

Abstract

Details

Postmodern Malpractice: A Medical Case Study in The Culture War
Type: Book
ISBN: 978-1-84950-091-3

Book part
Publication date: 11 December 2007

Renee R. Anspach and Sydney A. Halpern

Let us return to Nancy Cruzan's story. Hopeful that Nancy would eventually recover, her parents, Lester and Joyce Cruzan, agreed to have doctors insert a feeding tube to deliver…

Abstract

Let us return to Nancy Cruzan's story. Hopeful that Nancy would eventually recover, her parents, Lester and Joyce Cruzan, agreed to have doctors insert a feeding tube to deliver artificial hydration and nutrition – a decision they would one day regret. Although the Cruzans visited frequently, Nancy was unable to respond to their attention. After four years had elapsed, the Cruzans concluded that Nancy would never regain consciousness and should be allowed to die.

Details

Bioethical Issues, Sociological Perspectives
Type: Book
ISBN: 978-0-7623-1438-6

Article
Publication date: 7 December 2020

Michael Lyne and Jonathan Parker

This paper aims to examine advance decisions to refuse treatment (ADRTs) in the context of the COVID-19 (Coronavirus 2019) pandemic. This study considers the development of ADRTs…

Abstract

Purpose

This paper aims to examine advance decisions to refuse treatment (ADRTs) in the context of the COVID-19 (Coronavirus 2019) pandemic. This study considers the development of ADRTs, the lack of take up and confusion among the general public, clinicians and health and social care staff.

Design/methodology/approach

The paper is a conceptual piece that reflects on ADRTs in the particular context of COVID-19. It considers professional concerns and pronouncements on ADRTs.

Findings

ADRTs have a low take up currently. There is misunderstanding among public and professionals. There is a need for raising awareness, developing practice and a need to allay fears of misuse and abuse of ADRTs in clinical, health and social care settings.

Practical implications

The authors make recommendations that reflexive training and awareness become the norm in health and social care, that reform of ADRTs is undertaken to prevent misunderstandings and that the person becomes central in all decision-making processes.

Originality/value

This paper is original in considering ADRTs as a safeguarding issue from two perspectives: that of the person making the ADRT and being confident in respect for the decisions made; and that of clinicians and other professionals being reflexively aware of the need to accept advance decisions and not acting according to unconscious biases in times of crisis.

Details

The Journal of Adult Protection, vol. 22 no. 6
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 13 March 2017

Sue Wilkinson

The purpose of this paper is to introduce Advance Decisions, address low uptake and examine fundamental issues that can inform the development of policy and practice in this area.

Abstract

Purpose

The purpose of this paper is to introduce Advance Decisions, address low uptake and examine fundamental issues that can inform the development of policy and practice in this area.

Design/methodology/approach

This paper discusses findings from a research project with the charity Compassion in Dying (analysing calls to its telephone helpline) and practical experience of working with the charity Advance Decisions Assistance (helping people write Advance Decisions and training healthcare professionals).

Findings

Older people themselves identify the issues of autonomy, identity and efficacy as key challenges in writing Advance Decisions and having them respected.

Originality/value

This paper shows how addressing the “real world” challenges of advance decision making can inform policy and practice.

Details

Working with Older People, vol. 21 no. 1
Type: Research Article
ISSN: 1366-3666

Keywords

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