Susan P. Shapiro
- Published in print:
- 2019
- Published Online:
- January 2020
- ISBN:
- 9780226615608
- eISBN:
- 9780226615882
- Item type:
- book
- Publisher:
- University of Chicago Press
- DOI:
- 10.7208/chicago/9780226615882.001.0001
- Subject:
- Sociology, Gerontology and Ageing
Seventy percent of Americans age 60 or over requiring decisions about medical treatment in the final days of life lack capacity to make these decisions. The biggest life-and-death decisions of their ...
More
Seventy percent of Americans age 60 or over requiring decisions about medical treatment in the final days of life lack capacity to make these decisions. The biggest life-and-death decisions of their lives—literally—had to be made by someone else. Yet despite their critical role, we know remarkably little about these surrogate decision makers, the process they follow, the criteria they consider, the choices they make, and the challenges they face. Drawing on observations of two diverse intensive care units, day after day, for more than two years, this book exposes how and why surrogates navigate this grueling role and the impact of the course they fashion. Readers will learn how decision makers are selected, the interventions they weigh in on, the information they seek and evaluate, the values and memories they draw on, the criteria they weigh, the outcomes they choose, the conflicts they become embroiled in, and the challenges they face. Observations also provide insight into why some decision makers authorize one aggressive intervention after the next while others do not—even on behalf of patients with similar problems and prospects. And they expose the limited role of advance directives in structuring the process decision makers follow or the outcomes that result. These findings provide important lessons to future patients, their loved ones and surrogates; those who serve, counsel, or care for those as they near life’s end and their families (physicians, nurses, chaplains, social workers, and lawyers); and scholars, bioethicists, and health policy makers as well.Less
Seventy percent of Americans age 60 or over requiring decisions about medical treatment in the final days of life lack capacity to make these decisions. The biggest life-and-death decisions of their lives—literally—had to be made by someone else. Yet despite their critical role, we know remarkably little about these surrogate decision makers, the process they follow, the criteria they consider, the choices they make, and the challenges they face. Drawing on observations of two diverse intensive care units, day after day, for more than two years, this book exposes how and why surrogates navigate this grueling role and the impact of the course they fashion. Readers will learn how decision makers are selected, the interventions they weigh in on, the information they seek and evaluate, the values and memories they draw on, the criteria they weigh, the outcomes they choose, the conflicts they become embroiled in, and the challenges they face. Observations also provide insight into why some decision makers authorize one aggressive intervention after the next while others do not—even on behalf of patients with similar problems and prospects. And they expose the limited role of advance directives in structuring the process decision makers follow or the outcomes that result. These findings provide important lessons to future patients, their loved ones and surrogates; those who serve, counsel, or care for those as they near life’s end and their families (physicians, nurses, chaplains, social workers, and lawyers); and scholars, bioethicists, and health policy makers as well.
Neil Krishan Aggarwal
- Published in print:
- 2015
- Published Online:
- November 2015
- ISBN:
- 9780231166645
- eISBN:
- 9780231538442
- Item type:
- chapter
- Publisher:
- Columbia University Press
- DOI:
- 10.7312/columbia/9780231166645.003.0002
- Subject:
- Psychology, Social Psychology
This chapter raises issues concerning the alleged involvement of military medical professionals in the unjust interrogation of the Department of Defense to the psychologically distressed suspects of ...
More
This chapter raises issues concerning the alleged involvement of military medical professionals in the unjust interrogation of the Department of Defense to the psychologically distressed suspects of terrorism. In 2004, news stories on detainee abuse at the Abu Ghraib and Guantánamo Bay detention facilities aggravated allegations that military medical professionals have been sharing the medical information of war-traumatized patients to the military officers for interrogation. These accusations raise alarms that the detainees' mental and physical ailments might be exploited by interrogators to extract information in an inhumane way. Bioethicists condemned these actions, calling for “the non-military medical community to unite in support of their military colleagues, and condemn torture and inhumane and degrading practices against detainees.” Foremost among their principles in fighting detainee abuse are respect for autonomy (respect for the decision of the autonomous person), nonmaleficence (avoidance of harm), beneficence (providing benefits), and justice (distributing benefits, risks, and costs fairly).Less
This chapter raises issues concerning the alleged involvement of military medical professionals in the unjust interrogation of the Department of Defense to the psychologically distressed suspects of terrorism. In 2004, news stories on detainee abuse at the Abu Ghraib and Guantánamo Bay detention facilities aggravated allegations that military medical professionals have been sharing the medical information of war-traumatized patients to the military officers for interrogation. These accusations raise alarms that the detainees' mental and physical ailments might be exploited by interrogators to extract information in an inhumane way. Bioethicists condemned these actions, calling for “the non-military medical community to unite in support of their military colleagues, and condemn torture and inhumane and degrading practices against detainees.” Foremost among their principles in fighting detainee abuse are respect for autonomy (respect for the decision of the autonomous person), nonmaleficence (avoidance of harm), beneficence (providing benefits), and justice (distributing benefits, risks, and costs fairly).
