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It is rational for those who believe that Jesus was raised from the dead to believe that he was bodily raised from the dead. However, this is not the same as resuscitation. The concept of “spiritual resurrection”, popular with some New Testament scholars, is rejected as vague and inconsistent with Scripture. It is argued that bodily resurrection was what Paul believed, and that the New Testament accounts of the resurrection appearances present a unified picture. It is further argued that Jesus’ resurrection is an example of “bodily transformation”. Jesus’ resurrection body was numerically identical (but not qualitatively identical) to his pre-mortem body.

This chapter argues that when Mary Magdalene, Peter, and others saw the risen Jesus, their “seeing” was a case of a normal vision. This is the natural way to read the New Testament accounts, especially given the physical detail contained in many of them. Six possible arguments in favor of objective vision are discussed. Two arguments in favor of normal seeing are presented: that the early church interpreted the “seeing” as normal vision, and that it is theologically significant that the “seeing” was normal. It underscores the reality of the incarnation, and places the church in a strong apologetic position.

This chapter examines the importance of faith and spirituality in end-of-life care from the perspective of Islam, explaining the principles of the Islamic religion and suggesting that the terminally ill Muslim walks in faith, rooted in trust in the Almighty. It describes the contribution of Islam to medical technology, the practices concerning resuscitation orders, and Muslim customs and rituals in the healthcare setting.

This chapter provides an introduction to Advance Care Planning (ACP). It cites the underlying purpose and principles of ACP, in response to patient need. It reflects on the deeper significance of ACP conversations. Lastly, it presents some hope and expectations, and suggestions for planning ACP in different settings. ACP discussions are important. They are a key means of improving end of life care and of enabling better planning and provision of care in line with the needs and preferences of patients and their carers. The practice of ACP affirms the use of advance statements, in which patients clarify their wishes, needs, and preferences for the kind of care they would like to receive, and the means of leading a fuller life meanwhile. It can also include advance decisions or refusals of specific treatments including cardio-pulmonary resuscitation (CPR), and the appointment of a person to act as a proxy surrogate.

People might make a variety of advance decisions that might apply to a range of issues about their health, welfare, finances, or other personal matters. This chapter concentrates on the advance refusal of treatment. It provides background to advance decisions and care planning for end of life, looking also at the context of English law, society, and culture. It looks at related topics such as Advance Decisions to Refuse Treatment (ADRT) and children, decisions relating to cardiopulmonary resuscitation, and assisted suicide. Lastly, it looks forward to raising public and professional awareness, education, and professional development. The discussion also notes that people in England and Wales now have a legal right to refuse even life sustaining treatment.

This chapter discusses the development of cardiopulmonary resuscitation (CPR), the success rates of CPR, who should make the final decision about CPR, the CPR decision-making process involved in Advance Care Planning (ACP), and how to handle a conversation about CPR. The discussion shows that CPR is not as successful as many professionals think. CPR should not be offered if it is going to be futile. If patients have capacity they should be given the option to make decisions for themselves if there is a choice. CPR decisions may be complex and highly emotive. But by following the correct decision-making process, by not using false reassurance, and by being honest and direct, CPR decisions can be made appropriately. This can result in the patient having a dignified, and a good death.

This chapter discusses the different ethical issues that can be encountered when caring for the dying. It begins with the influence of the Liverpool Care Pathway for the Dying Patient (LCP) in ethical decision making, before examining an ethical framework and the best approach to ethical decision making. Issues with cardiopulmonary resuscitation, hydration, and euthanasia are also discussed. The chapter ends with a discussion on advanced directives, which should be recognized as a valid means by which patients can influence the treatments they receive when they are no longer competent to make decisions.

This chapter discusses the ethical issues connected to the care of the dying: issues of hydration and nutrition, issues of ventilation, and issues relating to capacity and decision making. It looks at an ethical framework that tackles the best approach to ethical decision making, which includes the four moral principles that govern the field of health care ethics, and discusses the influence and moral justification of the Liverpool Care Pathway for the Dying Patient (LCP) in ethical decision making. The chapter also discusses withholding and withdrawing interventions and treatments at the end of life and cardiopulmonary resuscitation (CPR).

Cardio-pulmonary resuscitation (CPR) is a treatment aimed at lengthening and prolonging life. Its primary aim is to restore circulation and maintain ventilation. CPR is also designed to acquire independence from artificial means of prolonging life, and is distinct from other life-prolonging treatments particularly within the context of decision-making process. In every clinical context except in emergency departments, physicians and patients are assumed to make advance decisions regarding CPR. In the absence of an advance decision against CPR, it is the only treatment that will always be attempted. This is because CPR is assumed to be in the best interests of the patient. This chapter examines the existing decision-making process suggested by the professionals regarding CPR, with reference to some of the issues arising from it. Its focus is on the use of CPR within the context of palliative care. The chapter also proposes an alternative decision-making process that can be applied to, and employed by, patients in the palliative setting, and to those in an acute hospital setting. It furthermore discusses the arguments and problems arising from the existence of advanced statements in the palliative care.

Communication is not just giving information; rather, it is a two-way process and involves the exchange of information, ideas, and knowledge. Eff ective communication is the key to success and can be achieved only if the receiver understands the exact information the sender is aiming to transfer. Medical communication is the art of speaking clearly and professionally, while reducing the possibility of being misunderstood. It will increase patient satisfaction and trust and improve understanding of treatment and compliance. Examiners consider effective communication to be the most essential skill any doctor requires to deal with the patient’s problems. The General Medical Council has highlighted the importance of communicating well by stating that ‘medical graduates must be able to communicate clearly, sensitively and effectively, not only with patients and their relatives, but also with colleagues and other healthcare professionals’. The Royal College of Paediatrics and Child Heath has put so much emphasis on communication that this is the only skill that is tested in two independent stations in the clinical examination. The College feels that a careful assessment of communication skills distinguishes the good candidates from the bad ones. Often, overseas-trained candidates and non-native English speakers find this station difficult, as they may not have grasped the basic skills of this assessment. In this station, the examiner will watch a communication scenario between the candidate and the patient’s family. It is of utmost importance to read the instructions carefully and understand them. A common mistake is to confuse this station with history taking. The examiner’s task is to observe only and not to ask any questions or make any comments on the candidate's performance. At the end of the episode, the examiner will evaluate the candidate’s performance. The key competence skills required in the communication station are given in table 2.1. Effective communication is a two-way process in which there is an exchange of thoughts, feelings, or ideas towards a mutually accepted goal. Speaking and listening are the two arms of effective communication. One cannot be an effective communicator if both speaking and listening are not mastered. Medical communication starts with speaking, which requires a sender, a message, a medium or channel, and a receiver. The sender encodes a package of information and transmits this by a medium to the receiver. Commonly used media include air, noise, signal, and paper. Content and context are the two elements of information that will be transmitted via the medium. Content is the actual words or symbols. Context is the way the message is delivered, that is the non-verbal components such as body language, facial expressions, posture, gestures, eye contact, and state of emotion. During communication, context is extremely important as it helps the patient and the doctor to understand one another. On receiving the message, the recipient decodes it and can give the sender feedback (figure 2.1).

Emergency medicine is not all ‘ER’—glamour and fast-moving action; much of it requires caring for relatively minor problems or complex elderly patients. Emergency Departments are busy, high-intensity work environments with a high turnover of patients. In order to make time-critical decisions effectively, it is necessary to have a good breadth and depth of knowledge underpinning a sensible and safe approach to dealing with clinical uncertainty. Patients will present with acute and chronic conditions from all specialties. Gathering information rapidly is important. Gaining clues from the patient and their relative(s) is useful, as is obtaining information on events at the scene from the ambulance paramedics. Hospital notes are often not available and neither is the general practitioner (GP), so decisions are made on the basis of limited information. Rather than making definitive diagnoses confirmed by expensive tests, the role of the emergency physician is to determine the immediate threat to life or limb and to treat that threat, while gathering information to make a ‘most likely’ diagnosis so that treatment can be started. Observing the patient in a Clinical Decision Unit can often help to confirm your suspicions, give you further information on how severe a condition is, or eliminate a possible diagnosis. Ultimately, emergency medicine requires the assessment of risk, evaluation of the added benefit of admission over discharge, and excellent communication. The only way to learn emergency medicine is to practise, to discuss patients, and to develop your analytical and decision-making skills. The following questions are designed to develop some of these skills, by showing you an approach to solving the clinical problems that are commonly encountered in the Emergency Department, how to use tests efficiently and effectively, and some of the options for treatment that are available other than admission under inpatient teams.

This chapter will outline the anatomy and physiology of the cardiovascular system and the changes that occur during childhood as this body system matures. Signs and symptoms of cardiovascular failure and nursing assessment and monitoring of the child will also be discussed. This knowledge will enable the nurse to recognize cardiovascular failure as early as possible and commence appropriate interventions. A range of interventions and clinical skills required for cardiovascular support are also explained, utilizing evidence-based guidelines. All aspects of care will be discussed using a family centred and child-friendly approach. The Nursing and Midwifery Council (NMC) introduced the use of essential skills clusters (ESC) to help pre-registration nursing students meet the standards of proficiency required for registration (NMC, 2007b). They are written from the perspective of what the public can expect of a newly qualified nurse and are designed to improve safe and effective practice. The information contained within this chapter covers aspects of most of the skills clusters. In particular, the underpinning principles from: care, compassion, and communication (1); organizational aspects of care (9, 10); infection prevention and control (22, 25, and 26); and nutrition and fluid management (29, 32) which are integrated throughout the discussion. At the end of this chapter you will: ● Understand the anatomy and physiology of the cardiovascular system and the changes that occur during childhood as this body system matures. ● Learn to recognize signs and symptoms of cardiovascular failure. ● Be familiar with nursing assessment and cardiovascular monitoring of the child. ● Understand how the nurse recognizes cardiovascular failure as early as possible and commences appropriate interventions. ● Begin to develop an understanding of the range of interventions and clinical skills required for cardiovascular support. The cardiovascular system is vital for supplying the tissues of the body with blood. This blood supply enables the needs of individual cells for oxygen and nutrients and removal of waste products to be met (metabolic demands). The body is also able to achieve these functions under a variety of circumstances: at rest or sleeping; during exertion through exercise; and during the extra demands placed on the body as a result of illness.

Discussions and decisions about whether or not cardiopulmonary resuscitation (CPR) should be attempted are challenging for patients and clinicians. Misunderstandings, poor decision making, and communication failures are common and have led to complaints, litigation, and adverse media reports. This chapter considers why decisions and recommendations about CPR and other potentially life-sustaining treatments are an important part of advance care planning (ACP), and are needed in other contexts as well. It summarizes what is needed to achieve high-quality, person-centred planning that is both ethical and lawful, and considers current efforts to develop a scheme that will encourage and support clinicians and their patients in that endeavour.

This chapter addresses the ethics of providing cardiopulmonary resuscitation (CPR) to patients enrolled in hospice, given that patients who select hospice care have decided to forgo potentially life-prolonging treatment in exchange for comfort near the end of life. Influential arguments favoring offering CPR, such as the promotion of autonomy and justice, are reviewed. Relevant regulatory requirements in the United States and the United Kingdom, the evidence for futility of CPR in dying patients, and the symbolism of CPR are discussed. Finally, the chapter translates ethics into health policy by recommending that patients who enroll in hospice receive an out-of-hospital do-not-resuscitate (DNR) form along with other enrollment materials such as a medication kit and 24-hour contact telephone number. This approach respects the right of patients to make health care decisions, honors the choice they make about CPR, but recommends a DNR order as consistent with usual hospice practice.

A second “push factor” for the increase of near-death experiences (and their reporting), emerging in the 1960s and 1970s, is the introduction of new reanimation techniques that increased the relative and absolute numbers of individuals surviving critical situations (such as heart attacks). In addition, the chapter discusses the impact of the broadly accepted new definition of death, namely, death as “irreversible coma.” This chapter demonstrates the impact of both, the innovation of reanimation measures and the brain-death discourse, on near-death experiences and near-death discourse—visible in the publications of Moody, who, for example, remained skeptical toward the definition of brain death.

Ebenezer Sibly’s friendship with Quaker physician John Till Adams and his brother, William, seems to have been one of Ebenezer’s primary motivations for moving to Bristol in 1783 or 1784. Sibly left Bristol unexpectedly in 1787, after selling forged lottery tickets. He left with a third wife, the second apparently having died. William Till Adams introduced Sibly to masonic lodges in Bristol. Sibly entered high-degree freemasonry in Bristol and began his to collect masonic degrees and orders, forming a vital connection for many of his later partnerships and projects. Through John Till Adams, Sibly became acquainted with occult, spiritual, and medical experimentation. Sibly sold books and became involved in astrological medicine. He picked up many of the enthusiasms that informed his later career here: resuscitation of drowning victims, electrical medicine, Mesmerism, herbal and astrological medicine, and alchemy.

The post-Revolutionary trend of universal charity found its greatest expression in the humane society movement for the rescue and resuscitation of drowning victims. Americans embraced the movement in the mid-1780s after a British visitor courted their return to transatlantic philanthropic circles. Meanwhile, in Britain the humane society cause helped propel the emerging abolition movement by raising concerns about drowning on slaving voyages, and American activists used the movement to showcase African Americans’ fitness for republican citizenship. In time, the movement became a channel for transatlantic reconciliation. Based on colonial practices, the Massachusetts Humane Society sought to work with the (London) Royal Humane Society to succor shipwrecked sailors. Thwarted, the Massachusetts group forged a new model of transatlantic collaboration based on affectionate ties and joint moral responsibility for drowning victims anywhere. The Royal Humane Society reciprocated and the former compatriots made global philanthropy a force for new postwar bonds.