Free Delivery Over $100
|
|
|||
|
||||
OverviewHospital intensive care units have changed when and how we die--and not always for the better. The ICU is a new world, one in which once-fatal diseases can be cured and medical treatments greatly enhance our chances of full recovery. But, paradoxically, these places of physical healing can exact a terrible toll, and by focusing on technology rather than humanity, they too often rob the dying of their dignity. By some accounts, the expensive medical treatments provided in ICUs also threaten to bankrupt the nation.In an attempt to give patients a voice in the ICU when they might not otherwise have one, the living will was introduced in 1969, in response to several notorious cases. These documents were meant to keep physicians from ignoring patients' and families' wishes in stressful situations. Unfortunately, despite their aspirations, living wills contain static statements about hypothetical preferences that rarely apply in practice. And they created a process that isn't faithful to who we are as human beings. Further confusing difficult and painful situations, living wills leave patients with the impression that actual communication with their physicians has taken place, when in fact their deepest desires and values remain unaddressed.In this provocative and empathetic book, medical researcher and ICU physician Samuel Morris Brown uses stories from his clinical practice to outline a new way of thinking about life-threatening illness. Brown's approach acknowledges the conflicting emotions we have when talking about the possibility of death and proposes strategies by which patients, their families, and medical practitioners can better address human needs before, during, and after serious illness.Arguing that any solution to the problems of the inhumanity of intensive care must take advantage of new research on the ways human beings process information and make choices, Brown imagines a truly humane ICU. His manifesto for reform advocates wholeness and healing for people facing life-threatening illness. Full Product DetailsAuthor: Samuel Morris BrownPublisher: Oxford University Press Inc Imprint: Oxford University Press Inc Dimensions: Width: 14.70cm , Height: 2.70cm , Length: 21.70cm Weight: 0.426kg ISBN: 9780199392957ISBN 10: 0199392951 Pages: 288 Publication Date: 19 March 2016 Audience: Professional and scholarly , Professional & Vocational Format: Hardback Publisher's Status: Active Availability: To order  Stock availability from the supplier is unknown. We will order it for you and ship this item to you once it is received by us. Table of ContentsTable of Contents Acknowledgments Introduction SECTION ONE: PAST Chapter 1. A Culture in Crisis Historical Death Culture and the Dying of Death Life Support and the Miracles of Resuscitation The Rise of Intensive Care and : Disability Stigma The Limits of Prediction Make Living Wills Difficult to Use Problems of race Living Wills Can Backfire Empirical evidence that Living Wills Don't Work SECTION TWO: PRESENT Chapter 4. Living Wills Don't Make Decisions; Human Beings Do Thinking like a Human Being What your Brain Doesn't Know Might Kill You Affective forecasting and psychological adaptation Things that Go Bump in the Night Moral Distress Moral Hazards Choosing to See Chapter 5. The Barbaric Life of the ICU Barbarism and Brutality The Experience of the Ventilator Immobilization Tubes and more tubes The Brain under Siege Terrible Communication We Don't Always Know What We Want Deforming Death in the Rush to Rescue Chapter 6. Life after the ICU A Few Visionary Researchers The Post-Intensive Care Syndrome Bodies Muscles Lungs Brains Psyches Is It All Worth It? The Tension between Outcomes Research and Advance Directives SECTION THREE: FUTURE Chapter 7. Reform: The Current State of the Art Eliciting Values and Wishes Registration Drives for Advance Directives in Wisconsin Multimedia Persuasion Tailoring Advance Care Planning Decision Aids Choice Architecture The Science of Communication The Conversation Project Redesigning the ICU Chapter 8. Healing the Intensive Care Unit Let Families In Fixing Code Status Hope for the Best, Prepare for the Worst Wrapping Up Recognize the Crossroads Create a Support Community Create Space for Facilitated Farewells Change the Framing to Manage Clinicians' Moral Distress Changing Culture outside Medicine Not Left Unsaid Authentic Personalization A Possible Map: Five Approaches to the ICU Approach 1: Do Everything Approach 2: Be Aggressive Only if I Have a Reasonable Chance of Recovery Approach 3: Only Admit Me to the ICU if I Have an Excellent Chance of Recovery Approach 4: Don't Admit Me to the ICU Approach 5: Don't Admit Me to a Hospital; Focus Only on My Comfort Epilogue. What Should We Do in the Meanwhile?ReviewsIf you work in an ICU, or in palliative care in a system that includes intensive medical care, there is a lot to think about here. * IAHPC, Roger Woodruff * The critically ill in America survive more often than before, but not without trauma to themselves and their loved ones. What do we want done for us when we are at the end of our lives, or afflicted by terrible disease? Our attempts to discuss these questions with our families and doctors have foundered despite the best of intentions. To tell us how we got here, and point a way forward, we need a wise clinician-scientist, fluid writer, and careful thinker. Sam Brown is that person, and his book is a clear-eyed testimony to the weakness of checkboxes and the primacy of humane care. --Zackary Berger, MD, PhD, Johns Hopkins School of Medicine and author of Making Sense of Medicine Not everyone will agree with all of Dr. Brown's moral and clinical positions. But nobody will argue with the depth of his moral and emotional engagement with the profound question of reducing unnecessary suffering during serious illness. This is a valuable and groundbreaking contribution to the necessary debate about how we live, heal, and die-in hospitals and at home-and how medicine can do better to reduce unnecessary suffering. --Katy Butler, Author of Knocking on Heaven's Door In this compelling book, Dr. Brown vividly presents the urgent need to re-humanize all medical care, stressing that each patient is a unique person, whose humanity needs as much attention and understanding, and skilled care, as the patient's physical body. When one day our Intensive Care Units (ICUs) reliably provide caring-in which Respect and Dignity are as central as physical survival-it will be thanks to pioneers like Dr. Brown, and to those of us who heed his call to action in this book. --Lachlan Forrow, MD, Harvard Medical School It is hard to find a physician as comfortable quoting the latest ICU studies as discussing life and death in the Bible, the Crimean War and The Island of Dr. Moreau but Samuel Brown is that doctor. Through the Valley of Shadows is a remarkably comprehensive, thoughtful and moving guide to practicing compassionate care in a place-the ICU-where humanity often disappears. --Barron H. Lerner, MD, PhD and author of The Good Doctor: A Father, A Son and the Evolution of Medical Ethics By bringing life, history, and cognitive psychology to our ongoing conversation about advance directives, Brown highlights the limitations to our current approach to end of life care and offers a path forward. In a tone that is at once pragmatic, and deeply compassionate, Brown moves beyond legalese and overly-simple conceptualizations toward a vision of critical care that accounts for the lived experiences of patients and their families, as well as the doctors struggling to help them. I suspect this book will provide tremendous comfort, to all those struggling with these end of life decisions, while also providing a framework for a system of care that, by better serving the values of its patients, will ultimately relieve some of the unnecessary struggle. --Lisa Rosenbaum, MD, Harvard Medical School and Brigham and Women's Hospital Author InformationSamuel Morris Brown is Assistant Professor of Pulmonary and Critical Care Medicine and Medical Ethics and Humanities, University of Utah School of Medicine and founder and director of the Center for Humanizing Critical Care at Intermountain Medical Center. A practicing intensive care physician, researcher and award-winning historian of ideas, Dr. Brown writes at the intersections of medicine, ethics, and culture. Tab Content 6Author Website:Countries AvailableAll regions |
||||
