E-Book Overview
Every one of us will die, and the processes we go through will be our own - unique to our own experiences and life stories. It is reasonable to reflect on what kinds of dying processes may be better or worse for us as we move toward our end. Such consideration, however, can raise troubling ethical concerns for patients, families, and healthcare providers. Even after forty years of concerted focus on biomedical ethics, these moral concerns persist in the care of lethally impaired, terminally ill, and inured patients. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so that their dying processes embody their life stories. He discusses three types of end-of-life patient populations - adults with decision-making capacity, adult without capacity, and children (with a strong focus on infants) - to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients.
E-Book Content
This page intentionally left blank
End-of-Life Care and Pragmatic Decision Making A Bioethical Perspective End-of-Life Care and Pragmatic Decision Making provides a philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences, and argues that when making end-of-life decisions, healthcare providers should pay close attention to the narratives of patients and the communities they inhabit so that their dying processes embody their life stories. Every one of us will die, and the processes we go through will be our own – unique to our own experiences and life stories. Hester argues that it is reasonable to reflect on what kinds of dying processes may be better or worse for us as we move toward our end. Such consideration, however, can raise troubling ethical concerns for patients, families, and healthcare providers. Even after forty years of concerted focus on biomedical ethics, these moral concerns persist in the care of lethally impaired, terminally ill, and injured patients. Hester discusses three types of end-of-life patient populations – adults with decision-making capacity, adults without capacity, and children (with a specific focus on infants) – to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients. D. Micah Hester is Associate Director of the Division of Medical Humanities and Associate Professor of Medical Humanities and Pediatrics at the University of Arkansas for Medical Sciences, and is clinical ethicist at Arkansas Children’s Hospital. He is the author and editor of eight books and numerous journal articles, and he coordinates the Pediatric Ethics Consortium and the Pediatric Ethics Affinity Group of the American Society for Bioethics and Humanities.
End-of-Life Care and Pragmatic Decision Making A Bioethical Perspective
D. MICAH HESTER University of Arkansas for Medical Sciences
CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo, Delhi, Dubai, Tokyo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521113809 © D. Micah Hester 2010 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cam