Decisions about life-sustaining treatment are often ethically challenging for patients, surrogate decision-makers, and health care professionals. Providing safe, effective, and compassionate care near the end of life is a priority for health care organizations. In times of uncertainty, crisis, or reflection, and in efforts to improve health care for seriously ill patients, guidelines can help. This is the first updated, expanded edition of The Hastings Center's 1987 Guidelines on the Termination of Life-Sustaining Treatment and Care of the Dying, which shaped the ethical and legal framework for decision-making on treatment and end-of-life care in the United States. The new edition, the product of an authoritative consensus process, incorporates 25 years of research, innovation, and developments in law and policy. It summarizes the current framework for making good decisions about treatment and care and identifies educational and organizational goals for health care systems. It covers care planning, decision-making for adults and for children, care transitions, the determination of death, and the policies and processes that support good care at the bedside. It also addresses the psychological and social dimensions of care near the end of life, with attention to effective communication with patients and loved ones and among team members. This book is written for physicians, nurses, and other clinicians in hospitals, nursing homes, home care, and hospice. It is structured for ease of reference during difficult clinical situations and includes extensive practical recommendations supported by print and online resources. This book is also essential reading for clinical ethicists, ethics committee members, health lawyers, and medical and nursing directors. As the U.S. confronts the challenges of health care reform, an aging population, increasing technological capacity to extend life, and serious cost implications, The Hastings Center Guidelines are invaluable to educators, scholars, and policymakers.
Nancy Berlinger is a Research Scholar at The Hastings Center and teaches ethics at the Yale University School of Nursing. She directed the Hastings Center project that produced the revised and expanded second edition of the Guidelines.
Bruce Jennings is Director of Bioethics at the Center for Humans and Nature and teaches ethics at the Yale University School of Medicine. He is an elected Fellow of The Hastings Center and was a co-author of the first edition of the Guidelines in 1987.
Susan M. Wolf is McKnight Presidential Professor of Law, Medicine & Public Policy at the University of Minnesota, as well as Faegre Baker Daniels Professor of Law, Professor of Medicine, and a Faculty Member in the University's Center for Bioethics. She is an elected Member of the National Academies' Institute of Medicine, Fellow of the American Association for the Advancement of Science, and Fellow of The Hastings Center. She directed the Hastings Center project that produced the first edition of the Guidelines in 1987, and was principal author of that work.