Ethical Patient Care: A Casebook for Geriatric Health Care Teams

by Mezey, Mathy Doval; Cassel, Christine K.; Bottrell, Melissa M.; Hyer, Kathryn; Howe, Judith L., Ph.D.

• ISBN13: 9780801867705
• ISBN10: 0801867703
• Format: Paperback
• Copyright: 2002-01-16
• Publisher: Johns Hopkins Univ Pr

Summary

The delivery of good medical care often involves professionals from various disciplines working together. Interdisciplinary health care teams can be especially valuable in managing patients with complex medical and social needs, such as older persons in hospital, community, or home settings. Such teams, however, can also complicate or even create problems because of their diverse views and responsibilities. Ethical Patient Care: A Casebook for Geriatric Health Care Teams is designed to teach effective and responsible group decision making to clinicians working in teams to treat older patients. The editors use the case study method to present ethical dilemmas that team members encounter in the management of geriatric patients. Patients with multiple chronic conditions so often require the care of more than one medical specialist, and in the introductory chapters the editors suggest ways to resolve conflicts among patients, health care professionals, and the institutions that support them, including hospitals, HMOs, insurance companies, and the government. The book is then divided into four sections, each dealing with one angle of the team-care picture. The first section treats the diverse ethical imperatives of various professionals, conflicts among disciplinary approaches, and and varying attitudes toward end-of-life- decision making. Section two focuses on the patient and covers patient confidentiality, family decisionmaking and interaction with the healthcare team, issues of patient and team nonadherence to the care plan, and elder abuse and neglect. Section three examines the emerging difficulties of decentralized health care in settings such as hospitals, nursing homes, and the home, including clinician accountability and how ethical dilemmas differ across settings. Section four discusses the problems arising from the increasing responsibility of clinicians to manage costs and serve the interests of hospitals and insurers. Ethical Patient Care is a valuable resource for bioethicists, gerontologists, and the physicians, nurses, social workers, and therapists who care for aging persons.

Author Biography

Mathy D. Mezey, Ed.D., R.N., is Independence Foundation Professor of Nursing Education and Director of the John A. Hartford Foundation Institute for Geriatric Nursing Practice in the Division of Nursing at New York University. She and her coeditors directed efforts for the John A. Hartford Foundation's Geriatric Interdisciplinary Team Training (GITT) Program.

Table of Contents

List of Contributors	ix
Foreword	xiii
Terrie Wetle
Preface	xv
I INTRODUCTION
An Introduction to Bioethics as It Relates to Teams and Geriatrics	3	(20)
Christine K. Cassel
Mathy D. Mezey
Melissa M. Bottrell
Using This Book as a Teaching Tool	23	(18)
Kathryn Hyer
Judith G. Howe
II PROFESSIONALS
Ethics and Cultures of Care	41	(26)
Russell Burck
Stanley Lapidos
Professional Attitudes Toward End-of Life Decision Making	67	(16)
Eileen R. Chichin
Mathy D. Mezey
III CARE RECIPIENTS
Protecting the Patient's Voice on the Team	83	(19)
Nancy L. Smith
Ernestine Kotthoff Burrell
Linda Farber Post
Guarding Patients' Secrets: Clinicians' Responsibility to Protect Patient Confidentiality	102	(17)
Ellen Olson
Conflicting Interests: Dilemmas of Decision Making for Patients, Families, and Teams	119	(17)
Laurence B. McCullough
Nancy L. Wilson
Jill A. Rhymes
Thomas A. Teasdale
Refusal to Comply: What to Do When the Interdisciplinary Team Plan Doesn't Work	136	(15)
Susan Kornblatt
Catherine Eng
Kate O'Malley
Protecting Patients: The Special Case of Elder Abuse and Neglect	151	(18)
Carmel B. Dyer
Eileen Silverman
Trang Nguyen
Laurence B. McCullough
IV TEAMS AND HOW THEY WORK ACROSS HEALTH CARE SETTINGS
Using Ethics Consultation to Resolve Team Conflict	169	(18)
Nancy Neveloff Dubler
Kathryn Hyer
Terry T. Fulmer
Avoiding the Dark Side of Geriatric Teamwork	187	(21)
Rosalie A. Kane
Exploring Responsibility, Accountability, and Authority in Geriatric Team Performance	208	(22)
Phillip G. Clark
Theresa J. K. Drinka
The Locus of Care and Its Effect on the Presentation of Ethical Conundrums	230	(29)
Steven K. Rothschild
Russell Burck
V IMPACT OF THE ORGANIZATION ON TEAM CARE
Ethical Dilemmas of Team Decisions in a Cost-Conscious Environment	259	(18)
Joann Castle
Duly Compensated or Compromised? Multiple Providers and Cross-Institutional Decision Making	277	(18)
Kathryn Hyer
Lori A. Roscoe
Bruce Robinson
Transitions from Setting to Setting along the Care Continuum: The Case for Megateams	295	(22)
Judith L. Howe
Jeremy Boal
Kirsten Ek
Christine K. Cassel
Emerging Ethical Issues in Geriatric Team Care	317	(16)
Peter J. Whitehouse
Glossary, compiled by Chandhana Paka	333	(10)
Index	343