Title: In defiance of death : exposing the real costs of end-of-life care /
Authors: Fisher, Kenneth A., 1941-; Rockwell, Lindsay E.; Scott, Missy, 1946-
Publisher: Praeger,
Year: 2008
Subjects: Terminally Ill psychology; Terminal Care legislation & jurisprudence; Patient Rights; Health Policy; Attitude to Death; Terminal Care ethics; Terminal Care economics; Terminal care Moral and ethical aspects United States.; Palliative treatment Moral and ethical aspects United States.; Death United States.; United States; United States
Abstract: Publisher's description -- Death is a natural part of life. But it has become a painful, protracted, humiliating process that is often inappropriate for the healthcare patient, puts an undue financial and emotional burden on the family, and provides a model of improper care for physicians in training. And it's expensive--about 22 percent of all medical expenditures are for people in the last year of their lives. Further, while studies show that 90 percent of all people would prefer to die at home surrounded by family and friends, the reality is that more than 70 percent die in institutions. As Dr. Ken Fisher argues so passionately in this book, it's time for a change. End-of-life care in the U.S. has evolved over the years into a nightmare for patients and family members, and it has created a near-crushing financial burden on the medical system that is not just excessive but unsustainable. It has driven the cost of healthcare out of reach for many people, and it is a large factor in preventing the creation of universal coverage. Defiance of Death reviews the current state of end-of-life care and highlights its many problems from a variety of economic, political, and social perspectives. Fisher and Rockwell illuminate the ethical dilemmas we all face as technology allows us to prolong life--but at a huge human and financial cost. This book documents these problems and provides a historical perspective of how our medical system evolved. It argues that America's "defiance of death" is far too costly and recommend that all stakeholders--including the public, medical community, Congress, and business leaders--join together to create a system that improves end-of-life care for everyone involved. This book, with workable solutions to improve our medical system, helps point the way.
Contents: Dying in America today -- Roots of the problem: the Patient Self-Determination Act, advance directives, and the Americans with Disabilities Act -- Why we need appropriate care committees -- The three most typical end-of-life populations -- Hospitals, escalating costs, and end-of-life care -- Nursing homes -- Palliative care and hospice -- A big step in the right direction: the VA transforms end-of-life care -- Results of my nonscientific, revealing survey -- The winds of change: suggestions for new directions in end-of-life care.