Ethical Patient Care: A Casebook for Geriatric Health Care Teams

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.