Caring for Patients at the End of Life: Facing an Uncertain Future Together 2001

In this book, Dr Quill draws on his extensive clinical experience of caring for seriously ill patients and their families to illustrate the challenges and potential of end of life care. Part One uses the near-death experiences of two patients to explore the values underpinning medical humanism, and then presents the case of 'Diane' to explore the fundamental clinical obligations of partnership. Part Two explores, illustrates and provides practical guidance for clinicians, patients and families on critical communication issues such as communicating bad news, discussing palliative care and exploring death wishes. In Part Three, the difficult ethical and political challenges of hospice work, including the principle of double effect, terminal sedation and physician-assisted suicide, are explored using a combination of real cases and analysis of the underlying clinical, ethical and political issues. In the final chapter, Dr Quill discusses the tragic death of his brother, which occurred as he was completing this book, and how his family made the most emotionally difficult decisions of their lives. Dr Quill exposes readers to an internally consistent and practical way of thinking, while also embracing the potential of palliative care, and acknowledging that it has limitations. His philosophy of offering open discussion with the patient and family, shared decision-making, the provision of medical and palliative expertise and a commitment to seeing the dying process through to the patient's death is vividly illustrated.