This book addresses a variety of ethical issues that arise in the care of oncology patients. Many volumes have been written on medical ethics in the past 30 years. However, few have focused on ethical issues specific to the care of cancer patients. This book brings together such a focused examination. The contributors are experienced clinicians, ethicists, medical humanists, and medical educators. The issues raised have direct relevance to the care of oncology patients in treatment as well as research settings. The chapters address issues that are central to contemporary medical practice and medical ethics inquiry. Any practicing clinician will be well aware of the problems of communication and how uncertainty, cross-cultural issues, and religious influences can impact patient care. The limits of care and the role of advance directives and palliative care are common issues that must be addressed in treating patients at the end of life. For oncologists and oncology patients, participation in clinical trials may be a thomy topic, especially when phase I clinical trials are being considered. The impact of managed care and reimbursement issues cannot be avoided in the contemporary patient care and similarly cannot be neglected when considering the ethical ramifications raised. No discussion of ethics in oncology can be complete without attention to the specific challenges raised by the pediatric patient with cancer. All of these topics are explored by the contributors to this book.

Unlike many other areas in health care, the practice of oncology presents unique challenges that make assessing and improving value especially complex. First, patients and professionals feel a well-justified sense of urgency to treat for cure, and if cure is not possible, to extend life and reduce the burden of disease. Second, treatments are often both life sparing and highly toxic. Third, distinctive payment structures for cancer medicines are intertwined with practice. Fourth, providers often face tremendous pressure to apply the newest technologies to patients who fail to respond to established treatments, even when the evidence supporting those technologies is incomplete or uncertain, and providers may be reluctant to stop toxic treatments and move to palliation, even at the end of life. Finally, the newest and most novel treatments in oncology are among the most costly in medicine. This volume summarizes the results of a workshop that addressed these issues from multiple perspectives, including those of patients and patient advocates, providers, insurers, health care researchers, federal agencies, and industry. Its broad goal was to describe value in oncology in a complete and nuanced way, to better inform decisions regarding developing, evaluating, prescribing, and paying for cancer therapeutics.

Pediatric Psycho-Oncology is a comprehensive handbook that provides best practice models for the management of psychological, cognitive, and social outcomes of adolescents living with cancer and their families. Chapters cover a wide range of topics including psychological aspects of particular pediatric cancers and their treatments, how to talk to a child and family at critical times during the disease course, genetic testing, individual, family, educational, psychological and psychiatric interventions, and caring for international patients . Each chapter highlights the necessity of embracing an interdisciplinary approach to ensure that each child has the best options for living with cancer and, when cure is not possible, that death occurs with as much dignity as possible for the child and family. An extensive resource section is appended to provide information on written, online, video, community, national and international services and programs. This book features contributions from experts designed to help clinicians review, anticipate and respond to emotional issues that often arise in the context of treating pediatric cancer patients. Numerous cross-references and succinct tables and figures make this concise reference easy to use. Pediatric Psycho-Oncology is an ideal resource for helping pediatric oncologists and nurses recognize when it may be best to refer patients to their mental health colleagues and for those who are establishing pediatric oncology services or adding psychosocial components to existing clinics.

This book identifies the various ethical challenges that arise in pediatric hematology/oncology and provides the necessary tools to overcome these challenges. Aiming to expand upon and strengthen providers’ knowledge and experience in pediatric health care ethical issues, the text positions providers to be beneficial resources to faculty, staff, patients, and families within their institution. It presents a multidisciplinary approach to sound ethical practices that is necessary to effectively care for these patients and their families. The book reviews the principles of ethical decision-making, the unique difficulties in using children as research subjects, common ethical conundrums involved in providing end-of-life care, and general moralities of professional practice. Written by experts in their fields, Ethical Issues in Pediatric Hematology/Oncology is an innovative and valuable resource for clinicians, practitioners, and trainees who work in the field of pediatric hematology/oncology.

Explores a range of issues--including pediatric hospice, historical, religious, spiritual and cultural perspectives on the end of life, hospice in nursing homes, surrogate decision making, physician assisted suicide, organ donation, and our society's legal tenants of end-of-life care. Includes an index.

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

This book is open access under a CC BY 4.0 license. This book examines the concept of care and care practices in healthcare from the interdisciplinary perspectives of continental philosophy, care ethics, the social sciences, and anthropology. Areas addressed include dementia care, midwifery, diabetes care, psychiatry, and reproductive medicine. Special attention is paid to ambivalences and tensions within both the concept of care and care practices. Contributions in the first section of the book explore phenomenological and hermeneutic approaches to care and reveal historical precursors to care ethics. Empirical case studies and reflections on care in institutionalised and standardised settings form the second section of the book. The concluding chapter, jointly written by many of the contributors, points at recurring challenges of understanding and practicing care that open up the field for further research and discussion. This collection will be of great value to scholars and practitioners of medicine, ethics, philosophy, social science and history.