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Bioethics Mediation: A Guide to Shaping Shared Solutions, Revised and Expanded Edition de Nancy Neveloff Dubler

Bioethics Mediation: A Guide to Shaping Shared Solutions, Revised and Expanded Edition

Autor Nancy Neveloff Dubler, Carol B. Liebman
en Limba Engleză Hardback – 6 iun 2011
Bioethics Mediation offers stories about patients, families, and health care providers enmeshed in conflict as they wrestle with decisions about life and death. It provides guidance for those charged with supporting the patient's traditional and religious commitments and personal wishes. Today's medical system, without intervention, privileges those within shared cultures of communication and disadvantages those lacking power and position, such as immigrants, the poor, and nonprofessionals. This book gives clinical ethics consultants, palliative care providers, and physicians, nurses, and other medical staff the tools they need to understand and manage conflict while respecting the values of patients and family members.
Conflicts come in different guises, and the key to successful resolution is early identification and intervention. Every bioethics mediator needs to be prepared with skills to listen, "level the playing field," identify individual interests, explore options, and help craft a "principled resolution" -- a consensus that identifies a plan aligned with accepted ethical principles, legal stipulations, and moral rules and that charts a clear course of future intervention.

The organization of the book makes it ideal for teaching or as a handbook for the practitioner. It includes actual cases, modified to protect the privacy of patients, providers, and institutions; detailed case analyses; tools for step-by-step mediation; techniques for the mediator; sample chart notes; and a set of actual role plays with expert mediator and bioethics commentaries. The role plays include:

- discharge planning for a dying patient

- an at-risk pregnancy

- HIV and postsurgical complications in the ICU

- treatment for a dying adolescent

- dialysis and multiple systems failure
Expanded by two-thirds from the 2004 edition, the new edition features two new role plays, a new chapter on how to write chart notes, and a discussion of new understandings of the role of the clinical ethics consultant.
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Specificații

ISBN-13: 9780826517715
ISBN-10: 0826517714
Pagini: 344
Dimensiuni: 178 x 254 x 25 mm
Greutate: 0.77 kg
Ediția:Revised, Expand
Editura: Vanderbilt University Press
Colecția Vanderbilt University Press

Notă biografică

Carol B. Liebman is Clinical Professor at Columbia Law School, where she is the director of the Columbia Law School Mediation Clinic and the Negotiation Workshop.

Nancy Neveloff Dubler is Senior Associate at the Montefiore-Einstein Center for Bioethics and Professor Emerita of Bioethics at the Albert Einstein College of Medicine. She cofounded the Certificate Program in Bioethics and Medical Humanities in 1994 with David Rothman of Columbia University. She is the Consultant for Ethics for the New York City Health and Hospitals Corporation, the nation's largest public hospital system.

Cuprins

Foreword by James R. Tallon Jr.

Preface

Part I: A Framework for Understanding Bioethics Mediation

Chapter 1: Why Mediation?
• The Angry Family Acting against the Best Interest of the Patient: Clarence Corning’s Case
• The Isolated Wife Adjusting to Loss: Edward Davidoff’s Case
• Managing Conflict in the Contemporary Medical Context
• What Is Bioethics?
• What Is Clinical Ethics Consultation?
• Mediation
• Mediation in Health Care Settings
• Principled Resolutions
• The Limitations of Mediation
• Mediation and Consultation Distinguished
• The Case for Mediation
• A Dying Patient and the Issue of Scarce Resources: Alex Barlow’s Case

Chapter 2: What Makes Bioethics Mediation Unique?
• The Bioethics Mediator Is Generally Employed by the Hospital
• The Bioethics Mediator and Members of the Treatment Team Are Repeat Players
• The Bioethics Mediator Provides Information, Enforces Norms, and Ensures That Resolutions Fall within Medical Best-Practice Guidelines
• Deciding Not to Reach a Resolution Is Not an Option
• The Playing Field Is Usually Uneven for Patients and Their Families
• Confidentiality Is Limited to Information Not Relevant to Patient Care
• Time Is of the Essence
• Bioethics Mediations Involve Life-and-Death Issues
• Facts Play a Different Role
• The Person with the Greatest Stake in the Dispute, the Patient, Is Often Not at the Table
• There May Be a Sequence of Separate, Prior Meetings in Addition to the Group Mediation
• Bioethics Mediations Are Almost Always Multiparty Events
• The Parties Usually Do Not Sign an Agreement to Mediate
• The Physical Setting May Not Be in the Mediator’s Control
• Bioethics Mediators Are Often Involved in Following Up on Implementation of the Agreement
• The Clinical Ethics Consultant Enters a Detailed Account of the Mediation in the Patient’s Chart
• All Participants in a Bioethics Mediation Have a Common Interest in the Well-Being of the Patient

Part II: A Practical Guide to Bioethics Mediation

Chapter 3: Before You Begin a Bioethics Mediation Program
• What Bioethics Mediators Should Know
• Who Should Conduct Bioethics Mediations
• Who Can Request a Bioethics Mediation and Who Must Participate

Chapter 4: The Stages of Bioethics Mediation
• Overview of the Stages of Bioethics Mediation
• How the Process Works: Jennifer’s Case
• Stage 1: Assessment and Preparation
• Stage 2: Beginning the Mediation
• Stage 3: Introducing the Patient
• Stage 4: Presenting and Refining the Medical Facts
• Stage 5: Gathering Information
• Stage 6: Problem Solving
• Stage 7: Resolution
• Stage 8: Follow-up

Chapter 5: Techniques for Mediating Bioethics Disputes
• STADA
• Summarizing
• Reframing
• Questioning
• Looking beyond Labels
• Dealing with Power and Power Imbalances
• An “Old Lady” and Her Twelve Cats
• Generating Movement

Part III: Chart Notes

Chapter 6: How to Write a Bioethics Mediation Chart Note
• Introduction
• The Chart Note
• Typical Ethical Issues and Analysis

Part IV: Case Analyses

Chapter 7: Mediation with a Competent Patient: Mr. Samuels’s Case

Chapter 8: Mediation with a Dysfunctional Family: Mrs. Bates’s Case

Chapter 9: A Complex Mediation with a Large and Involved Family: Mrs. Leonari’s Case

Part V: Role-Plays: Practicing Mediation Skills

Chapter 10: Discharge Planning for a Dying Patient: A Role-Play

Chapter 11: An At-Risk Pregnancy: A Role-Play

Chapter 12: HIV and Postsurgical Complications in the ICU: A Role-Play

Chapter 13: Treating the Dying Adolescent: A Role-Play

Chapter 14: She Didn’t Mean It: A Role-Play

Chapter 15: Don’t Tell Mama: A Role-Play

Part VI: Annotated Transcripts of Bioethics Mediation Role-Plays

Chapter 16: An At-Risk Pregnancy: A Role-Play Transcript

Chapter 17: HIV and Postsurgical Complications in the ICU: A Role-Play Transcript

Chapter 18: She Didn’t Mean It: A Role-Play Transcript

Chapter 19: Don’t Tell Mama: A Role-Play Transcript

Afterword

Appendix: Charting the Future: Credentialing, Privileging, Quality, and Evaluation in Clinical Ethics Consultation

References

Suggested Reading on Mediation

Index

Recenzii

"In addition to a spirited theoretical defense of bioethics mediation, the authors present a detailed practical model for how one does bioethics mediation. Scholars will find the book a gold mine of ideas worthy of further investigation."
--Robert M. Arnold, MD
About the 1st Edition:
"Dubler and Liebman show how mediation and mediative techniques can facilitate the resolution of conflicts that, while often framed in abstract bioethical terms, are better understood as disputes within families and between families and professionals. They offer practical guidance and include in this helpful book everything one would need to train professionals for this innovative work."
--Robert Mnookin
"This is a valuable book for all health care providers who want to understand and resolve bioethical concerns and for faculty who teach bioethics...Highly recommended."
--CHOICE
"A dramatically innovative approach to clinical ethics. The mediation framework seems intuitively right for the kinds of problems encountered by ethics committees and consultants. This approach will surely provoke much discussion and win many followers in the years ahead."
--Jonathan d. Moreno

Descriere

A "how-to" book for clinical ethics consultants, palliative care professionals, and bioethics mediators in the most difficult situations in health care. Expanded by two-thirds from the 2004 edition, the new edition features two new role plays, a new chapter on how to write chart notes, and a discussion of new understandings of the role of the clinical ethics consultant.