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

  • Formaat: 344 pages
  • Ilmumisaeg: 30-Apr-2021
  • Kirjastus: Vanderbilt University Press
  • Keel: eng
  • ISBN-13: 9780826503268
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  • Formaat: 344 pages
  • Ilmumisaeg: 30-Apr-2021
  • Kirjastus: Vanderbilt University Press
  • Keel: eng
  • ISBN-13: 9780826503268
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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 organisation 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.
Foreword xi
James R. Tallon Jr.
Preface xiii
Acknowledgments xxiii
PART I A Framework for Understanding Bioethics Mediation
1(30)
1 Why Mediation?
3(18)
The Angry Family Acting Against the Best Interest of the Patient: Clarence Coming's Case
3(2)
The Isolated Wife Adjusting to Loss: Edward Davidoff's Case
5(2)
Managing Conflict in the Contemporary Medical Context
7(1)
What Is Bioethics?
8(1)
What Is Clinical Ethics Consultation?
9(2)
Mediation
11(1)
Mediation in Health Care Settings
12(2)
Principled Resolutions
14(1)
The Limitations of Mediation
15(1)
Mediation and Consultation Distinguished
15(1)
The Case for Mediation
16(1)
A Dying Patient and the Issue of Scarce Resources: Alex Barlow's Case
17(4)
2 What Makes Bioethics Mediation Unique?
21(10)
The Bioethics Mediator Is Generally Employed by the Hospital
22(1)
The Bioethics Mediator and Members of the Treatment Team Are Repeat Players
23(1)
The Bioethics Mediator Provides Information, Enforces Norms, and Ensures That Resolutions Fall within Medical Best-Practice Guidelines
23(1)
Deciding Not to Reach a Resolution Is Not an Option
24(1)
The Playing Field Is Usually Uneven for Patients and Their Families
24(1)
Confidentiality Is Limited to Information Not Relevant to Patient Care
25(1)
Time Is of the Essence
26(1)
Bioethics Mediations Involve Life-and-Death Issues
26(1)
Facts Play a Different Role
26(1)
The Person with the Greatest Stake in the Dispute, the Patient, Is Often Not at the Table
27(1)
There May Be a Sequence of Separate, Prior Meetings in Addition to the Group Mediation
28(1)
Bioethics Mediations Are Almost Always Multiparty Events
28(1)
The Parties Usually Do Not Sign an Agreement to Mediate
28(1)
The Physical Setting May Not Be in the Mediator's Control
29(1)
Bioethics Mediators Are Often Involved in Following Up on Implementation of the Agreement
29(1)
The Clinical Ethics Consultant Enters a Detailed Account of the Mediation in the Patient's Chart
29(1)
All Participants in a Bioethics Mediation Have a Common Interest in the Well-Being of the Patient
30(1)
PART II A Practical Guide to Bioethics Mediation
31(62)
3 Before You Begin a Bioethics Mediation Program
33(10)
What Bioethics Mediators Should Know
33(4)
Who Should Conduct Bioethics Mediations
37(3)
Who Can Request a Bioethics Mediation and Who Must Participate
40(3)
4 The Stages of Bioethics Mediation
43(30)
Overview of the Stages of Bioethics Mediation
43(1)
How the Process Works: Jennifer's Case
44(3)
Stage 1 Assessment and Preparation
47(7)
Stage 2 Beginning the Mediation
54(3)
Stage 3 Introducing the Patient
57(1)
Stage 4 Presenting and Refining the Medical Facts
58(3)
Stage 5 Gathering Information
61(5)
Stage 6 Problem Solving
66(2)
Stage 7 Resolution
68(3)
Stage 8 Follow-up
71(2)
5 Techniques for Mediating Bioethics Disputes
73(20)
STADA
74(1)
Summarizing
75(3)
Reframing
78(1)
Questioning
79(2)
Looking beyond Labels
81(1)
Dealing with Power and Power Imbalances
81(2)
An "Old Lady" and Her Twelve Cats
83(2)
Generating Movement
85(8)
PART III Chart Notes
93(38)
6 How to Write a Bioethics Mediation Chart Note
95(36)
Introduction
95(3)
The Chart Note
98(13)
Typical Ethical Issues and Analysis
111(20)
PART IV Case Analyses
131(30)
7 Mediation with a Competent Patient: Mr. Samuels's Case
133(8)
8 Mediation with a Dysfunctional Family: Mrs. Bates's Case
141(6)
9 A Complex Mediation with a Large and Involved Family: Mrs. Leonari's Case
147(14)
PART V Role-Plays: Practicing Mediation Skills
161(52)
10 Discharge Planning for a Dying Patient: A Role-Play
165(8)
11 An At-Risk Pregnancy: A Role-Play
173(6)
12 HIV and Postsurgical Complications in the ICU: A Role-Play
179(10)
13 Treating the Dying Adolescent: A Role-Play
189(8)
14 She Didn't Mean It: A Role-Play
197(6)
15 Don't Tell Mama: A Role-Play
203(10)
PART VI Annotated Transcripts of Bioethics Mediation Role-Plays
213(78)
16 An At-Risk Pregnancy: A Role-Play Transcript
215(12)
17 HIV and Postsurgical Complications in the ICU: A Role-Play Transcript
227(26)
18 She Didn't Mean It: A Role-Play Transcript
253(20)
19 Don't Tell Mama: A Role-Play Transcript
273(18)
Afterword 291(2)
Appendix Charting the Future: Credentialing, Privileging, Quality, and Evaluation in Clinical Ethics Consultation 293(18)
References 311(4)
Suggested Reading on Mediation 315(2)
Index 317
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. ----------------------------------------------------------------------------- ---||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. -------------------------------------------------------------------------------