Palliative Care - Core Skills and Clinical Competencies - L. Emanuel, S. Librach (Saunders, 2007) WW.pdf

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PALLIATIVE CARE: CORE SKILLS AND CLINICAL COMPETENCIES
ISBN: 978-1-4160-2597-9
Copyright # 2007 by Saunders, an imprint of Elsevier Inc.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any
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Notice
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our knowledge, changes in practice, treatment and drug therapy may become necessary
or appropriate. Readers are advised to check the most current information provided (i) on proce-
dures featured or (ii) by the manufacturer of each product to be administered, to verify the recom-
mended dose or formula, the method and duration of administration, and contraindications. It is
the responsibility of the practitioner, relying on their own experience and knowledge of the patient,
to make diagnoses, to determine dosages and the best treatment for each individual patient, and
to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher
nor the Editors assumes any liability for any injury and/or damage to persons or property arising
out or related to any use of the material contained in this book.
The Publisher
Library of Congress Cataloging-in-Publication Data
Palliative care : core skills and clinical competencies / [edited by] Linda Emanuel, S. Lawrence Librach. –
1st ed.
p. ; cm.
ISBN 1-4160-2597-9
1. Palliative treatment. I. Emanuel, Linda L. II. Librach, S. Lawrence.
[DNLM: 1. Palliative Care. 2. Clinical Competence. WB 310 P1661 2007]
R726.8.P3427 2007
616’.029–dc22
2006034475
Acquisitions Editor: Kim Murphy
Developmental Editor: Pamela Hetherington
Project Manager: Bryan Hayward
Design Direction: Lou Forgione
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
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Dedication
Photo courtesy of St. Christopher’s
Hospice, London, UK
“The last stages of life should not be seen as defeat, but rather as life’s fulfillment. It
is not merely a time of negation but rather an opportunity for positive achieve-
ment. One of the ways we can help our patients most is to learn to believe and
to expect this.”
Cicely Saunders, 1965
–First published in American Journal of Nursing;
republished in Cicely Saunders: selected writings by David Clark
Oxford University Press, 2006
We dedicate this book to the memory of Dame Cicely Saunders. In its pages,
we have sought to provide for the core skills that a clinician needs in order to make
it possible for every man, woman and child that, when dying is necessary, it
becomes life’s fulfillment.
Linda Emanuel, S. Lawrence Librach, 2007
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Contributors
Carla S. Alexander, MD
Assistant Professor of Medicine, University of Maryland School of Medicine
Director of Palliative Care, Institute of Human Virology, University of
Maryland School of Medicine, Baltimore, Maryland
HIV/AIDS
Wendy Gabrielle Anderson, MD
Fellow in Palliative Care Medicine, University of Pittsburgh, Pittsburgh,
Pennsylvania
Withholding and Withdrawing Life-Sustaining Therapies
Peter Angelos, MD, PhD
Professor of Surgery, Chief of Endocrine Surgery,
Associate Director of the MacLean Center for Clinical Medical Ethics,
Department of Surgery, University of Chicago, Chicago, Illinois
Principles of Palliative Surgery
Robert M. Arnold, MD
Professor of General Internal Medicine, University of Pittsburgh School of
Medicine, Pittsburgh, Pennsylvania
Chief, Section of Palliative Care and Medical Ethics, University of Pittsburgh,
Pittsburgh, Pennsylvania
Withholding and Withdrawing Life-Sustaining Therapies
Al B. Benson III, MD
Professor of Medicine, Associate Director for Clinical Investigations of the
RHLCCC of Northwestern University, Department of Medicine,
Northwestern University Feinberg School of Medicine, Chicago, Illinois
v
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vi
Contributors
Attending Physician, Department of Medicine, Northwestern Memorial
Hospital, Chicago, Illinois
Ann M. Berger, MD, MSN
Bethesda, Maryland
Nausea/Vomiting, Anorexia/Cachexia, and Fatigue
Stephen L. Berger
Darnestown, Maryland
Nausea/Vomiting, Anorexia/Cachexia, and Fatigue
Richard H. Bernstein, MD
Assistant Professor of Clinical Medicine, Mt. Sinai School of Medicine,
New York, New York
Integrating Palliative Care into Disease Management
Alexander A. Boni-Saenz, MSc
Research Associate, Buehler Center on Aging Health & Society,
Northwestern University Feinberg School of Medicine, Chicago, Illinois
The Economic Burden of End-of-Life Illness
Robert O. Bonow, MD
Goldberg Distinguished Professor of Medicine, Northwestern University
Feinberg School of Medicine, Chicago, Illinois
Chief, Division of Cardiology, Co-Director, Bluhm Cardiovascular Institute,
Northwestern Memorial Hospital, Chicago,Illinois
Heart Disease
Kerry Bowman, PhD
Assistant Professor, Department of Family and Community Medicine,
University of Toronto
Bioethicist, Department of Bioethics, Mount Sinai Hospital, Toronto,
Ontario, Canada
Understanding and Respecting Cultural Differences
Frank J. Brescia, MD, MA
Professor of Medicine, Medical University of South Carolina, Charleston,
South Carolina
Program Director, Survivorship Program, Hollings Cancer Center,
Charleston, South Carolina
Depression, Anxiety, and Delirium
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