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Ethical Patient Care

A Casebook for Geriatric Health Care Teams

Edited by Mathy D. Mezey, R.N., Ed.D., Christine K. Cassell, M.D., Melissa Bottrell, M.P.H., Ph.D.(c), Kathryn Hyer, Dr.P.A, M.P.P., Judith L. Howe, Ph.D., and Terry Fulmer, R.N., Ph.D.
Published by Johns Hopkins
Publication date: February 2002
354 pp.
ISBN: 0801867703

The authors use the case study method to explore ethical dilemmas that members of multidisciplinary teams can face when working with geriatric patients. The delivery of good care often involves professionals from various disciplines working together. Interdisciplinary teams are standard in hospice care, and can be of value in the management of any patients with complex medical and social needs. Such teams, however, can also encounter problems because of their diverse views and professional responsibilities. This book is specifically designed to teach effective and responsible group decision making to clinicians working in teams to treat older patients.

In the introductory chapters the editors suggest ways to resolve conflicts among patients, health care professionals, and the institutions that support them, including hospitals, HMOs, insurance companies, and the government. The book is then divided into four sections, each dealing with one angle of the team-care picture. The first section treats the diverse ethical imperatives of various professionals, conflicts among disciplinary approaches, and varying attitudes toward end-of-life- decision making. Section two focuses on the patient and covers patient confidentiality, family decisionmaking and interaction with the healthcare team, issues of patient and team nonadherence to the care plan, and elder abuse and neglect. Section three examines the emerging difficulties of decentralized health care in settings such as hospitals, nursing homes, and the home, including clinician accountability and how ethical dilemmas differ across settings. Section four discusses the problems arising from the increasing responsibility of clinicians to manage costs and serve the interests of hospitals and insurers. Ethical Patient Care is a valuable resource for bioethicists, gerontologists, and the physicians, nurses, social workers, and therapists who care for aging persons.

Mathy D. Mezey, Ed.D., R.N., is Independence Foundation Professor of Nursing Education and Director of the John A. Hartford Foundation Institute for Geriatric Nursing Practice in the Division of Nursing at New York University. She and her coeditors directed efforts for the John A. Hartford Foundation's Geriatric Interdisciplinary Team Training (GITT) Program.

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