Caregiving Help Library
Care of the Dying Part 2: Encouraging Conversations About Death |
Continued
12 that might address the topic of dying, and indeed appears to contain some deterrents. The introduction of managed care in the United States has increased the number of patients that physicians must see daily, Footnote 13 decreasing the amount of time available to spend in conversation with any given patient on the topic of dying or any other. Modern health care is frequently provided by multiple physicians in multiple sites, long-term physician-patient relationships are increasingly rare, and relationships between health care workers and physicians are increasingly impersonal. Footnote 14 All of these factors inhibit conversations on the topic of dying. Nevertheless, those difficult conversations are prerequisites for many of the modern tool that we have to help guide our health care providers and family members during the final hours of life.
Just as some of us transfer our fear of insects to our children, so might we instead transfer a love and respect for all creatures, and a fascination with their uniqueness. Just as some of us transfer our fear of death to our children, so might we instead transfer a love and respect for all people, and a fascination with each moment of their lives.
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4 Goldstein, Amy. Dying Patients' Care Varies Widely by Place Study Says. The Washington Post, October 18, 1997, pp. A1, A6.
5 Larson, D, Tobin, D., End-of-Life Conversations: Evolving Practice and Theory,
JAMA, Sept. 27, 2000, Vol. 284, No. 12, pp. 1573-1578.
6 Larson, D, Tobin, D., End-of-Life Conversations: Evolving Practice and Theory
J AMA, Sept. 27, 2000, Vol. 284, No. 12, pp 1573-1578.
7Rogers, Carl, and Farson, Richard, Active Listening, in Osland, Joyce, et al., The Organizational Behavior Reader (Seventh Edition). (Upper Saddle River: Prentice-Hall, Inc., 2001) p. 192.
8 Larson, D, Tobin, D. End-of-Life Conversations: Evolving Practice and Theory,JAMA, Sept. 27, 2000, Vol. 284, No. 12, pp 1573-1578.
9 Manzoni's account of the plague of 1630 (chapters 31 to 37) in Sontag, Susan. Illness and Metaphor and AIDS and its Metaphors. (New York: Anchor Books, 1989), p. 137.
10 Sontag, Susan. Illness and Metaphor and AIDS and its Metaphors. (New York: Anchor Books, 1989), p. 105.
11 Larson, D, Tobin, D., End-of-Life Conversations: Evolving Practice and Theory JAMA, Sept. 27, 2000, Vol. 284, No. 12, pp 1573-1578.
12 Larson, D, Tobin, D. End-of-Life Conversations: Evolving Practice and Theory, JAMA, Sept. 27, 2000, Vol. 284, No. 12, pp 1573-1578.
13 Williams, Erin, and van der Reis, Leo. Health Care at the Abyss: Managed Care vs. the Goal of Medicine. (Buffalo: William S. Hein & Co., Inc.,1997), p. 171.
14 Larson, D, Tobin, D. End-of-Life Conversations: Evolving Practice and Theory, JAMA, Sept. 27, 2000, Vol. 284, No. 12, pp 1573-1578.
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