Bioethics

How Hospitals Shape End of Life Care
Summary of Sharon. Kaufman, PhD Presentation to
California Coalition for Compassionate Care
Steering Committee Meeting June 3, 2005
Excerpted from Minutes of Meeting

Sharon Kaufman, Ph.D. Professor of Medical Anthropology at UC San Francisco recently published a book entitled, And a Time to Die: How American Hospitals Shape the End of Life. (2005, NY: Scribner). Dr. Kaufman said in her role as a medical anthropologist she “makes the strange, familiar; and makes the familiar, strange.” She described her recent research about the culture of hospitals and how they influence the “problem of death,” which she defined as people dying with too much technology and not enough humanity.

A Framework For Thinking Ethically
Markkula Center for Applied Ethics, Santa Clara University
This document is designed as an introduction to thinking ethically. We all have an image of our “better selves” - or of how we are when we act ethically or are “at our best.” We probably also have an image of what an ethical community, an ethical business, or an ethical government is - and maybe even an ethical society as a whole. Ethics really has to do with all three levels - acting ethically as individuals, creating ethical organizations and governments, and making our society as a whole ethical in the way it treats all.

This important study and related reports released by the California Healthcare Foundation in March 16, 2007 reports that: In California, the most populous and diverse state in the country, significant racial and ethnic differences exist at the end of life. These reports – the first in a new series of CHCF-supported projects focusing on end-of-life issues - found significant variations in the expectations, experiences, and decisions of patients and their families in the months preceding death.

“As California’s diverse population grows older, ensuring quality care at the end of life for everyone takes on even greater significance,” Mark D. Smith, M.D., M.B.A., president and CEO of CHCF, said Thursday at the Association of Health Care Journalists conference in Los Angeles. “By supporting research and projects to improve the quality of end-of-life care, CHCF sees an opportunity to help make California a national example of best medical practices and culturally appropriate care.”

The Center for Practical Bioethics offers a variety of publications, video and audiotapes designed to enhance ethics education and promote discussion of ethics issues. Links are provided for free material and for items to purchase via their online store.

Case studies provide a way for us to analyze and think-through difficult medical and moral situations. This Center for Practical Bioethics webpage links you to stories that will challenge you to think clearly as you consider options at the crossroads of decision.

Diversity Rx: Promoting language and cultural competence to improve the quality of health care for minority, immigrant, and ethnically diverse communities. Diversity Rx is supported by: The National Conference of State Legislatures (NCSL), Resources for Cross Cultural Health Care (RCCHC), and Henry J. Kaiser Family Foundation of Menlo Park, CA. For more information contact Diversity Rx

Living Old is one hour Frontline program filmed November 21, 2006 presenting a powerful and intimate journey into the uncharted territory of Americans living longer than ever — and what it means for them, their loved ones and our society. On this site you can view the whole program or individual chapters including:
The Stories-Living lives that neither the elderly nor their families ever prepared for.
Interviews-Doctors, one family’s story, and a conversation with a remarkable 94 year-old.
The Big Issues-What Needs to Change; Nursing Homes; Parents and Children; When Enough is Enough.

A forum for research and discussion in all areas of applied ethics
The Markkula Center for Applied Ethics at Santa Clara University is one of the preeminent centers for research and dialogue on ethical issues in critical areas of American life. The center works with faculty, staff, students, community leaders, and the public to address ethical issues more effectively in teaching, research, and action. The center’s focus areas are business, health care and biotechnology, character education, government, global leadership, technology, and emerging issues in ethics. Articles, cases, briefings, and dialogue in all fields of applied ethics are available on this site. Publisher of Issues in Ethics Winter 2003 Volume 14 number 1 titled Last Things contains excellent insight into end of life care for the Latino community, article titled: Reluctant Realism by Margaret R. McClean and Margaret A. Graham