Caring for Patients at the End of Life: Facing an Uncertain Future Together

In Caring for Patients at the End of Life: Facing an Uncertain Future Together, Dr. Quill uses his wide range of clinical experience caring for severely ill patients and their families to illustrate the challenges and potential of end-of-life care. Section one utilizes the near death experiences of two patients to explore values underlying medical humanism, and then presents the case of "Diane" to explore the fundamental clinical commitments of partnership and non-abandonment. Section two explores, illustrates, and provides practical guidance for clinicians, patients, and families about critical communication issues including delivering bad news, discussing palliative care, and exploring the wish to die. In section three, difficult ethical and policy challenges inherent in hospice work, including the rule of double effect, terminal sedation, and physician-assisted suicide, are explored using a mix of real cases and an analysis of underlying clinical, ethical, and policy issues. In a final chapter, Dr. Quill discusses the tragic death of his brother which occurred as this book was being completed, and how his family made the most emotionally challenging decisions of their lives. Dr. Quill exposes readers to an internally consistent and practical way of thinking by simultaneously embracing the potential of palliative care, and also acknowledging that it has limitations. His philosophy of offering forthright discussions with patient and family, mutual decision-making, ensuring medical and palliative care expertise and of committing to see the dying process through to the patient's death is vividly illustrated.

Review :
"Nothing is harder than communication with patients and families at the end of life. Nothing is more important to quality of care than effective communication. Nothing is better for teaching than personal narratives. Nobody puts all this together better than Tim Quill."--Christine K. Cassel, M.D., Professor and Chairman, The Henry L. Schwartz Department of Geriatrics and Adult Development, Mount Sinai School of Medicine "This book is fresh air for doctors who care for seriously ill patients. Dr. Quill brings the incredible privilege of being a doctor to life on the page. His book transcends the emotional pain and intimacy of accompanying our patients on their path, bringing a concise intellectual clarity and an organized approach to the complicated task of doctoring." -- Diane Meier, M.D., Director, Hertzberg Palliative Care Institute and Co-director, Center to Advance Palliative Care, Mount Sinai School of Medicine "To guide us in end-of-life care, no voice is more respected than Timothy Quill's. In this book, he brings to bear all of his experience, his wisdom and his sensitivity, to help readers through this most difficult of journeys." -- Sherwin Nuland, M.D., author of How We Die "Timothy Quill is a guiding light to the medical profession and to the rest of us who will eventually need help as life comes to its inevitable end. His ability to see how increased longevity has created not just medical dilemmas but complex emotional, spiritual, and familial concerns comes not a moment too soon. This book should be required reading in every medical school and for every doctor nationwide. It should also be a bedside companion for those at the end of life and for those who love them." -- Marilyn Webb, author of The Good Death: The New American Search to Reshape the End of Life