There are over 13.7 million cancer survivors in the US today, and over 1.5 million people will be newly diagnosed this year. Over the last several years that has been substantial progress in cancer treatments resulting in increased life expectancy. While certainly desirable, the dynamic has changed to more people are now living with cancer as a chronic illness. All of these individuals face a series of complex decisions related to their care that include screenings, treatment choices, and the financial challenges of cancer care. Yet less than one third of all people facing cancer receive appropriate counseling and support. A 2008 Institute of Medicine (US) Committee noted that: “The remarkable advances in biomedical care for cancer have not been matched by achievements in providing high-quality care for the psychological and social effects of cancer. Numerous cancer survivors and their caregivers report that cancer care providers did not understand their psychosocial needs, failed to recognize and adequately address depression and other symptoms of stress, were unaware of or did not refer them to available resources, and generally did not consider psychosocial support to be an integral part of quality cancer care.” (Institute of Medicine 2008)
Over the last several years since The Institute of Medicine (IOM) landmark report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs there has been growing awareness of the value of psychosocial support. A number of other professional and standard setting organizations have recognized the importance of and mandated social and emotional care as a part of their quality recommendations and/or measures, including Patient-Center Outcomes Research Institute (PCORI): 2012 Rese...
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...arguable savings to our healthcare system housed under stories of “good deaths” provided arguments too compelling for policymakers to ignore.
The lessons here are clear and evident: it is possible to offer patient-centered and cost- effective care to patients and their families that is clinically appropriate and ethically responsible. Given the prevalence of cancer, applying some of the same thinking to integrate psychosocial interventions in cancer support settings may yield positive results for patients, their families and the healthcare system. Strategies can include more emphasis on education and program planning, changing reimbursement and funding strategies, and adding more specificity in standards for accreditation for cancer centers. If we do not, we will continue to face the ethical implications of the culture of exclusivity in cancer supportive care.
When it comes to a bad diagnosis it is often difficult for doctors to tell their patients this devastating news. The doctor will likely hold back from telling the patient the whole truth about their health because they believe the patient will become depressed. However, Schwartz argues that telling the patient the whole truth about their illness will cause depression and anxiety, but rather telling the patient the whole truth will empower and motivate the patient to make the most of their days. Many doctors will often also prescribe or offer treatment that will likely not help their health, but the doctors do so to make patients feel as though their may be a solution to the problem as they are unaware to the limited number of days they may have left. In comparison, people who are aware there is no cure to their diagnosis and many choose to live their last days not in the hospital or pain free from medications without a treatment holding them back. They can choose to live their last days with their family and will have more time and awareness to handle a will. Schwartz argues the importance of telling patients the truth about their diagnosis and communicating the person’s likely amount of time left as it will affect how the patient chooses to live their limited
It is important as a professional health care provider to have guidelines, regulations, and ethical standards to obey when providing care to the public. The ACA is to improve the quality of professional counselors in the community with education, knowledge, and guidelines by providing an ACA Code of Ethics standard when delivering treatment toward a clientele (American Counseling Association, 2015). One particular part of the ACA mission that is essential, is the ACA Code of Ethics. The purpose of the ACA Code of Ethics is a guide to ensure counselors in training and professional counselors understand the ethical obligations toward clients, possible grievances for conduct unbecoming, and professional responsibilities, which supports the ACA
Dr. Gawande did an excellent job convincing me that his argument was valid. He provided hard data and policy analysis to show the “overkill” of medical
In this chapter Ludmila goes to visit her former mentor Dr. Oreshchenkov. He lives in a nice home and it is filled with things of the past and who he is. Ludmila has realized that she has cancer. However, she is not willing to except her own intuition and goes to Oreshchenkov to be
Before, there were no breakthroughs with the opportunity of saving lives. Innovations in medical technology made contributions to correct abnormal heartbeats and save lives by using a defibrillator and modern respirator. Who would know that the rapid discoveries would include successfully giving patients surgical transplants? Furthermore, President Lyndon Johnson implemented an executive policy requiring the usage of medical response trauma teams. Since 1976, this executive order has allowed the widespread use of CPR, and organizations like the American Red Cross and the American Heart Association were founded. “About 6.4 million people now survive angina chest pain each year, while an additional 700,000 people survive a heart attack each year (pg. 15 of Last Rights) Despite these remarkable breakthroughs that help those badly injured, the law becomes vague and allows more opportunities for misinterpretation on defining death. As a result, this could be advantageously used against the best interest of others and the government. “This ten-year mishmash of laws is what led the previously mentioned President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, established by an act of Congress in 1978 , to tackle the first task of defining death.” (pg. 81). The President’s Commission forced the U.S Supreme Court and
Thanks in part to the scientific and technological advances of todays’ society, enhanced medicinal treatment options are helping people battle illnesses and diseases and live longer than ever before. Despite these advances, however, many people with life threatening illnesses have needs and concerns that are unidentified and therefore unmet at the end of life, notes Arnold, Artin, Griffith, Person and Graham (2006, p. 62). They further noted that when these needs and concerns remain unmet, due in part to the failure of providers to correctly evaluate these needs, as well as the patients’ reluctance to discuss them (p. 63, as originally noted by Heaven & Maguire, 1997), a patient’s quality of life may be adversely affected. According to Bosma et al. (2010, p. 84), “Many generalist social work skills regarding counseling, family systems, community resources, and psychosocial assessments are relevant to working with patients and families with terminal illness”, thereby placing social workers in the distinctive position of being able to support and assist clients with end of life decisions and care planning needs. In fact, they further noted that at some point, “most social work practitioners will encounter adults, children, and families who are facing progressive life limiting illness, dying, death, or bereavement” (p. 79).
Maintaining communication with patients, survivors, families, and the health care providers to monitor patient satisfaction with the cancer care experience.
Tulsky, J. A. (2005). Interventions to Enhance Communication among Patients, Providers, and Families. JOURNAL OF PALLIATIVE MEDICINE (8), 1. S95 - S102.
... only provide patients who are sick a way out, but can keep hospitals from prolonging a patient’s life.
Cancer. The word by itself can conjure images of severely ill and frail people attached to IV medications and chemotherapy drugs as they cling to life in a hospital bed. Other illustrations and pictures depict unrecognizable, misshaped organs affected by abnormal cells that grow out of control, spread, and invade other parts of the body. Cancer studies show that close to one-half of all men and one-third of all women in the United States will be diagnosed with cancer during their lives. Today, millions of people are living with cancer or have had cancer. As patients are newly diagnosed with their specific type of cancer, whether it be breast, lung, prostate, skin, or blood cancer, etc., each patient has to consider what will happen with their future health care plan and who will be involved in their long journey from treatment to recovery. Once diagnosed, cancer patients become the focal point and the center of all activity in terms of care but cancer not only physically invades the patient’s body and well-being, it goes beyond the patient and significantly affects the emotional stability and support from from their loved ones and caregivers. Based on the insidious nature of cancer and typically late detection of malignant diseases, family members (either spouses, children, parents, other relatives, and friends) often become the patient's main caregiver. These caregivers, also known as informal caregivers, provide the cancer patient with the majority of the support outside of the medical facility or hospital environment and become the primary person to provide various types of assistance. They provide the physical support with bathing and assisting in activities of daily living, they become emotional ...
Kenneth Schwartz was a health-care lawyer who had only been exposed to the business side of healthcare. It was not until he was diagnosed with lung cancer that he would experience another role in healthcare, being a patient. The battle he was up against would not only be physical but also emotional. In the end, Schwartz lost his battle against lung cancer just under a year of being diagnosed. The one thing he repeatedly emphasized was the empathetic acts of kindness the caregivers bestowed upon him. Cancer to him was not just about physically beating the cancer, it was for his well-being as a whole ,and his desire to stay intact through out the process. He may have lost his battle with cancer but the care he was provided kept him hopeful and optimistic until his untimely passing. Compassionate care should be a staple for all healthcare providers. It can improve outcomes of health, increase the satisfaction of the patient, and aid in better adherence to recommendations from the caregivers. Patients should never feel they are being rushed, that they are not important, or that they are not receiving the best provision of care possible.
However, it has been reported that telling a patient the truth may significantly improve their wellbeing as they approach the end of their life. One study revealed that truth telling may reduce terminal cancer patients’ uncertainty and anxiety, as indicated by lower scores on a Hospital Anxiety and Depression scale, and higher scores on a Spiritual Well-being scale (Kao et al. 2013). Furthermore, while there is no explicit principle regarding lying within the Hippocratic Oath, honesty is a virtue that is closely associated with physicians and health care providers. In fact, honesty can be closely related to respect for persons, which implies that it is necessary for the maintenance of the physician-patient relationship. Honesty about all relevant aspects of a patient’s diagnosis, prognosis and treatment are necessary to build trust, and to obtain informed consent.
Cancer patients often wonder if going through treatments like chemotherapy and radiation are worth the risk of the side effects, in addition to the cancerous side effects. They feel that they can’t enjoy or relax in what a short amount of time they have left because they are bedridden from the nausea and pain that treatments put them through. Patients tell their loved ones to just let them die so long as they don’t have to go through any more pain. Those who are too old, are unable to recover from the effects, or are just too far in the grips of cancer, should refuse the more harsh treatments like chemo and radiation. On the positive side, refusing treatments after a certain point can save their families from the stress and cost of hospital bills. If caught early enough, patients can opt for safer and easier routes to getting rid of cancer like surgery or by doing a stem cell transplant.
Palliative care involves the holistic care to maintain and improve the quality of life of the patient and family during hospitalisation until the terminal stage. Palliation of care refers to the multidisciplinary approach of providing comfort and support for the terminally ill patient and family, thus has an important role in maintaining and improving the quality of life of the whole family. Chronic illness such as cancer gives a physiologic and emotional burden for the patient and family. Education and counselling of the possible options as well as treatments for pain and other symptoms that could help alleviate anxiety, suffering and discomfort. Palliative care provides assistance for the family as a channel for communication between the
The East Pennsboro elementary school raised money for a statue at a local park. The statue was a ring of children that were holding hands. There was one child missing; the link was broken. The statue was dedicated to East Pennsboro students that did not make it to their graduation. My sophomore year of high school inspired this piece of artwork.