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Communication at the End of Life

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Edited By Jon F. Nussbaum, Howard Giles and Amber Worthington

Communication is at the heart of any complete understanding of the end of life. While it is true that individuals physically die as a single entity, the process of ending an individual life is located within a complex system of relationships and roles connected and constructed through communicative processes. In this volume, top scholars from numerous disciplines showcase the latest empirical investigations and theoretical advances that focus on communication at the end of life. This multi-contextual approach serves to integrate current findings, expand our theoretical understanding of the end of life, prioritize the significance of competent communication for scholars and practitioners, and provide a solid foundation upon which to build pragmatic interventions to assist individuals at the end of life as well as those who care for and grieve for those who are dying. This book is suitable for undergraduate and graduate courses in Death and Dying, Communication and Aging, Health Communication, Life Span Development, Life Span Communication, Long term care, Palliative care and Social Work.
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Chapter Twelve: Ethical Issues in End-of-Life Communication

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CHAPTER TWELVE

Ethical Issues IN End-of-Life Communication

CRAIG M. KLUGMAN

Mrs. Johnson is in hospice with advanced kidney cancer. Mira, her daughter with a troubled past, is her primary caregiver. When Mrs. Johnson loses consciousness, Mira calls 9-1-1 and, ignoring her mother’s wishes, presses for all treatment possible. Mrs. Johnson is unconscious, uncomfortable, and in pain. The medical and nursing staff believe that interventions are causing discomfort with no hope for improvement. As Mrs. Johnson’s kidneys fail and pain medication loses effectiveness, Mira demands dialysis and experimental treatments.

Mrs. Chang has been admitted to the hospital with severe abdominal pain, bloating, fatigue, weight loss, and constipation. She is an immigrant and speaks limited English. A biopsy is sent to the lab for diagnosis, with advanced ovarian cancer being the most likely finding. Her eldest son has asked the medical team not to inform his mother if the result is cancer. He explains that in their society it is considered a cruel burden to inform someone that she has a terminal disease and that all information and decisions should come to him, not his mother.

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