Values at the End of Life: The Logic of Palliative Care

This study explores the complex tensions between financial considerations, emotional attachments, and moral arguments that drive end-of-life decisions in the American healthcare system. It documents the rise of hospice and palliative care and the growing acceptance of the idea that a life consumed by suffering may not be worth living. Clinicians are advancing the idea that invasive, expensive hospital procedures often compound a patient's suffering, particularly among affluent, educated families.

Format: Hardback
Length: 360 pages
Publication date: 28 June 2019
Publisher: Harvard University Press

This profound exploration delves into the intricate interplay of financial considerations, emotional attachments, and moral arguments that shape end-of-life decisions. The foundation of America's healthcare system has traditionally been rooted in the belief that life should be extended at all costs, regardless of the financial implications. This commitment has often led to patients enduring heroic interventions that prolong their lives by mere weeks or months, at great expense. However, this approach to end-of-life care is now being increasingly scrutinized from both a moral and financial standpoint. Sociologist Roi Livne has documented the rise and effectiveness of hospice and palliative care, as well as the growing acceptance of the notion that a life consumed by suffering may not be worth living.

Values at the End of Life is a comprehensive work that combines an in-depth historical analysis with an extensive study conducted in three hospitals. Livne observed terminally ill patients, their families, and caregivers navigating treatment, capturing the ambivalent and conflicted moments when individuals articulate and act upon their moral intuitions about dying. Through interviews with medical staff, Livne was able to isolate the strategies clinicians employ to assist families in understanding their options. As he uncovered, clinicians are advancing the idea that invasive and expensive hospital procedures often exacerbate a patient's suffering, particularly among affluent and educated families.

What is particularly striking is the shift in attitudes among American families and healthcare professionals, who once defied death or were in denial of its inevitability. Increasingly, there is a growing recognition that less treatment in the end may be better treatment, as it focuses on relieving pain and enhancing quality of life. This paradigm shift is driven by a moral calculus that values compassion and dignity over prolonging life at all costs.

In conclusion, this insightful study provides a valuable exploration of the complex dynamics that shape end-of-life decisions. It sheds light on the tensions between financial considerations, emotional attachments, and moral arguments, highlighting the need for a more holistic and compassionate approach to end-of-life care. By embracing the notion that less treatment may be better treatment, we can strive to provide better care for the terminally ill and enhance the quality of life for all individuals facing the end of their lives.

Weight: 680g
Dimension: 236 x 169 x 30 (mm)
ISBN-13: 9780674545175