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Approaching Death

Author : Committee on Care at the End of Life
Publisher : National Academies Press
ISBN 13 : 0309518253
Total Pages : 457 pages
Book Rating : 4.3/5 (95 download)

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Book Synopsis Approaching Death by : Committee on Care at the End of Life

Download or read book Approaching Death written by Committee on Care at the End of Life and published by National Academies Press. This book was released on 1997-10-30 with total page 457 pages. Available in PDF, EPUB and Kindle. Book excerpt: When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

A Field Manual for Palliative Care in Humanitarian Crises

Author : Elisha Waldman
Publisher : Oxford University Press
ISBN 13 : 0190066539
Total Pages : 112 pages
Book Rating : 4.1/5 (9 download)

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Book Synopsis A Field Manual for Palliative Care in Humanitarian Crises by : Elisha Waldman

Download or read book A Field Manual for Palliative Care in Humanitarian Crises written by Elisha Waldman and published by Oxford University Press. This book was released on 2019-11-11 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt: As humanitarian aid organizations have evolved, there is a growing recognition that incorporating palliative care into aid efforts is an essential part of providing the best care possible. A Field Manual for Palliative Care in Humanitarian Crises represents the first-ever effort at educating and providing guidance for clinicians not formally trained in palliative care in how to incorporate its principles into their work in crisis situations. Written by a team of international experts, this pocket-sized manual identifies the needs of people affected by natural hazards, political or ethnic conflict, epidemics of life-threatening infections, and other humanitarian crises. Later chapters explore topics including pain management, skin conditions, non-communicable diseases, palliative care emergencies, the law and ethics of end of life care, and more. Concise and highly accessible, this manual is an ideal educational tool pre-deployment or during fieldwork for clinicians involved in planning and providing humanitarian aid, local care providers, and medical trainees.

Care of the Dying Patient

Author : David A. Fleming
Publisher : University of Missouri Press
ISBN 13 : 0826272215
Total Pages : 172 pages
Book Rating : 4.8/5 (262 download)

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Book Synopsis Care of the Dying Patient by : David A. Fleming

Download or read book Care of the Dying Patient written by David A. Fleming and published by University of Missouri Press. This book was released on 2010-04-15 with total page 172 pages. Available in PDF, EPUB and Kindle. Book excerpt: Although the need for improved care for dying patients is widely recognized and frequently discussed, few books address the needs of the physicians, nurses, social workers, therapists, hospice team members, and pastoral counselors involved in care. Care of the Dying Patient contains material not found in other sources, offering advice and solutions to anyone—professional caregiver or family member—confronted with incurable illness and death. Its authors have lectured and published extensively on care of the dying patient and here review a wide range of topics to show that relief of physical suffering is not the only concern in providing care. This collection encompasses diverse aspects of end-of-life care across multiple disciplines, offering a broad perspective on such central issues as control of pain and other symptoms, spirituality, the needs of caregivers, and special concerns regarding the elderly. In its pages, readers will find out how to: effectively utilize palliative-care services and activate timely referral to hospice, arrange for care that takes into account patients’ cultural beliefs, and respond to spiritual and psychological distress, including the loss of hope that often overshadows physical suffering. The authors especially emphasize palliative care and hospice, since some physicians fear that such referrals may be viewed by patients and families as abandonment. They also address ethical and legal risks in pain management and warn that fear of overprescribing pain medication may inadvertently lead to ineffective pain relief and even place the treating team at risk of liability for undertreatment of pain. While physicians have the ability to treat disease, they also help to determine the time and place of death, and they must recognize that end-of-life choices are made more complex than ever before by advances in medicine and at the same time increasingly important. Care of the Dying Patient addresses some of the challenges frequently confronted in terminal care and points the way toward a more compassionate way of death.

Dying in America

Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309303133
Total Pages : 470 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis Dying in America by : Institute of Medicine

Download or read book Dying in America written by Institute of Medicine and published by National Academies Press. This book was released on 2015-03-19 with total page 470 pages. Available in PDF, EPUB and Kindle. Book excerpt: For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Textbook of Palliative Care

Author : Roderick Duncan MacLeod
Publisher : Springer
ISBN 13 : 9783031489907
Total Pages : 0 pages
Book Rating : 4.4/5 (899 download)

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Book Synopsis Textbook of Palliative Care by : Roderick Duncan MacLeod

Download or read book Textbook of Palliative Care written by Roderick Duncan MacLeod and published by Springer. This book was released on 2025-05-29 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This second edition provides the most up-to-date information on all aspects of palliative care including recent developments (including COVID-19), global policies, service provision, symptom management, professional aspects, organization of services, palliative care for specific populations, palliative care emergencies, ethical issues in palliative care, research in palliative care, public health approaches and financial aspects of care. This new Textbook of Palliative Care remains a unique, comprehensive, clinically relevant and state-of-the art book, aimed at advancing palliative care as a science, a clinical practice and as an art. Palliative care has been part of healthcare for over fifty years but we still needs to be explained. Healthcare education and training has been slow to recognize the vital importance of ensuring that all practitioners have a good understanding of what is involved in the care of people with serious or advanced illnesses and theirfamilies. However, the science of palliative care is advancing and this new edition will contribute to a better understanding of this specialty. This new edition offers 20 new chapters out of over 120, written by experts in their given fields provide up-to-date information on a wide range of topics of relevance to those providing care towards the end of life no matter what the disease may be. We present a global perspective on contemporary and classic issues in palliative care with authors from a wide range of disciplines involved in this essential aspect of care. The Textbook includes sections addressing aspects such as symptom management and care provision, organization of care in different settings, care in specific disease groups, palliative care emergencies, ethics, public health approaches and research in palliative care. This new Textbook will be of value to practitioners in all disciplines and professions where the care of people approaching death is important, specialists as well as non-specialists, in any setting where people with serious advanced illnesses are residing. It is also an important resource for researchers, policy-and decision-makers at national or regional levels. Neither the science nor the art of palliative care will stand still so the Editors and contributors from all over the world aim to keep this Textbook updated so that the reader can find new evidence and approaches to care.

The Shift

Author : Theresa Brown
Publisher : Algonquin Books
ISBN 13 : 1616206020
Total Pages : 273 pages
Book Rating : 4.6/5 (162 download)

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Book Synopsis The Shift by : Theresa Brown

Download or read book The Shift written by Theresa Brown and published by Algonquin Books. This book was released on 2016-05-03 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: Practicing nurse and New York Times columnist Theresa Brown invites us to experience not just a day in the life of a nurse but all the life that happens in just one day on a busy teaching hospital’s cancer ward. In the span of twelve hours, lives can be lost, life-altering treatment decisions made, and dreams fulfilled or irrevocably stolen. Unfolding in real time--under the watchful eyes of this dedicated professional and insightful chronicler of events--The Shift gives an unprecedented view into the individual struggles as well as the larger truths about medicine in this country. By shift’s end, we have witnessed something profound about hope and humanity.

Caring for the Dying Patient and the Family

Author : Janet Moscrop
Publisher : Springer
ISBN 13 : 148993376X
Total Pages : 301 pages
Book Rating : 4.4/5 (899 download)

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Book Synopsis Caring for the Dying Patient and the Family by : Janet Moscrop

Download or read book Caring for the Dying Patient and the Family written by Janet Moscrop and published by Springer. This book was released on 2013-11-11 with total page 301 pages. Available in PDF, EPUB and Kindle. Book excerpt: This third edition of a popular textbook has been completely revised by the joint editors, Janet Moscrop and Joy Robbins. As in previous editions, the focus is on the person dying at home, in residential care or in hospital and the emphasis is on teamwork in caring for the individual and their relatives and friends. Experts in all aspects of care have contributed to this complete revision of the previous text and each chapter is written by a different member of the multiprofessional team. The chapter on the terminal care of people suffering from AIDS has been enlarged and consideration is also given to care of those in the term inal stages of other non-malignant diseases. Other new material includes chapters on complementary therapy, the use of the day centre, the value of volunteers, diversional therapy and respite care. The chapter on bereavement covers many aspects of grief and loss and there is a sensitive approach to the need for supporting staff in this spe cialized work. Consideration is also given to the needs of dying and griev ing people from differing ethnic backgrounds with varying cultural expectations in a pluralistic society. The third edition offers a broad overview of the support given to the dying person and the carers by medical and nursing staff, physiothera pists, pharmacists, social workers, the chaplaincy and members of the pastoral care team. Students of all these disciplines should find this book both readable and informative.

Top Five Regrets of the Dying

Author : Bronnie Ware
Publisher : Hay House, Inc
ISBN 13 : 1401956009
Total Pages : 322 pages
Book Rating : 4.4/5 (19 download)

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Book Synopsis Top Five Regrets of the Dying by : Bronnie Ware

Download or read book Top Five Regrets of the Dying written by Bronnie Ware and published by Hay House, Inc. This book was released on 2019-08-13 with total page 322 pages. Available in PDF, EPUB and Kindle. Book excerpt: Revised edition of the best-selling memoir that has been read by over a million people worldwide with translations in 29 languages. After too many years of unfulfilling work, Bronnie Ware began searching for a job with heart. Despite having no formal qualifications or previous experience in the field, she found herself working in palliative care. During the time she spent tending to those who were dying, Bronnie's life was transformed. Later, she wrote an Internet blog post, outlining the most common regrets that the people she had cared for had expressed. The post gained so much momentum that it was viewed by more than three million readers worldwide in its first year. At the request of many, Bronnie subsequently wrote a book, The Top Five Regrets of the Dying, to share her story. Bronnie has had a colourful and diverse life. By applying the lessons of those nearing their death to her own life, she developed an understanding that it is possible for everyone, if we make the right choices, to die with peace of mind. In this revised edition of the best-selling memoir that has been read by over a million people worldwide, with translations in 29 languages, Bronnie expresses how significant these regrets are and how we can positively address these issues while we still have the time. The Top Five Regrets of the Dying gives hope for a better world. It is a courageous, life-changing book that will leave you feeling more compassionate and inspired to live the life you are truly here to live.

Dying Well

Author : Ira Byock
Publisher : Penguin
ISBN 13 : 110150028X
Total Pages : 321 pages
Book Rating : 4.1/5 (15 download)

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Book Synopsis Dying Well by : Ira Byock

Download or read book Dying Well written by Ira Byock and published by Penguin. This book was released on 1998-03-01 with total page 321 pages. Available in PDF, EPUB and Kindle. Book excerpt: From Ira Byock, prominent palliative care physician and expert in end of life decisions, a lesson in Dying Well. Nobody should have to die in pain. Nobody should have to die alone. This is Ira Byock's dream, and he is dedicating his life to making it come true. Dying Well brings us to the homes and bedsides of families with whom Dr. Byock has worked, telling stories of love and reconciliation in the face of tragedy, pain, medical drama, and conflict. Through the true stories of patients, he shows us that a lot of important emotional work can be accomplished in the final months, weeks, and even days of life. It is a companion for families, showing them how to deal with doctors, how to talk to loved ones—and how to make the end of life as meaningful and enriching as the beginning. Ira Byock is also the author of The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life.

The Inner Life of the Dying Person

Author : Allan Kellehear
Publisher : Columbia University Press
ISBN 13 : 0231536933
Total Pages : 283 pages
Book Rating : 4.2/5 (315 download)

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Book Synopsis The Inner Life of the Dying Person by : Allan Kellehear

Download or read book The Inner Life of the Dying Person written by Allan Kellehear and published by Columbia University Press. This book was released on 2014-05-27 with total page 283 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique book recounts the experience of facing one's death solely from the dying person's point of view rather than from the perspective of caregivers, survivors, or rescuers. Such unmediated access challenges assumptions about the emotional and spiritual dimensions of dying, showing readers that—along with suffering, loss, anger, sadness, and fear—we can also feel courage, love, hope, reminiscence, transcendence, transformation, and even happiness as we die. A work that is at once psychological, sociological, and philosophical, this book brings together testimonies of those dying from terminal illness, old age, sudden injury or trauma, acts of war, and the consequences of natural disasters and terrorism. It also includes statements from individuals who are on death row, in death camps, or planning suicide. Each form of dying addressed highlights an important set of emotions and narratives that often eclipses stereotypical renderings of dying and reflects the numerous contexts in which this journey can occur outside of hospitals, nursing homes, and hospices. Chapters focus on common emotional themes linked to dying, expanding and challenging them through first-person accounts and analyses of relevant academic and clinical literature in psycho-oncology, palliative care, gerontology, military history, anthropology, sociology, cultural and religious studies, poetry, and fiction. The result is an all-encompassing investigation into an experience that will eventually include us all and is more surprising and profound than anyone can imagine.

Compassionate Person-Centered Care for the Dying

Author : Bonnie Freeman, RN, DNP, ANP, ACHPN
Publisher : Springer Publishing Company
ISBN 13 : 0826122485
Total Pages : 297 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis Compassionate Person-Centered Care for the Dying by : Bonnie Freeman, RN, DNP, ANP, ACHPN

Download or read book Compassionate Person-Centered Care for the Dying written by Bonnie Freeman, RN, DNP, ANP, ACHPN and published by Springer Publishing Company. This book was released on 2015-02-23 with total page 297 pages. Available in PDF, EPUB and Kindle. Book excerpt: A milestone resource for palliative care nurses that facilitates evidence-based compassionate and humanistic care of the dying "A valuable contribution to the evolving field of palliative nursing care. It is authored by a model for this field, Bonnie Freeman, and brings to the bedside what her practice embodies--evidence-based clinically expert care...The CARES tool is a long-needed resource and we are all grateful to the author for moving her passion to paper. It will touch the lives and deaths of patients, families, and the nurses who care for them." --Betty Ferrell, PhD, RN, MA, FAAN, FCPN, CHPN Professor and Director, Division of Nursing Research and Education City of Hope National Medical Center From the Foreword This groundbreaking reference for palliative care nurses is the first to provide realistic and achievable evidence-based methods for incorporating compassionate and humanistic care of the dying into current standards of practice. It builds on the author's research-based CARES tool; a reference that synthesizes five key elements demonstrated to enable a peaceful death, as free from suffering as possible: comfort, airway management, management of restlessness and delirium, emotional and spiritual support, and selfcare for nurses. The book describes, step by step, how nurses can easily implement the basic tenets of the CARES tool into their end-of-life practice. It provides a clearly defined plan that can be individualized for each patient and tailored to specific family needs, and facilitates caring for the dying in the most respectful and humane way possible. The book identifies the most common symptom management needs in dying patients and describes, in detail, the five components of the CARES paradigm and how to implement them to enable a peaceful death and minimize suffering. It includes palliative care prompts founded on 29 evidence-based recommendations and the National Consensus Project for Palliative Care Clinical Practice Guidelines. The resource also addresses the importance of the nurse to act as a patient advocate, how to achieve compassionate communication with the patient and family, and barriers and challenges to compassionate care. Case studies emphasize the importance of compassionate nursing care of the dying and how it can be effectively achieved. Key Features: Provides nurses with a clear understanding of the most common needs of the dying and supplies practical applications to facilitate and improve care Clarifies the current and often complex literature on care of the dying Includes case studies illustrating the most common needs of dying patients and how these are addressed effectively by the CARES tool Based on extensive evidence as well as on the National Consensus Project for Palliative Care Clinical Practice Guidelines

Final Gifts

Author : Maggie Callanan
Publisher : Simon and Schuster
ISBN 13 : 1451677294
Total Pages : 222 pages
Book Rating : 4.4/5 (516 download)

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Book Synopsis Final Gifts by : Maggie Callanan

Download or read book Final Gifts written by Maggie Callanan and published by Simon and Schuster. This book was released on 2012-02-14 with total page 222 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this moving and compassionate classic—now updated with new material from the authors—hospice nurses Maggie Callanan and Patricia Kelley share their intimate experiences with patients at the end of life, drawn from more than twenty years’ experience tending the terminally ill. Through their stories we come to appreciate the near-miraculous ways in which the dying communicate their needs, reveal their feelings, and even choreograph their own final moments; we also discover the gifts—of wisdom, faith, and love—that the dying leave for the living to share. Filled with practical advice on responding to the requests of the dying and helping them prepare emotionally and spiritually for death, Final Gifts shows how we can help the dying person live fully to the very end.

Improving Palliative Care for Cancer

Author : National Research Council
Publisher : National Academies Press
ISBN 13 : 0309074029
Total Pages : 344 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Improving Palliative Care for Cancer by : National Research Council

Download or read book Improving Palliative Care for Cancer written by National Research Council and published by National Academies Press. This book was released on 2001-10-19 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: In our society's aggressive pursuit of cures for cancer, we have neglected symptom control and comfort care. Less than one percent of the National Cancer Institute's budget is spent on any aspect of palliative care research or education, despite the half million people who die of cancer each year and the larger number living with cancer and its symptoms. Improving Palliative Care for Cancer examines the barriersâ€"scientific, policy, and socialâ€"that keep those in need from getting good palliative care. It goes on to recommend public- and private-sector actions that would lead to the development of more effective palliative interventions; better information about currently used interventions; and greater knowledge about, and access to, palliative care for all those with cancer who would benefit from it.

Companioning the Dying

Author : Greg Yoder
Publisher : Companion Press
ISBN 13 : 161722149X
Total Pages : 158 pages
Book Rating : 4.6/5 (172 download)

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Book Synopsis Companioning the Dying by : Greg Yoder

Download or read book Companioning the Dying written by Greg Yoder and published by Companion Press. This book was released on 2012-04-01 with total page 158 pages. Available in PDF, EPUB and Kindle. Book excerpt: This guide for counselors and lay caregivers explores the art of caring for the dying and their families. Based on the tenets first articulated by renowned grief educator Dr. Alan Wolfelt, this respectful and gratifying guide to caregiving includes personal accounts that debunk the myth of the "good death" and teach caregivers to find the transformative potential of every moment in every experience. Written with wit and illustrated throughout with the author's poetry and artwork, it includes advice for comforting patients and their families as well as advice for dealing with the internal stress common to the profession. The guidance provided will help counselors feel affirmed in their abilities to "be with" the dying and support them and their families.

The Art of Dying Well

Author : Katy Butler
Publisher : Scribner
ISBN 13 : 1501135473
Total Pages : 288 pages
Book Rating : 4.5/5 (11 download)

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Book Synopsis The Art of Dying Well by : Katy Butler

Download or read book The Art of Dying Well written by Katy Butler and published by Scribner. This book was released on 2020-02-11 with total page 288 pages. Available in PDF, EPUB and Kindle. Book excerpt: This “comforting…thoughtful” (The Washington Post) guide to maintaining a high quality of life—from resilient old age to the first inklings of a serious illness to the final breath—by the New York Times bestselling author of Knocking on Heaven’s Door is a “roadmap to the end that combines medical, practical, and spiritual guidance” (The Boston Globe). “A common sense path to define what a ‘good’ death looks like” (USA TODAY), The Art of Dying Well is about living as well as possible for as long as possible and adapting successfully to change. Packed with extraordinarily helpful insights and inspiring true stories, award-winning journalist Katy Butler shows how to thrive in later life (even when coping with a chronic medical condition), how to get the best from our health system, and how to make your own “good death” more likely. Butler explains how to successfully age in place, why to pick a younger doctor and how to have an honest conversation with them, when not to call 911, and how to make your death a sacred rite of passage rather than a medical event. This handbook of preparations—practical, communal, physical, and spiritual—will help you make the most of your remaining time, be it decades, years, or months. Based on Butler’s experience caring for aging parents, and hundreds of interviews with people who have successfully navigated our fragmented health system and helped their loved ones have good deaths, The Art of Dying Well also draws on the expertise of national leaders in family medicine, palliative care, geriatrics, oncology, and hospice. This “empowering guide clearly outlines the steps necessary to prepare for a beautiful death without fear” (Shelf Awareness).

Compassionate Person-Centered Care for the Dying

Author : Bonnie Freeman
Publisher : Springer Publishing Company
ISBN 13 : 0826122477
Total Pages : 297 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis Compassionate Person-Centered Care for the Dying by : Bonnie Freeman

Download or read book Compassionate Person-Centered Care for the Dying written by Bonnie Freeman and published by Springer Publishing Company. This book was released on 2015-02-23 with total page 297 pages. Available in PDF, EPUB and Kindle. Book excerpt: This groundbreaking reference for palliative care nurses is the first to provide realistic and achievable evidence-based methods for incorporating compassionate and humanistic care of the dying into current standards of practice. It builds on the author’s research-based CARES Tool, a reference that synthesizes five key elements demonstrated to enable a peaceful death as free from suffering as possible: Comfort, Airway Management, Management of Restlessness and Delirium, Emotional and Spiritual Support, and Self-Care for Nurses. The book describes step-by-step how nurses can easily implement the basic tenets of the CARES Tool into their end-of-life practice. It provides a clearly defined plan that can be individualized for each patient and tailored to specific family needs, and facilitates caring for the dying in the most respectful and humane way possible.

Physician-Assisted Dying

Author : Timothy E. Quill
Publisher : JHU Press
ISBN 13 : 9780801880704
Total Pages : 364 pages
Book Rating : 4.8/5 (87 download)

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Book Synopsis Physician-Assisted Dying by : Timothy E. Quill

Download or read book Physician-Assisted Dying written by Timothy E. Quill and published by JHU Press. This book was released on 2004-10-13 with total page 364 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this volume, a distinguished group of physicians, ethicists, lawyers, and activists come together to present the case for the legalization of physician-assisted dying, for terminally ill patients who voluntarily request it. To counter the arguments and assumptions of those opposed to legalization of assisted suicide, the contributors examine ethical arguments concerning self-determination and the relief of suffering; analyze empirical data from Oregon and the Netherlands; describe their personal experiences as physicians, family members, and patients; assess the legal and ethical responsibilities of the physician; and discuss the role of pain, depression, faith, and dignity in this decision. Together, the essays in this volume present strong arguments for the ethical acceptance and legal recognition of the practice of physician-assisted dying as a last resort -- not as an alternative to excellent palliative care but as an important possibility for patients who seek it.