Rescue: Faith in the Unlimited Future

Chapple, Helen Stanton

doi:10.1007/s12115-015-9925-z

Cited by 3 publications

(4 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They must adopt a way of life robbed of the illusion of infinitude and embrace a "critical present" of sorts. 3 Supporting that specific vulnerability, as hospice does, becomes a skill relevant to acute care settings in view of the difficulty in differentiating between the seriously ill and the dying, both living in mortal time.…”

Section: Vulnerability and Mortal Timementioning

confidence: 99%

Solidarity in Mortal Time

2022

AMA Journal of Ethics

View full text Add to dashboard Cite

The concept of mortal time is useful in exploring what the hospice care framework might offer nonhospice clinicians. While hospice patients seem distinct from those in other settings, life-threatening serious illness brings with it profound vulnerability that permeates the atmosphere of caregiving. Hospice clinicians lean into this vulnerability, seeking to make meaning for patients and families in the critical present. Clinicians elsewhere can strive to overcome it, working to save themselves and their patients for a rosier future. Mortal time signals the shared human condition, however, and, as such, it can be an entry point for solidarity among patients and coworkers, strengthening both.

show abstract

Section: Vulnerability and Mortal Timementioning

confidence: 99%

Solidarity in Mortal Time

2022

AMA Journal of Ethics

View full text Add to dashboard Cite

show abstract

“…Furthermore, to do so can erode clinicians' belief not only in their ability to rescue persons from imminent death, but also in the illusion of their own unlimited futures. 10 Outside the hospital, dying is not a status that almost anyone openly embraces. And why should they?…”

Section: Dying Is Not a Classification To Be Conferred Quickly Due Tmentioning

confidence: 99%

“…16 Discrete "markers" of dying, such as a DNR order in the chart, may be less important than listening to the patient and the family and helping them orchestrate-and make the most of-the critical present in this moment. 10 But because the hospital is organized around rescue as its most important task, its culture may regard an official designation of dying as an opportunity for closing down or minimizing involvement, perhaps of reassigning staff. Clinicians may see the withdrawal of life support as an opportunity to administer opioids without restraint in order to limit the patient's-or the family's or their own-suffering.…”

Section: Patients' Dual Liminality and Clinician Painmentioning

confidence: 99%

Bringing Dying Out of the Hospital's Closet

Chapple

2020

AMA Journal of Ethics

View full text Add to dashboard Cite

“…It is possible to anticipate a positive outcome while laying the groundwork for something else [13,17,18]. What is key for everyone involved here is to embrace the critical present.…”

Section: The Critical Presentmentioning

confidence: 99%

Strategies for Building Trust with the Caregiver of a Patient with End-Stage Dementia

Chapple

2017

AMA Journal of Ethics

View full text Add to dashboard Cite

This case describes a patient with advanced dementia and an unrealistic spouse, presenting an apparent dilemma about nutrition for physicians. By eliciting the perspective of the caregiver, the physicians can gain insight and rebuild trust that protects the interests of both the patient and the spouse. Their goal needs to shift from resolving the professional ethical dilemma to affirming the immeasurable contribution of the caregiver, acknowledging her journey, asking for her advice, and enabling the work of making meaning in the time available. CaseAs part of a geriatric medicine elective in his fourth year of medical school, Thomas spends a couple of afternoons a week at a local nursing home seeing patients with the attending geriatrician, Dr. Smith. One of the patients that Thomas sees with Dr. Smith is Mindt, a 78-year-old man with a history of advanced dementia who is recovering from pneumonia. He was diagnosed approximately ten years ago and moved into the nursing home about five years ago when he experienced greater functional and cognitive decline. His wife, Nila, who is in her early 70s, lives in the community and visits him frequently. They had one son who died of a myocardial infarction about 13 years ago. Nila is the health care proxy, but since Mindt didn't clarify his preferences for end-of-life care while he had decision-making capacity, she and his other caregivers are unsure about how to respond when Mindt's dementia progresses to the point at which he has trouble eating. Now that he either won't open his mouth or appears to be choking when she has been trying to feed him, it seems that the time has arrived for a critical end-of-life conversation and decision.Nila requests a meeting with Dr. Smith to discuss her concerns about her husband's eating. A family meeting is arranged among Nila, Dr. Smith, Thomas, and a nurse and speech-language therapist who both work closely with Mindt. During this meeting, Nila expresses that if Mindt is not eating, he won't be able to keep up his strength, and if he can't keep up his strength, she worries that he won't continue to recover from pneumonia. Dr. Smith explains to Nila that appetite loss and difficulties in eating are part

show abstract

Rescue: Faith in the Unlimited Future

Cited by 3 publications

References 14 publications

Solidarity in Mortal Time

Solidarity in Mortal Time

Bringing Dying Out of the Hospital's Closet

Strategies for Building Trust with the Caregiver of a Patient with End-Stage Dementia

Contact Info

Product

Resources

About