clinical and ethical dilemmas in palliative and end-of-life care

Part of the ＂What Do I Do Now: Palliative Care＂ series, Clinical and Ethical Dilemmas in Palliative and End-of-Life Care bridges the gap between the clear, logical, and harmonious clinical world of textbooks and the chaotic, turbulent, resource-constrained, and often unpredictable world of everyday practice. Each chapter begins with a case and is followed by a diagnosis, explanation of next steps, and rationale for decision-making by experts in the field, mimicking the kind of ＂curbside consult＂ that occurs between an experienced clinician and someone new to the field.

Tackling dilemmas related to patients, families, healthcare professionals, and the healthcare system, this book comprehensively helps readers learn to apply practical knowledge in challenging circumstances-and often with incomplete information-to achieve clinical competency. The volume is also a self-assessment tool that tests the reader’s ability to answer the question, ＂What do I do now?＂

Daniel B. Carr, MD, FABPM is Professor Emeritus of Public Health and Community Medicine at Tufts Medical Center, Boston, and was Saltonstall Professor of Pain Research in the Departments of Anesthesia and Medicine. He is known internationally for his contributions to pain research, evidence-based pain medicine, and to the social and political aspects of pain relief.

Dr. Carr co-chaired and drafted major portions of the Agency for Health Care Policy and Research Clinical Practice Guidelines on Acute and Cancer Pain Management. He was the principal technical consultant for the Agency for Healthcare Research and Quality evidence reports on cancer pain and symptom control; had leadership roles in the formation of comprehensive multidisciplinary pain treatment centers at the Massachusetts General Hospital, Tufts-New England Medical Center, and Caritas-St. Elizabeth’s Medical Center; and co-developed a novel outcomes instrument (＂TOPS＂) for patients with chronic pain.

In addition, Dr. Carr was the founding editor of the International Association for the Study of Pain’s publication Pain: Clinical Updates, has been lead editor for pain trials in the Cochrane collaborative review group on Pain, Palliative and Supportive Care, and serves on the editorial boards of several pain-related journals.

Ann Berger, MD, MSN completed her undergraduate degree with a B.S. in nursing from New York University, then received her MSN in Oncology Nursing from University of Pennsylvania. After working as an Oncology Clinical Nurse Specialist for several years, Dr. Berger completed her medical training at Medical College of Ohio in Toledo, Ohio. Following medical school, Dr. Berger completed an internship and residency at Hartford Hospital in Connecticut and a Fellowship in medical oncology and pain/palliative care at Yale University in Connecticut.

Dr. Berger has had over 30 years of experience in pain and palliative care. Most recently, she was chief of pain and palliative care at National Institutes of Health Clinical Center where she held patient care, education, administrative, and research responsibilities. Dr. Berger has also been cochair of the National Institutes of Health Clinical Center wellness initiative for health care professionals and support staff and was an intramural advisor for several scientific interest groups.

Dr. Berger has lectured nationally and internationally. She researched the development of ways to measure psychosocial spiritual healing, as well as the use of integrative modalities for wellness for health care professionals and others, such as teachers. She has also published extensively in the field of pain, palliative care, and wellness for health care providers. Currently, Dr. Berger is a consultant in pain, palliative care, and well being.