Background: This article provides a literature review exploring reasons for disclosure and nondisclosure of bad news to people with learning disabilities. Connections are made to current policy, law and ethics to highlight the complexity of this issue. Methods: This review examines literature on disclosing bad news to people with learning…

This article contributes to a growing literature that takes a more nuanced approach to exploring the complexities of relationships and negotiations with gatekeepers. Using our study of young people living with a parent at the end of life as a 'critical case' of sensitive qualitative research, we discuss how far from being a smooth, linear process,…

Art therapy can be an effective way to focus on end of life issues with cancer patients facing imminent death. This viewpoint discusses ethical challenges in the treatment of a 63-year-old man with terminal lung cancer who was participating in short-term individual art therapy. Difficult issues that often surface in the final days of life may…

In 2005, the American Counseling Association (ACA) introduced a new ethical standard for counselors working with clients with terminal illness who are considering hastened death options. The authors' purpose is to inform counselors of the Death With Dignity Act and explore relevant ethical guidelines in the "ACA Code of Ethics" (ACA, 2005).

We present, in a synthetic way, some of the main findings from five studies that were conducted in the field of empirical bioethics, using the Functional Measurement framework. These studies were about (a) the rationing of rare treatments, (b) adolescents' abortions, (c) end-of-life decision-making regarding damaged neonates, (d) end-of-life…

The first major revision of the "ACA Code of Ethics" in a decade occurred in late 2005, with the updated edition containing important new mandates and imperatives. This article provides interviews with members of the Ethics Revision Task Force that flesh out seminal changes in the revised "ACA Code of Ethics" in the areas of confidentiality,…

End-of-life care is continuously becoming an issue of paramount importance given an increase in medical advances, the aging of the population, and the movement toward contributing toward a quality of life among terminally ill patients. However, there is a dearth in literature related to this topic specifically in terms of preparing counselors to…

"Code status" is a prominent feature of end-of-life discussions in U.S. hospitals. This essay analyzes how the rhetoric of code status articulates the terms of end-of-life decision-making in one hospital's "Patient" Preferences Worksheet. The Worksheet signifies the abandonment of the technological fix as the preferred…

Presents sentiment argument, distinguishing artificial feeding from medical treatments which may be discontinued when there is little hope of recovery. Describes probable origins of feelings about food and drink and shows that such feelings cannot be transferred without distortion to the hospital world. Argues that authentic sentiment seems to…

Explores issues related to "right to die." Makes case for counselors to assist clients and families with concerns related to refusal or withdrawal of medical treatment in cases of terminal illness or in cases where quality of life is severely impaired such as permanent comatose state. Presents historical, ethical, and legal perspectives.…

Notes that suicide is common in old age, but public opinion remains negative. Following a review of theories of suicide and summary of arguments against suicide, constructs argument for why elderly have unique claim to an ethical, unobstructed suicide. Claim rests on their "developmental autonomy," based on experience and wisdom of the elderly.…

Ethical dilemmas are inherent in every health care setting. A sample of hospice social workers with no direct access to a hospice ethics committee (N = 110) was surveyed regarding ethical issues in hospice care, how the issues were managed, and the extent to which social workers participated in resolution of ethical dilemmas. Common issues…

Debates the question of suicide as a defensible choice, particularly for the terminally ill, examining the relevance of such issues as the mortality, rationality, and dynamics of the suicidal act, and the legitimacy of physician-assisted suicide. Contrasting perspectives are articulated by two prominent suicidologists as a spur to the reader's…

Based on nearly three years of participant-observation research in hospice settings, factors that interfere with the hospice philosophy of providing patient autonomy include efforts at symptom control, patient residence, patient disease state, and staff limit setting. Discusses examples, implications, and staff attempts at solutions. (JPS)

Explores many dimensions of suicide among the terminally ill, including preemptive, surcease, and rational suicide. The critical issues addressed are the incidence of suicide in HIV-positive individuals, contributing factors associated with the risk of suicide among people with HIV/AIDS, and the clinical and ethical implications of this issue for…