We Can, But Should We? One Physician's Reflections on End of Life Ethical Dilemmas is a hybrid: part memoir, part reflection, and part text. It explores specific ethical values and dilemmas that frequently occur in hospital settings. Dr. Gospe, with over thirty years experience in bioethics, draws the reader into the maze of making end of life decisions. His extensive consultations and ethical patient care conferences form the basis of this book. He gives the reader an insight to this world of endings and beginnings. Though the cases are real, the names and events have been changed to protect the privacy of the patients and hospital staff. Each of the sixteen narratives outlines stepping-stones for patients, families, and the professional staff as they seek solutions with or for a loved one. Each story reveals both the frailty and the strength of being human. Each story is both heartbreaking and soul nurturing. Dr. Gospe likens the nature of an ethical dilemma to a broken ancient pottery urn. When we first look upon the pieces that litter the ground, our eyes see a multitude of small irregular unrelated shapes. It may take hours or days of struggle to find where each one fits. Solving a medical dilemma is filled with pieces too: tests, multiple diagnoses, and varied treatment options. Only when all the information is laid out along with the pros and cons for each specific treatment, is it possible for all involved to view a bigger picture. Like the shards that morph into a beautiful vessel, the important pieces of the patient's story and her current status reveal a solution. This process can give the hospital staff and patient's family heartfelt peace in knowing their patient is receiving the most appropriate care for her condition, according to her desires. Dr. Gospe offers perspective and advice for healthcare providers and families as they navigate end of life medical ethical issues. He does this by evaluating medical dilemmas through the lens of ever-changing goals of therapy, seemingly contrasting values, and active listening. He suggests that all concerned become proactive in seeking resolution of these issues before they grow into unmanageable situations. He also offers ideas to reverse the dysfunction that may arise between the medical team and the patient's family. The key for professionals, patients, and families alike is to come together with a non-judgmental attitude when communicating concerns or revising treatment plans. Participation in engagement of decision-making enriches everyone. We Can, but Should We? may be utilized as a teaching guide for members of hospital ethics committees, practicing physicians, nurses, social workers, and chaplains as well as students in the medical field. It can also be helpful for family members, clergy, and other support people caring for a loved one.
About the Author: J. Michael Gospe, M.D. joined Santa Rosa Memorial Hospital's newly formed bioethics group in 1982 and soon became its chairperson. In 1999, upon retiring from his thirty-year practice in gastroenterology and internal medicine, he established the role of Medical Director of Ethics at the hospital. He continues to hold both positions at the time of this book's completion. Dr. Gospe has consulted on more than a thousand patients with medical ethical issues. Many patients and their families have inspired him by their love of life and their acceptance of the unfolding of their last days. Others have saddened him by the paralyzing fear that ruled their final hours. Working within this field of end of life decisions, Dr. Gospe has deepened his awareness of the complexity and beauty of the human spirit. He has written this book in order to enable healthcare providers and families to better support patients and loved ones as they travel along the final phase of their lives.