End-of-Life Care in Cardiovascular Disease

Cardiovascular (CV) disease is the leading cause of death worldwide. While death rates from many acute CV illnesses have declined in developing countries, a substantial proportion of individuals with CV disease ultimately die from CV causes. As the popula

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End-of-Life Care in Cardiovascular Disease

Sarah J. Goodlin • Michael W. Rich Editors

End-of-Life Care in Cardiovascular Disease

Editors Sarah J. Goodlin, MD Patient-Centered Education and Research Salt Lake City, Utah USA

Michael W. Rich, MD Washington University School of Medicine St Louis, Missouri USA

Portland VA Medical Center Portland, OR USA

ISBN 978-1-4471-6520-0 ISBN 978-1-4471-6521-7 DOI 10.1007/978-1-4471-6521-7 Springer London Heidelberg New York Dordrecht

(eBook)

Library of Congress Control Number: 2014950791 © Springer-Verlag London 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher's location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)

Foreword

I have heard so many bad stories of life at its end with heart disease, and so many of them were made distressing and frustrating by the actions of the health care team that just meant to do good for the patient. There’s the poor fellow dying of pancreatic cancer whose implanted defibrillator fired off twenty times in as many hours while he debated with himself about the moral status of turning it off – having never considered the issue until his own last hours. There’s the person drowning in fluid begging in gasps to make this stop, but no one was willing and able to provide sedation when the only other option was to die of suffocation and exhausti