Weill Medical College of Cornell University

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A Palliative Ethic of Care

Dr. Fins is renowned internationally as a champion of the rights of patients to be treated as whole individuals and receive appropriate and ethical care, and especially of their right to make decisions concerning their treatment. During the past 15 years much of his work has focused on ethical issues related to the end of life and palliative care. His most recent book, A Palliative Ethic of Care: Clinical Wisdom at Life’s End, both explores why there are so many difficulties surrounding end-of-life care and presents a guide for clinicians to help patients and families set and achieve goals of care. He wrote it to help clinicians, residents, attorneys, and medical students understand the transition from curative care to palliative care and to guide them through the great complexities and difficulties involved. Much of the book grew out of Dr. Fins’s experiences - as an internist who sometimes had to care for dying patients and as a physician leading ethics consultations.

The book puts death and dying into a broader social and philosophical context and examines why issues surrounding the right to die have been so difficult. It provides guidelines for goal setting and a strategy for effective palliative care, with the use of the Goals of Care Assessment tool (GCAT). The GCAT is a framework for exploring major issues encountered by patients with terminal illnesses, for identifying goals of care, and for achieving them in a way that best serves the patient and family. Read more about A Palliative Ethic of Care.

Dr. Fins wrote the original draft of a palliative care and training act that was recently signed into law by the New York State Legislature as part of Governor Spitzer’s 2007 Budget Bill. Dr. Fins also analyzed and developed amendments to the Act, which provides $2.1 million in grants to medical schools and $2.5 million in grants to residency training programs. The legislation additionally establishes a statewide Palliative Care Education and Training Council that will serve as a resource center for best practices at the end of life and in palliative care. Read the press release.