Over a period of almost 10 years, the work of the Project on Death in America (PDIA) played a formative role in the advancement of end of life care in the United States. The project concerned itself with adults and children, and with interests crossing boundaries between the clinical disciplines, the social sciences, arts and humanities. PDIA engaged with the problems of resources in poor communities and marginalized groups and settings, and it attempted to foster collaboration across a range of sectors and organizations. Authored by medical sociologist David Clark, whose research career has focused on mapping, archiving and analyzing the history and development of hospice, palliative care and related end of life issues, this book examines the broad, ambitious conception of PDIA - which sought to 'transform the culture of dying in America' - and assesses PDIA's contribution to the development of the palliative care field and to wider debates about end of life care within American society. Chapters consider key issues and topics tackled by PDIA grantees which include: explorations of the meanings of death in contemporary American culture; the varying experiences of care at the end of life (in different settings, among different social and ethnic groups); the innovations in service development and clinical practice that have occurred in the US in response to a growing awareness of and debate about end of life issues; the emerging evidence base for palliative and end of life care in the US; the maturation of a field of academic and clinical specialization; the policy and legal issues that have shaped development, including the ethical debate about assisted suicide and the Oregon experience; the opportunities and barriers that have been encountered; and the prospects for future development. A final chapter captures developments and milestones in the field since PDIA closed in 2003, and some of the challenges going forward.

Autorentext

Director of Interdisciplinary Studies, University of Glasgow

Inhalt

1. Brief History of the Project on Death in America Project on Death in America: Programs and Grants, 1994-2003 Exit Strategy 2. Exploring the Meanings of Death Contemporary Meanings and Practices Relating to Death and Dying Arts and Humanities Grants Program 3. Highlighting Experiences of Care Giving and Receiving Care Community and Media Representations 4. Service Innovation and Practice Developments Services Clinical Practice 5. Opportunities, Barriers, and Underserved Communities Policy Matters Underserved Communities 6. Ethical, Legal, and Financial issues The Question of Assisted Suicide Wider Ethical Issues Legal and Financial Matters in End-of-Life Care 7. Developing the Field A Science of Care Professional Educational Initiatives Specialization, Recognition, and Interdisciplinary issues 8. Assessing the Impact of the Project on Death in America Modus Operandi The Special Role of the Faculty Scholars The Impact 9. A Culture Transformed? Post-PDIA Progress in Palliative and End-of-Life Care Continuing Role of Foundations Ongoing Work of PDIA Faculty Scholars, Leaders, and Grantees Future Challenges