With a focus on end-of-life discussion in aging and chronically ill populations, this book offers insight into the skill of communicating in complex and emotionally charged discussions. This text is written for all clinicians and professionals in the fields of healthcare and public health who are faced with questions of ethical deliberation when a patient’s illness turns from chronic to terminal. This skill is required to manage care well in an age of advanced technology, and numerous autonomous choices.

The book will explain previously unconnected clinical data such as why mammography works better for women age 50-59 than it does for women age 40-49, why adjuvant chemotherapy works best for premenopausal patients with positive lymph nodes, and it may also explain the racial disparity in outcome. In particular, it points to the perioperative period when systemic inflammation persists for a week or so.

This book explores the current wider political, social and economic context of hospitals in the public and private sector globally and identifies the push and pull tension between the demands of the quality regulator and the requirements of health care commissioning processes.