Daniel B. Carr, MD, FABPM is Professor Emeritus of Public Health and Community Medicine at Tufts Medical Center, Boston, and was Saltonstall Professor of Pain Research in the Departments of Anesthesia and Medicine. He is known internationally for his contributions to pain research, evidence-based pain medicine, and to the social and political aspects of pain relief.Dr. Carr co-chaired and drafted major portions of the Agency for Health Care Policy and Research Clinical Practice Guidelines on Acute and Cancer Pain Management. He was the principal technical consultant for the Agency for Healthcare Research and Quality evidence reports on cancer pain and symptom control; had leadership roles in the formation of comprehensive multidisciplinary pain treatment centers at the Massachusetts General Hospital, Tufts-New England Medical Center, and Caritas-St. Elizabeth's Medical Center; and co-developed a novel outcomes instrument ("TOPS") for patients with chronic pain.In addition, Dr. Carr was the founding editor of the International Association for the Study of Pain's publication Pain: Clinical Updates, has been lead editor for pain trials in the Cochrane collaborative review group on Pain, Palliative and Supportive Care, and serves on the editorial boards of several pain-related journals.Ann Berger, MD, MSN completed her undergraduate degree with a B.S. in nursing from New York University, then received her MSN in Oncology Nursing from University of Pennsylvania. After working as an Oncology Clinical Nurse Specialist for several years, Dr. Berger completed her medical training at Medical College of Ohio in Toledo, Ohio. Following medical school, Dr. Berger completed an internship and residency at Hartford Hospital in Connecticut and a Fellowship in medical oncology and pain/palliative care at Yale University in Connecticut. Dr. Berger has had over 30 years of experience in pain and palliative care. Most recently, she was chief of pain and palliative care at National Institutes of Health Clinical Center where she held patient care, education, administrative, and research responsibilities. Dr. Berger has also been cochair of the National Institutes of Health Clinical Center wellness initiative for health care professionals and support staff and was an intramural advisor for several scientific interest groups.Dr. Berger has lectured nationally and internationally. She researched the development of ways to measure psychosocial spiritual healing, as well as the use of integrative modalities for wellness for health care professionals and others, such as teachers. She has also published extensively in the field of pain, palliative care, and wellness for health care providers. Currently, Dr. Berger is a consultant in pain, palliative care, and well being.

• PrefaceForewordContributors List Part I: Dilemmas Related to PatientsChapter 3: A Choice of Comfort FeedingWesley Boyette & M. Jennifer Cheng Chapter 4: Patients Seeking Alternative Treatments for Cancer Pain Steven Mach & Salahadin Abdi Chapter 6: Delivering Difficult News as a Covering ProviderScott Ian Borison Chapter 8: To Pray or Not to Pray: Is that the Question?Marta Illueca Chapter 9: My Patient with Substance Use Disorder is in Acute Sickle Cell Pain CrisisBaraa O. Tayeb & Antje M. Barreveld Chapter 10: My Dying Patient Receiving Opioids Has a Respiratory Rate of 6Baraa O. Tayeb & Antje M. Barreveld Chapter 11: Video Gaming and Virtual Reality in PediatricsElizabeth Pasternak & Pamela Ressler Chapter 12: Native American Spirituality and HealingMarta Illueca Chapter 27: Dying AloneSharon Kim Part II: Dilemmas Related to FamiliesChapter 1: Navigating Familial Conflict Regarding Information Sharing Nafiisah B.M.H. Rajabalee & Scott Ian Borison Chapter 5: Dis/Continuing Transfusions in a 2 Year Old Dying of LeukemiaElizabeth Pasternak & Pamela Ressler Chapter 13: Managing Family ConflictBetty R. Ferrell Chapter 16: Dilemmas Related to FamiliesAnna Barreiro Albán & Beth B. Hogans Chapter 20: Complicated GriefZhu Wang & Salahadin Abdi Part III: Dilemmas Related to Healthcare ProfessionalsChapter 23: Moral Distress: My Patient is Suffering and "We Can't Keep Torturing Them"Anthony Eidelman & Regina M. Fink Chapter 24: Work-Nonwork Life Fit: Tensions for Healthcare CliniciansEmily P. Guinee, Angela K.M. Lipshutz, M. Jennifer Cheng, & Deborah J. Snyder Chapter 25: Burnout and ResilienceJennifer Winegarden & Ylisabyth Bradshaw Chapter 26: Planning and Facing RetirementDaniel B. Carr & Stephen Gullo Part IV: Dilemmas Related to the Healthcare SystemChapter 14: Balancing Opioid Benefit and Risk for Subacute or Chronic Noncancer PainScott A. Strassels & Daniel B. Carr Chapter 19: The Emerging Role of Independent Patient AdvocatesShiella Dowlatshahi Chapter 21: Managing Outpatient Workplace ViolencePragya B. Gupta & Daniel B. Carr Chapter 22: Maladaptive Team DynamicsMoe Norton-Westbrook, Sylvia Christie, & Constance Dahlin Chapter 28: Allocation of Scarce ResourcesJustin Price Chapter 29: Introducing Novel Treatments: Navigating Institutional PoliciesJennifer Winegarden Chapter 34: Racial Inequalities in HealthcareCarmen Renee Green V: Dilemmas Related to Ethical IssuesChapter 2: Hydration and Artificial Nutrition at the End of LifeTamara Vesel & Carol Pilgrim Chapter 7: Physician Assisted Death (PAD)Sudha Chandrasekhar Chapter 15: Decision-Making Around Dialysis WithdrawalMary K. Buss & Tamara Vesel Chapter 17: LGBTQ: to Disclose or Not to Disclose Gabriel Lutz Chapter 18: Can Minors Make Major Healthcare Decisions? Sudha Chandrasekhar Chapter 30: Surrogate Decision MakingMargaret M. Mahon Chapter 31: Approaching Palliative Sedation at the End of LifeAbigail Lebovitz & Tamara Vesel Chapter 32: Advance Care PlanningNnamdi C. Iwuala & Lauren Shaiova Chapter 33: Substituted JudgmentGabriel Lutz Index

Daniel B. Carr, MD, FABPM is Professor Emeritus of Public Health and Community Medicine at Tufts Medical Center, Boston, and was Saltonstall Professor of Pain Research in the Departments of Anesthesia and Medicine. He is known internationally for his contributions to pain research, evidence-based pain medicine, and to the social and political aspects of pain relief.Dr. Carr co-chaired and drafted major portions of the Agency for Health Care Policy and Research Clinical Practice Guidelines on Acute and Cancer Pain Management. He was the principal technical consultant for the Agency for Healthcare Research and Quality evidence reports on cancer pain and symptom control; had leadership roles in the formation of comprehensive multidisciplinary pain treatment centers at the Massachusetts General Hospital, Tufts-New England Medical Center, and Caritas-St. Elizabeth's Medical Center; and co-developed a novel outcomes instrument ("TOPS") for patients with chronic pain.In addition, Dr. Carr was the founding editor of the International Association for the Study of Pain's publication Pain: Clinical Updates, has been lead editor for pain trials in the Cochrane collaborative review group on Pain, Palliative and Supportive Care, and serves on the editorial boards of several pain-related journals.Ann Berger, MD, MSN completed her undergraduate degree with a B.S. in nursing from New York University, then received her MSN in Oncology Nursing from University of Pennsylvania. After working as an Oncology Clinical Nurse Specialist for several years, Dr. Berger completed her medical training at Medical College of Ohio in Toledo, Ohio. Following medical school, Dr. Berger completed an internship and residency at Hartford Hospital in Connecticut and a Fellowship in medical oncology and pain/palliative care at Yale University in Connecticut. Dr. Berger has had over 30 years of experience in pain and palliative care. Most recently, she was chief of pain and palliative care at National Institutes of Health Clinical Center where she held patient care, education, administrative, and research responsibilities. Dr. Berger has also been cochair of the National Institutes of Health Clinical Center wellness initiative for health care professionals and support staff and was an intramural advisor for several scientific interest groups.Dr. Berger has lectured nationally and internationally. She researched the development of ways to measure psychosocial spiritual healing, as well as the use of integrative modalities for wellness for health care professionals and others, such as teachers. She has also published extensively in the field of pain, palliative care, and wellness for health care providers. Currently, Dr. Berger is a consultant in pain, palliative care, and well being.

• PrefaceForewordContributors List Part I: Dilemmas Related to PatientsChapter 3: A Choice of Comfort FeedingWesley Boyette & M. Jennifer Cheng Chapter 4: Patients Seeking Alternative Treatments for Cancer Pain Steven Mach & Salahadin Abdi Chapter 6: Delivering Difficult News as a Covering ProviderScott Ian Borison Chapter 8: To Pray or Not to Pray: Is that the Question?Marta Illueca Chapter 9: My Patient with Substance Use Disorder is in Acute Sickle Cell Pain CrisisBaraa O. Tayeb & Antje M. Barreveld Chapter 10: My Dying Patient Receiving Opioids Has a Respiratory Rate of 6Baraa O. Tayeb & Antje M. Barreveld Chapter 11: Video Gaming and Virtual Reality in PediatricsElizabeth Pasternak & Pamela Ressler Chapter 12: Native American Spirituality and HealingMarta Illueca Chapter 27: Dying AloneSharon Kim Part II: Dilemmas Related to FamiliesChapter 1: Navigating Familial Conflict Regarding Information Sharing Nafiisah B.M.H. Rajabalee & Scott Ian Borison Chapter 5: Dis/Continuing Transfusions in a 2 Year Old Dying of LeukemiaElizabeth Pasternak & Pamela Ressler Chapter 13: Managing Family ConflictBetty R. Ferrell Chapter 16: Dilemmas Related to FamiliesAnna Barreiro Albán & Beth B. Hogans Chapter 20: Complicated GriefZhu Wang & Salahadin Abdi Part III: Dilemmas Related to Healthcare ProfessionalsChapter 23: Moral Distress: My Patient is Suffering and "We Can't Keep Torturing Them"Anthony Eidelman & Regina M. Fink Chapter 24: Work-Nonwork Life Fit: Tensions for Healthcare CliniciansEmily P. Guinee, Angela K.M. Lipshutz, M. Jennifer Cheng, & Deborah J. Snyder Chapter 25: Burnout and ResilienceJennifer Winegarden & Ylisabyth Bradshaw Chapter 26: Planning and Facing RetirementDaniel B. Carr & Stephen Gullo Part IV: Dilemmas Related to the Healthcare SystemChapter 14: Balancing Opioid Benefit and Risk for Subacute or Chronic Noncancer PainScott A. Strassels & Daniel B. Carr Chapter 19: The Emerging Role of Independent Patient AdvocatesShiella Dowlatshahi Chapter 21: Managing Outpatient Workplace ViolencePragya B. Gupta & Daniel B. Carr Chapter 22: Maladaptive Team DynamicsMoe Norton-Westbrook, Sylvia Christie, & Constance Dahlin Chapter 28: Allocation of Scarce ResourcesJustin Price Chapter 29: Introducing Novel Treatments: Navigating Institutional PoliciesJennifer Winegarden Chapter 34: Racial Inequalities in HealthcareCarmen Renee Green V: Dilemmas Related to Ethical IssuesChapter 2: Hydration and Artificial Nutrition at the End of LifeTamara Vesel & Carol Pilgrim Chapter 7: Physician Assisted Death (PAD)Sudha Chandrasekhar Chapter 15: Decision-Making Around Dialysis WithdrawalMary K. Buss & Tamara Vesel Chapter 17: LGBTQ: to Disclose or Not to Disclose Gabriel Lutz Chapter 18: Can Minors Make Major Healthcare Decisions? Sudha Chandrasekhar Chapter 30: Surrogate Decision MakingMargaret M. Mahon Chapter 31: Approaching Palliative Sedation at the End of LifeAbigail Lebovitz & Tamara Vesel Chapter 32: Advance Care PlanningNnamdi C. Iwuala & Lauren Shaiova Chapter 33: Substituted JudgmentGabriel Lutz Index

Daniel B. Carr, MD, FABPM is Professor Emeritus of Public Health and Community Medicine at Tufts Medical Center, Boston, and was Saltonstall Professor of Pain Research in the Departments of Anesthesia and Medicine. He is known internationally for his contributions to pain research, evidence-based pain medicine, and to the social and political aspects of pain relief.Dr. Carr co-chaired and drafted major portions of the Agency for Health Care Policy and Research Clinical Practice Guidelines on Acute and Cancer Pain Management. He was the principal technical consultant for the Agency for Healthcare Research and Quality evidence reports on cancer pain and symptom control; had leadership roles in the formation of comprehensive multidisciplinary pain treatment centers at the Massachusetts General Hospital, Tufts-New England Medical Center, and Caritas-St. Elizabeth's Medical Center; and co-developed a novel outcomes instrument ("TOPS") for patients with chronic pain.In addition, Dr. Carr was the founding editor of the International Association for the Study of Pain's publication Pain: Clinical Updates, has been lead editor for pain trials in the Cochrane collaborative review group on Pain, Palliative and Supportive Care, and serves on the editorial boards of several pain-related journals.Ann Berger, MD, MSN completed her undergraduate degree with a B.S. in nursing from New York University, then received her MSN in Oncology Nursing from University of Pennsylvania. After working as an Oncology Clinical Nurse Specialist for several years, Dr. Berger completed her medical training at Medical College of Ohio in Toledo, Ohio. Following medical school, Dr. Berger completed an internship and residency at Hartford Hospital in Connecticut and a Fellowship in medical oncology and pain/palliative care at Yale University in Connecticut. Dr. Berger has had over 30 years of experience in pain and palliative care. Most recently, she was chief of pain and palliative care at National Institutes of Health Clinical Center where she held patient care, education, administrative, and research responsibilities. Dr. Berger has also been cochair of the National Institutes of Health Clinical Center wellness initiative for health care professionals and support staff and was an intramural advisor for several scientific interest groups.Dr. Berger has lectured nationally and internationally. She researched the development of ways to measure psychosocial spiritual healing, as well as the use of integrative modalities for wellness for health care professionals and others, such as teachers. She has also published extensively in the field of pain, palliative care, and wellness for health care providers. Currently, Dr. Berger is a consultant in pain, palliative care, and well being.

• PrefaceForewordContributors List Part I: Dilemmas Related to PatientsChapter 3: A Choice of Comfort FeedingWesley Boyette & M. Jennifer Cheng Chapter 4: Patients Seeking Alternative Treatments for Cancer Pain Steven Mach & Salahadin Abdi Chapter 6: Delivering Difficult News as a Covering ProviderScott Ian Borison Chapter 8: To Pray or Not to Pray: Is that the Question?Marta Illueca Chapter 9: My Patient with Substance Use Disorder is in Acute Sickle Cell Pain CrisisBaraa O. Tayeb & Antje M. Barreveld Chapter 10: My Dying Patient Receiving Opioids Has a Respiratory Rate of 6Baraa O. Tayeb & Antje M. Barreveld Chapter 11: Video Gaming and Virtual Reality in PediatricsElizabeth Pasternak & Pamela Ressler Chapter 12: Native American Spirituality and HealingMarta Illueca Chapter 27: Dying AloneSharon Kim Part II: Dilemmas Related to FamiliesChapter 1: Navigating Familial Conflict Regarding Information Sharing Nafiisah B.M.H. Rajabalee & Scott Ian Borison Chapter 5: Dis/Continuing Transfusions in a 2 Year Old Dying of LeukemiaElizabeth Pasternak & Pamela Ressler Chapter 13: Managing Family ConflictBetty R. Ferrell Chapter 16: Dilemmas Related to FamiliesAnna Barreiro Albán & Beth B. Hogans Chapter 20: Complicated GriefZhu Wang & Salahadin Abdi Part III: Dilemmas Related to Healthcare ProfessionalsChapter 23: Moral Distress: My Patient is Suffering and "We Can't Keep Torturing Them"Anthony Eidelman & Regina M. Fink Chapter 24: Work-Nonwork Life Fit: Tensions for Healthcare CliniciansEmily P. Guinee, Angela K.M. Lipshutz, M. Jennifer Cheng, & Deborah J. Snyder Chapter 25: Burnout and ResilienceJennifer Winegarden & Ylisabyth Bradshaw Chapter 26: Planning and Facing RetirementDaniel B. Carr & Stephen Gullo Part IV: Dilemmas Related to the Healthcare SystemChapter 14: Balancing Opioid Benefit and Risk for Subacute or Chronic Noncancer PainScott A. Strassels & Daniel B. Carr Chapter 19: The Emerging Role of Independent Patient AdvocatesShiella Dowlatshahi Chapter 21: Managing Outpatient Workplace ViolencePragya B. Gupta & Daniel B. Carr Chapter 22: Maladaptive Team DynamicsMoe Norton-Westbrook, Sylvia Christie, & Constance Dahlin Chapter 28: Allocation of Scarce ResourcesJustin Price Chapter 29: Introducing Novel Treatments: Navigating Institutional PoliciesJennifer Winegarden Chapter 34: Racial Inequalities in HealthcareCarmen Renee Green V: Dilemmas Related to Ethical IssuesChapter 2: Hydration and Artificial Nutrition at the End of LifeTamara Vesel & Carol Pilgrim Chapter 7: Physician Assisted Death (PAD)Sudha Chandrasekhar Chapter 15: Decision-Making Around Dialysis WithdrawalMary K. Buss & Tamara Vesel Chapter 17: LGBTQ: to Disclose or Not to Disclose Gabriel Lutz Chapter 18: Can Minors Make Major Healthcare Decisions? Sudha Chandrasekhar Chapter 30: Surrogate Decision MakingMargaret M. Mahon Chapter 31: Approaching Palliative Sedation at the End of LifeAbigail Lebovitz & Tamara Vesel Chapter 32: Advance Care PlanningNnamdi C. Iwuala & Lauren Shaiova Chapter 33: Substituted JudgmentGabriel Lutz Index