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Ethics palliative care

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https://www.readbyqxmd.com/read/28618112/older-patients-with-late-stage-copd-their-illness-experiences-and-involvement-in-decision-making-regarding-mechanical-ventilation-and-noninvasive-ventilation
#1
Heidi Jerpseth, Vegard Dahl, Per Nortvedt, Kristin Halvorsen
Older patients with late-stage COPD: their illness experiences and involvement in decision-making regarding mechanical ventilation and noninvasive ventilation AIMS AND OBJECTIVES: The aim of this study was twofold: first, to explore the illness experiences of older patients' with late-stage chronic obstructive pulmonary disease; and second, to develop knowledge about how patients perceive their preferences to be taken into account in decision-making processes concerning mechanical ventilation and /or non-invasive ventilation...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28615954/response-to-lipuma-and-demarco-s-article-on-hastening-death
#2
REVIEW
Julia Zenz
The paper "Palliative care and patient autonomy: moving beyond prohibitions against hastening death" by LiPuma and DeMarco deals with an aspect of end of life care which is the source of considerable disagreement. It is important to emphasize that autonomy is not the unique feature for end of life care. There is always a medical and ethical commitment to care, i.e. beneficence and nonmaleficence. All of these aspects have to be taken into account when treating patients at the very end of life. There is considerable scientific proof indicating that most patients and families can experience a death in dignity when being cared for in palliative care or hospice units...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28602377/end-of-life-care-in-the-treatment-of-heart-failure-in-older-adults
#3
REVIEW
John Arthur McClung
Heart failure presents unique challenges to the clinician who desires to provide excellent and humane care near the end of life. Accurate prediction of mortality in the individual patient is complicated by a chronic disease that is punctuated by recurrent acute episodes and sudden death. Health care providers continue to have difficulty communicating effectively with terminally ill patients and their caregivers regarding end-of-life care preferences, all of which needs to occur earlier rather than later. This article also discusses various means of providing palliative care, and specific issues regarding device therapy, cardiopulmonary resuscitation, and palliative sedation with concurrent discussion of the ethical ramifications and pitfalls of each...
July 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/28601143/psychiatric-and-palliative-care-in-the-intensive-care-unit
#4
REVIEW
Stephanie M Harman
Palliative care is specialized medical care focused on patients with serious illness and their families. In the intensive care unit (ICU), palliative care encompasses core skills to support patients and their families throughout their ICU course and post-ICU stays. Psychiatric symptoms are common among patients approaching the end of life and require particular attention in the setting of sedating medications, typically used when patients require ventilators and other life-sustaining treatments. For patients with preexisting severe mental illness who have a concurrent serious medical illness, a palliative psychiatric approach can address complex symptom management and support ethical and value-based shared decision making...
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28580748/opioid-addiction-and-misuse-in-adult-and-adolescent-patients-with-cancer
#5
Ross Pinkerton, Janet R Hardy
In the context of a therapeutic opioid epidemic, particularly in the USA, where increasingly stringent screening for 'at risk' individuals and close monitoring of opioid prescription and use is strongly recommended, the issue of misuse within the cancer population must be addressed. Most patients with advanced cancer will have pain requiring opioid therapy at some stage during their disease course. In the majority, this will provide good pain relief with no short- or longer-term adverse sequelae. A subset will present with substance misuse issues that will influence management and prescribing practice...
June 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28557875/supporting-the-support-system-how-assessment-and-communication-can-help-patients-and-their-support-systems
#6
Jane Harkey, Jared Young, Jolynne Jo Carter, Michael Demoratz
PURPOSE/OBJECTIVE: The benefits of having a support system, such as social relationships with close friends and family, have been well documented for patients with serious health issues. As scientific evidence has shown, individuals who have the lowest level of involvement in social relationships face a greater mortality risk. Support systems, however, are not infallible. Relationship stress can have a negative impact on people-patient and caregiver alike-behaviorally, psychosocially, and physiologically...
July 2017: Professional Case Management
https://www.readbyqxmd.com/read/28557661/opioids-in-cancer-pain-right-or-privilege
#7
Leanne K Jackson, Syed N Imam, Ursula K Braun
Opioid analgesia is a mainstay of the treatment of cancer pain. Treatment of pain in patients with cancer with an ongoing substance abuse disorder can be difficult. We report the ethical challenges of treating a patient with cancer with a concomitant substance abuse disorder in an outpatient palliative care setting. We present an analysis of ethical considerations for the palliative care physician and strategies to aid in the successful treatment of such patients. We argue that there are select patients with cancer for whom exclusion from treatment with opioid therapy is warranted if their health is endangered by prescription of these medications...
May 30, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28521799/what-are-the-differences-among-occupational-groups-related-to-their-palliative-care-specific-educational-needs-and-intensity-of-interprofessional-collaboration-in-long-term-care-homes
#8
S Kaasalainen, T Sussman, M Bui, N Akhtar-Danesh, R D Laporte, L McCleary, A Wickson Griffiths, K Brazil, D Parker, V Dal Bello-Haas, A Papaioannou, J O'Leary
BACKGROUND: The purpose of this study was to compare the differences across occupational groups related to their end-of-life care-specific educational needs and reported intensity of interprofessional collaboration in long-term care (LTC) homes. METHODS: A cross-sectional survey, based on two questionnaires, was administered at four LTC homes in Ontario, Canada using a modified Dilman's approach. The first questionnaire, End of Life Professional Caregiver Survey, included three domains: patients and family-centered communication, cultural and ethical values, effective care delivery...
May 18, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28501793/ethical-issues-in-death-dying-and-palliation-the-ijme-sixth-national-bioethics-conference
#9
Rakhi Ghoshal, V Deepa, Sunita Simon Kurpad
The IJME Sixth National Bioethics Conference (6th NBC), on the theme "Healing and dying with dignity: ethical issues in palliative care, end-of-life care and euthanasia", was held in Pune, Maharashtra from January 12-15, 2017. Palliative care (PC) and end-of-life care (EOLC) are closely related areas of concern, yet they have been neglected so far. There is an urgent need to discuss these issues in India due to the changing demographics, socioeconomic and work profiles of the population, people's living conditions and health status, and the contexts of the country's population...
May 10, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28501792/healing-ministry-and-palliative-care-in-christianity
#10
S Stephen Jayard, Nishant A Irudayadason, J Charles Davis
Death is inevitable, but that does not mean it can be planned or imposed. It is an ethical imperative that we attend to the unbearable pain and suffering of patients with incurable and terminal illnesses. This is where palliative care plays a vital role. Palliative care has been growing faster in the world of medicine since its emergence as a specialty in the last decade. Palliative care helps to reduce physical pain while affirming the aspect of human suffering and dying as a normal process. The goal of palliative care is to improve the quality of life both of the patient and the family...
May 3, 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28497868/person-centred-care-dialectics-inquired-in-the-context-of-palliative-care
#11
Joakim Öhlén, Sheryl Reimer-Kirkham, Barbara Astle, Cecilia Håkanson, Joyce Lee, Marjukka Eriksson, Richard Sawatzky
Although a widely used concept in health care, person-centred care remains somewhat ambiguous. In the field of palliative care, person-centred care is considered a historically distinct ideal and yet there continues to be a dearth of conceptual clarity. Person-centred care is also challenged by the pull of standardization that characterizes much of health service delivery. The conceptual ambiguity becomes especially problematic in contemporary pluralistic societies, particularly in the light of continued inequities in healthcare access and disparities in health outcomes...
May 12, 2017: Nursing Philosophy: An International Journal for Healthcare Professionals
https://www.readbyqxmd.com/read/28488922/predicting-prognosis-in-patients-with-advanced-cancer-a-prospective-study
#12
Teresa Tavares, Margarida Oliveira, João Gonçalves, Vera Trocado, Jéssica Perpétuo, Alexandra Azevedo, Firmino Machado, Vasco Barreto, Céu Rocha
BACKGROUND: Prognosis is one of the most challenging questions with which physicians are confronted. Accuracy in the prediction of survival is necessary for clinical, ethical, and organizational reasons. AIM: Evaluate young doctors' clinical prediction of survival and the aids they could get: expert opinion, Palliative Prognostic score, and Palliative Prognostic Index. DESIGN: Prospective, observational study. SETTING/PARTICIPANTS: Advanced cancer patients under observation of an inhospital palliative care team, from April to July 2014...
May 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28479121/ethical-considerations-and-palliative-care-in-patients-with-amyotrophic-lateral-sclerosis-a-review
#13
REVIEW
V Danel-Brunaud, L Touzet, L Chevalier, C Moreau, D Devos, S Vandolaeghe, L Defebvre
Amyotrophic lateral sclerosis (ALS) is not a curable disease, but it is treatable. By definition, much of the care provided to ALS patients is palliative, even though active life-sustaining strategies are available to prolong survival. Healthcare professionals must develop communication skills that help patients cope with the inexorable progression of the disease and the inevitability of death. Symptomatic treatments as well as respiratory insufficiency and nutritional life-sustaining therapies must be regularly evaluated as the disease progresses, without losing sight of the burden placed on the patient's non-professional caregivers...
May 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28473036/ethical-analysis-of-withdrawing-total-artificial-heart-support
#14
Erin S DeMartino, Sara E Wordingham, John M Stulak, Barry A Boilson, Kayla R Fuechtmann, Nausheen Singh, Daniel P Sulmasy, Octavio E Pajaro, Paul S Mueller
OBJECTIVES: To describe the characteristics of patients who undergo withdrawal of total artificial heart support and to explore the ethical aspects of withdrawing this life-sustaining treatment. PATIENTS AND METHODS: We retrospectively reviewed the medical records of all adult recipients of a total artificial heart at Mayo Clinic from the program's inception in 2007 through June 30, 2015. Management of other life-sustaining therapies, approach to end-of-life decision making, engagement of ethics and palliative care consultation, and causes of death were analyzed...
May 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28469440/the-exercise-of-autonomy-by-older-cancer-patients-in-palliative-care-the-biotechnoscientific-and-biopolitical-paradigms-and-the-bioethics-of-protection
#15
REVIEW
Márcio Niemeyer-Guimarães, Fermin Roland Schramm
Toward the end of life, older cancer patients with terminal illness often prefer palliative over life-extending care and also prefer to die at home. However, care planning is not always consistent with patients' preferences. In this article, discussions will be centered on patients' autonomy of exercising control over their bodies within the current biotechnoscientific paradigm and in the context of population aging. More specifically, the biopolitical strategy of medicine in the context of hospital-centered health care control and of the frail condition of cancer patients in the intensive care unit will be considered in terms of the bioethics of protection...
2017: Palliative Care
https://www.readbyqxmd.com/read/28462897/radiation-oncology-resident-palliative-education
#16
Monica Krishnan, Margarita Racsa, Joshua Jones, Eva Chittenden, Kristen G Schaefer, Alex Spektor, Andrea Enzinger, Randy Wei, Tracy Balboni
PURPOSE: Although palliative care is recognized as integral to oncology care, limited data exist regarding the extent to which palliative care training is incorporated into radiation oncology residency training in the United States. We aim to characterize US radiation oncology residents' perceived palliative care educational needs and experience to guide future palliative oncology educational interventions. METHODS AND MATERIALS: An 8-person expert panel developed a survey to assess resident perceptions of generalist palliative care education within radiation oncology residency...
March 14, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28460515/life-sustaining-treatment-and-palliative-care-in-patients-with-liver-cirrhosis-legal-ethical-and-practical-issues
#17
Dong Joon Kim, Moon Seok Choi
With the enactment of the 'Act on Decisions on Life-Sustaining Treatment for Patients in Hospice and Palliative Care or at the End of Life' (Act No. 14013) in Korea, there is growing concern about the practicality of this law. In this review, we discuss definitions, ethics, and practical issues related to this law.
May 2, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28438584/strategies-for-enhancing-family-participation-in-research-in-the-icu-findings-from-a-qualitative-study
#18
Danae Dotolo, Elizabeth L Nielsen, J Randall Curtis, Ruth A Engelberg
CONTEXT: Family members of critically ill patients who participate in research focused on palliative care issues have been found to be systematically different from those who do not. These differences threaten the validity of research and raise ethical questions about worsening disparities in care by failing to represent diverse perspectives. OBJECTIVES: This study's aims were to explore: 1) barriers and facilitators influencing family members' decisions to participate in palliative care research; and 2) potential methods to enhance research participation...
April 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28426520/nursing-practice-research-and-education-in-the-west-the-best-is-yet-to-come
#19
Heather M Young, Susan Bakewell-Sachs, Linda Sarna
PURPOSE: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. BACKGROUND: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing...
May 2017: Nursing Research
https://www.readbyqxmd.com/read/28426307/how-california-prepared-for-implementation-of-physician-assisted-death-a-primer
#20
Laura A Petrillo, Elizabeth Dzeng, Krista L Harrison, Lindsay Forbes, Benjamin Scribner, Barbara A Koenig
Physician-assisted death is now legal in California, and similar laws are being considered in many other states. The California law includes safeguards, yet health care providers will face practical and ethical issues while implementing physician-assisted death that are not addressed by the law. To help providers and health care facilities in California prepare to provide optimal care to patients who inquire about physician-assisted death, we brought together experts from California, Oregon, and Washington...
June 2017: American Journal of Public Health
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