keyword
MENU ▼
Read by QxMD icon Read
search

palliative ethics

keyword
https://www.readbyqxmd.com/read/29649848/-palliative-sedation-despite-guidelines-a-difficult-process-of-decisions
#1
Martin Kamprad, Ute Helm
A distinction needs to be made between intermediate and continuous sedation as well as between minimal, moderate and deep sedation. To gain ethical acceptance it is crucial that for palliative sedation (PS) minimally required doses are administered to decrease suffering. Intermittent PS is used for decreasing physical symptoms, whereas deep continuous PS is used to minimize intolerable suffering or psychological symptoms. Precise medical indication and education of patient and relatives are pre-requirements to any PS...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29623160/geriatric-basics-for-the-neurohospitalist
#2
REVIEW
Josef G Heckmann, Jörg Kraus, Christoph J G Lang
Due to the increasing age of the population, neurohospitalists are more frequently caring for old and very old people. Fundamental definitions and topics related to geriatric medicine are therefore of particular importance. In this review, common issues encountered in geriatric patients hospitalized on the neurology service are discussed. Focus is put on the geriatric assessment, multiprofessional diagnostic and therapeutic procedures, geriatric syndromes, pharmacotherapy of the aged, delirium, pain, and palliative management as they are relevant for the neurohospitalist...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29618364/exploring-attitudes-toward-physician-assisted-death-in-patients-with-life-limiting-illnesses-with-varying-experiences-of-palliative-care-a-pilot-study
#3
Patricia Hizo-Abes, Lauren Siegel, Gil Schreier
BACKGROUND: On February 6th, 2015, the Supreme Court of Canada ruled that competent adults suffering intolerably from a grievous and irremediable medical condition have the right to the assistance of a physician in ending their own lives, an act known as physician-assisted death, and later defined as medical assistance in dying, allowing for provision by a physician or a nurse practitioner. As of June 6th, 2016, this is no longer illegal across Canada. There is strong support amongst the general population for physician-assisted death, however there is no recent data on the attitudes of terminally ill patients...
April 4, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29609787/-ethical-issues-and-limiting-of-cancer-treatments-in-the-advanced-stage
#4
Gisèle Chvetzoff, Géraldine Thevenet
Nurses play a strategic role alongside patients and their families in the process leading to the decision to limit cancer treatments in the advanced phase of the disease. This stage of the patient's care requires support and guidance as part of the palliative approach, which, in addition to the patient and the family, also concerns the oncologist.
April 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29609785/-the-ethical-issues-of-inclusion-in-clinical-trials
#5
Julie Henry
Envisaging the wider ethical issues regarding the inclusion of patients in clinical trials means considering the wider context (regional coverage and patient pathway). It is also necessary to take into account the role of the lead caregivers in maintaining continuity of care for the patients, whether they are included in a clinical trial or given palliative care.
April 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29606699/managing-the-unmanageable-a-two-staged-palliative-resection-to-control-life-threatening-duodenal-bleeding-due-to-recurrent-paraganglioma
#6
Levi Y Smucker, Ashley N Hardy, Peter J O'Neil, Roderich E Schwarz
BACKGROUND This report presents therapeutic decision-making and management of refractory, life-threatening duodenal bleeding in a young man with recurrent metastatic retroperitoneal paraganglioma. CASE REPORT The patient had been symptom free for 8 years after radioactive MIBG (metaiodobenzylguanidine) therapy. Failure of endoscopic or angiographic bleeding control led to urgent need to evaluate possible endocrine functional status, tumor curability, safety of incomplete resection, intra- and postoperative support needs, and anticipated recovery potential and postoperative function...
April 2, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29591838/getting-comfortable-with-comfort-feeding-an-exploration-of-legal-and-ethical-aspects-of-the-australian-speech-language-pathologist-s-role-in-palliative-dysphagia-care
#7
Katherine Kelly, Steven Cumming, Belinda Kenny, Jennifer Smith-Merry, Hans Bogaardt
PURPOSE: With an ageing population, speech-language pathologists (SLPs) can expect to encounter legal and ethical challenges associated with palliative and end-of-life care more frequently. An awareness of the medico-legal and ethical framework for palliative dysphagia management will better equip SLPs to work effectively in this area. METHOD: This narrative review examines a range of legislation, legal, ethical and SLP literature that is currently available to orient SLPs to legal and ethical palliative dysphagia management in the Australian context...
March 28, 2018: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/29573444/assessment-of-palliative-care-needs-of-patients-families-living-with-cancer-in-a-developing-country
#8
Akon Ndiok, Busisiwe Ncama
PURPOSE: The study seeks to assess the care needs of oncology in-patients and clinic attendees or families in two tertiary health institutions. METHODS: This was a descriptive study which utilised a quantitative survey questionnaire of all cancer patients diagnosed between January 2014 and September 2016 (n = 547) with the return rate (n = 455) representing 82%. The questionnaire explored assessment of palliative care need. These instruments were used, because patients with cancer and their families are reluctant to talk about the disease...
March 24, 2018: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29573054/relational-ethics-of-delirium-care-findings-from-a-hospice-ethnography
#9
David Kenneth Wright, Susan Brajtman, Mary Ellen Macdonald
Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end-of-life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end-of-life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients' comfort and dignity were deemed most at stake and therefore commanded nurses' primary attention...
March 24, 2018: Nursing Inquiry
https://www.readbyqxmd.com/read/29570850/physician-characteristics-influence-the-trends-in-resuscitation-decisions-at-different-ages
#10
Thor Willy Ruud Hansen, Olaf Aasland, Annie Janvier, Reidun Førde
AIM: We examined how physicians in different medical specialties would evaluate treatment decisions for vulnerable patients in need of resuscitation. METHODS: A survey depicting six acutely ill patients from newborn infant to aged, all in need of resuscitation with similar prognoses, was distributed (in 2009) to a representative sample of 1650 members of the Norwegian Medical Association and 676 members of the Norwegian Pediatric Association. RESULTS: There were 1335 respondents (57% participation rate)...
March 23, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29550781/development-and-validation-of-a-casemix-classification-to-predict-costs-of-specialist-palliative-care-provision-across-inpatient-hospice-hospital-and-community-settings-in-the-uk-a-study-protocol
#11
Ping Guo, Mendwas Dzingina, Alice M Firth, Joanna M Davies, Abdel Douiri, Suzanne M O'Brien, Cathryn Pinto, Sophie Pask, Irene J Higginson, Kathy Eagar, Fliss E M Murtagh
INTRODUCTION: Provision of palliative care is inequitable with wide variations across conditions and settings in the UK. Lack of a standard way to classify by case complexity is one of the principle obstacles to addressing this. We aim to develop and validate a casemix classification to support the prediction of costs of specialist palliative care provision. METHODS AND ANALYSIS: Phase I: A cohort study to determine the variables and potential classes to be included in a casemix classification...
March 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29534713/palliative-sedation-in-germany-factors-and-treatment-practices-associated-with-different-sedation-rate-estimates-in-palliative-and-hospice-care-services
#12
Stephanie Stiel, Mareike Nurnus, Christoph Ostgathe, Carsten Klein
BACKGROUND: Clinical practice of Palliative Sedation (PS) varies between institutions worldwide and sometimes includes problematic practices. Little available research points at different definitions and frameworks which may contribute to uncertainty of healthcare professionals in the application of PS. This analysis investigates what demographic factors and characteristics of treatment practices differ between institutions with high versus low sedation rates estimates in Palliative and Hospice Care in Germany...
March 13, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29533131/the-hospice-patient-s-right-to-oral-care-making-time-for-the-mouth
#13
Kristi Soileau, Nanette Elster
The hospice philosophy embraces palliative care for the terminally ill, for whom quality of life is the central focus of comfort care management. Often, caregivers hesitate or simply do not elect to extend oral care for patients nearing the end of life, due to difficulties encountered in patient compliance, a sense of futility in doing so, staff time constraints in prioritizing care, underfunding, or a lack of education as to how and why such care should be delivered to the hospice patient. This article aims to show physiological and psychosocial reasons why the hospice patient has a need for properly and regularly implemented oral care and why dental professionals have an ethical responsibility to address the current void that exists in hospice-centered oral care...
January 1, 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29532465/voluntary-stopping-eating-and-drinking
#14
John W Wax, Amy W An, Nicole Kosier, Timothy E Quill
Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt to hasten death in the setting of suffering refractory to optimal palliative interventions or prolonged dying that a person finds intolerable. Individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden. VSED can theoretically be performed independent of clinician assistance and therefore avoids many of the ethical and legal concerns associated with physician-assisted dying or other palliative measures of last resort, However, VSED is an intense process fraught with new sources of somatic and emotional suffering for individuals and their caregivers, so VSED is best supervised by an experienced, well-informed clinician who can provide appropriate pre-intervention assessment, anticipatory guidance, medical treatment of symptoms, and emotional support...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29523198/compassionate-use-programs-in-italy-ethical-guidelines
#15
Ludovica De Panfilis, Roberto Satolli, Massimo Costantini
BACKGROUND: This article proposes a retrospective analysis of a compassionate use (CU), using a case study of request for Avelumab for a patient suffering from Merkel Cell Carcinoma. The study is the result of a discussion within a Provincial Ethics Committee (EC) following the finding of a high number of requests for CU program. The primary objective of the study is to illustrate the specific ethical and clinical profiles that emerge from the compassionate use program (CUP) issue. The secondary goals are: a) to promote a moral reflection among physicians who require approval for the CUP and b) provide the basis for recommendations on how to request CUP...
March 9, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29514481/palliative-care-patients-quality-of-dying-and-circumstances-of-death-comparison-of-informal-caregivers-and-health-care-professionals-estimates
#16
Stephanie Stiel, Maria Heckel, Kim Nikola Wendt, Martin Weber, Christoph Ostgathe
BACKGROUND: Patient-reported outcomes are usually considered to be the gold standard assessment. However, for the assessment of quality of dying and death, ratings of informal caregivers (ICGs) or health-care professionals (HCPs) must be considered for ethical and methodological reasons. This article aims to present results of ICGs' and HCPs' estimates of the questionnaire, quality of dying and death (QoDD) on patients who died in PCUs and to compare the level of agreement of both ratings/raters...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29502379/-the-option-of-critical-patients-with-cancer-for-icu
#17
R Xia, D H Wang
With the improvement of diagnosis and treatment, tumor has become a chronic disease, and an increasing number of older patients will live with tumors. This change has led to an increase in demand for intensive care unit (ICU) and a challenge to the traditional ICU treatment concept. The option of ICU consists of two parts. The first is the option for admission. Since classic predictors of mortality are no longer relevant, we suggest broadening the criteria for ICU admission. Patients during the first course of cancer therapies should be treated with a full-code status similar to that of other patients without malignancy...
February 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29496535/refractory-schizophrenia-attempted-suicide-and-withdrawal-of-life-support-a-clinical-ethics-case-report
#18
Cory Taylor, Jamie C Fertal, Solomon Liao
BACKGROUND: Withdrawal of life-support for an individual with refractory schizophrenia following attempted suicide remains controversial. Discussion regarding prognosis of mental illness and the distinction between somatic and mental illness brings out many ethical issues. This paper will examine the role and weight of severe persistent mental illness in the withdrawal of life support following attempted suicide. CASE DESCRIPTION: A 30-year-old gentleman with deafness and schizophrenia was admitted with multiple self-inflicted visceral stab wounds...
February 26, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29494791/physician-assisted-suicide-and-midwest-social-workers-where-do-they-stand
#19
N Rose Gaston, Jill M Randall, Lisa R Kiesel
Physician-assisted suicide (PAS) is explicitly legal in five states and by court decision in one. Legislative bills have been introduced in other states including Minnesota, Iowa, and Wisconsin. This quantitative study was designed to understand Midwest, hospice and palliative care at end-of-life social workers' attitudes toward PAS, preferred terminology, perception of preparedness for the implementation, and awareness of PAS legislation in their state. Sixty-two social workers from Minnesota, Iowa, and Wisconsin completed an anonymous online survey...
March 1, 2018: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/29490907/parents-refusing-dialysis-for-a-3-month-old-with-renal-failure
#20
Laurel Willig, Erin Paquette, D Micah Hester, Bradley A Warady, John D Lantos
A 3-month-old boy with failure to thrive was referred to a nephrology clinic after a diagnostic workup for failure to thrive revealed a serum urea nitrogen level of 95 mg/dL and creatinine level of 3.6 mg/dL. A renal ultrasound revealed marked bilateral hydronephrosis with little remaining renal cortex in either kidney. A voiding cystourethrogram revealed evidence of posterior urethral valves. The child had no evident comorbidities. Fulguration of the valves was successfully performed but did not lead to improvement in kidney function...
February 28, 2018: Pediatrics
keyword
keyword
31088
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"