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Ideology and Palliative Care: Moral Hazards at the Bedside

Published online by Cambridge University Press:  07 December 2017

ROSAMOND RHODES  and
JAMES J. STRAIN
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Abstract:

Palliative care has had a long-standing commitment to teaching medical students and other medical professionals about pain management, communication, supporting patients in their decisions, and providing compassionate end-of-life care. Palliative care programs also have a critical role in helping patients understand medical conditions, and in supporting them in dealing with pain, fear of dying, and the experiences of the terminal phase of their lives. We applaud their efforts to provide that critical training and fully support their continued important work in meeting the needs of patients and families. Although we appreciate the contributions of palliative care services, we have noted a problem involving some palliative care professionals’ attitudes, methods of decisionmaking, and use of language. In this article we explain these problems by discussing two cases that we encountered.

Keywords

palliative carenonjudgmental regardbest interest standardmedically inappropriateliberateideology
Type
Special Section: Open Forum
Information
Cambridge Quarterly of Healthcare Ethics , Volume 27 , Issue 1 , January 2018 , pp. 137 - 144
Copyright
Copyright © Cambridge University Press 2017 

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References

Notes

1. Gert, B, Culver, C, Clouser, KD. Bioethics: A Return to Fundamentals. New York: Oxford University Press; 1997.Google Scholar

2. Kopelman, LM. A new analysis of the best interests standard and its crucial role in pediatric practice. The Journal of Law, Medicine & Ethics 2007;35(1):187–96.CrossRefGoogle Scholar

3. Kopelman, LM. Using the best interests standard to generate actual duties. American Journal of Bioethics Primary Research 2013;4(2):11–14, at 11.Google Scholar

4. Annas, GE. Legal issues in medicine: Asking the courts to set the standard of emergency care—The case of Baby K. The New England Journal of Medicine 1994;330:1542–5.CrossRefGoogle Scholar

5. Cantor NL. Can healthcare providers obtain judicial intervention against surrogates who demand “medically inappropriate” life support for incompetent patients? Critical Care Medicine 1996;24(5):883–7.

6. Cheney JR. Houston Methodist Bioethics Committee, Houston, TX. Letter to: Ms. Evelyn Kelly and Mr. David Dunn, 2015; available at http://www.thaddeuspope.com/images/Dunn_v_Methodist_001.pdf (last accessed 20 Jan 2016).

7. Johnson DH. Helga Wanglie revisited: Medical futility and the limits of autonomy. Cambridge Quarterly of Healthcare Ethics 1993;2(2):161–70.

8. Levine EM. A new predicament for physicians: The concept of medical futility, the physician’s obligation to render inappropriate treatment, and the interplay of the medical standard of care. Journal of Law and Health 1994;9(1):69–108.

9. Truog, RD, Brett, AS, Frader, J. The problem with futility. The New England Journal of Medicine. 1992;326(23):1560–4.CrossRefGoogle ScholarPubMed

10. Hall, JB, Wood, LDH. Liberation of the patient from mechanical ventilation. JAMA 1987;257(12):1621–8.CrossRefGoogle ScholarPubMed

11. Manthous, CA, Schmidt, GA, Hall, JB. Liberation from mechanical ventilation: A decade of progress. CHEST Journal 1998;114(3):886–901.CrossRefGoogle ScholarPubMed

12. Nelson JE, Tandon N, Mercado AF, Camhi SL, Ely W, Morrison RS. Brain dysfunction: Another burden for the chronically critically ill. Archives of Internal Medicine 2006;166(18):1993–9.

13. Nelson JE, Mercado AF, Camhi SL, Tandon N, Wallenstein S, August GI, et al. Communication about chronic critical illness. Archives of Internal Medicine 2007;67(22):2509–15.

14. Vincent J, ed. Intensive Care Medicine: Annual Update. Brussels: Springer; 2007.

15. Carson SS, Garrett J, Hanson LC, Lanier J, Govert J, Brake MC, et al. A prognostic model for 1-year mortality in patients requiring prolonged mechanical ventilation. Critical Care Medicine 2008; 36(7):2061–9.

16. Unroe M, Kahn JM, Carson SC, Govert JA, Martinu T, Sathy SJ, et al. One year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation. Annals of Internal Medicine 2010;153:167–75.

17. Hess DR, MacIntyre NR, Mishoe SC, Galvin WF, Adams AB. Respiratory Care: Principles and Practice, 2nd ed. Sudbury, MA: Jones and Bartlett Learning; 2012.

18. Nelson, JE, Cox, CE, Hope, AA, Carson, SS. Chronic critical illness. American Journal of Respiratory and Critical Care Medicine 2010;182(4):446–54.CrossRefGoogle ScholarPubMed