Ethical considerations and palliative care in patients with amyotrophic lateral sclerosis: A review.

Ethical considerations and palliative care in patients with amyotrophic lateral sclerosis: A review. Rev Neurol (Paris). 2017 May 04;: Authors: Danel-Brunaud V, Touzet L, Chevalier L, Moreau C, Devos D, Vandolaeghe S, Defebvre L Abstract 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. The decision-making process regarding tracheostomy with invasive ventilation (TIV) is of greater complexity. Providing full information is crucial. Several long interviews are necessary to explain, discuss and allow assimilation of the information. Also, physicians should be careful not to focus exclusively on the biomedical aspects of disease, as ALS patients generally welcome the opportunity to discuss end-of-life issues with their physicians. Psychological factors, education level and cognitive status (especially the level of executive dysfunction) have a major influ...
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research