Israeli Medical Association – New Position Paper on Medical Futility

The Israeli Medical Association recently issued a new position paper titled "Medical Ethics and the Treatment of Patients with Incurable Diseases and Useless Treatments." (Note that this is my translation.) The ethics committee decided on nine guiding principles:The physician and the patient in an incurable disease will discuss the patient's aspirations and expectations from the treatment, against realistic medical capabilities and set the treatment goals. The physician will consider and decide on the most appropriate clarification and treatment for the patient, according to up-to-date guidelines in medical expertise, professional knowledge and experience as a physician. Will consider benefits against unwanted side effects. Continuing ineffective and futile treatment can harm the patient and even shorten his life. The physician will involve the patient and the significant lenders in the patient's eyes with the medical data, as soon as possible, to enable understanding, adaptation to the situation and correct patient decision-making. The physician will avoid concealing or beautifying the condition and the absence of curative treatment in order to preserve the patient's autonomy. The physician will be aware of his or her own personal values, and ascertain what the patient's values ​​are. Any action or failure to be aware of these considerations when making decisions about patients with ill-incurable diseases. The physician will identify in his work environmen...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs

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CONCLUSIONS: The various options of treatment should have different indications: primary anastomosis in stable patients, Hartmann in critical cases, SEMS for palliative intent and stoma when neo-adjuvant therapy is needed. PMID: 32456396 [PubMed - as supplied by publisher]
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research
Abstract Often Only a Side Event, but Sometimes Groundbreaking - an Ectopic ACTH Secretion as an Example of a Paraneoplastic Syndrome Abstract. Various tumors can cause a paraneoplastic ACTH production, particularly small-cell lung cancers. Patients suffer from a secondary Cushing syndrome with hypokalemia, hypertension, hyperglycemia and edema. There are three therapeutic approaches: treatment of the underlying disease, hormonal inhibition and symptomatic treatment. The prognosis of an ACTH-producing lung cancer is poor due to numerous complications. In the presented case study, the patient refused treatment of t...
Source: Praxis - Category: General Medicine Authors: Tags: Praxis (Bern 1994) Source Type: research
Conclusion This study provided the organization with vital information about their initiative to expand end-of-life resources. Utilization and timing of palliative consults and floating hospice referrals were lower and later than expected, highlighting the importance of developing purposeful strategies beyond education to address ICU cultural and structural barriers.
Source: Dimensions of Critical Care Nursing - Category: Nursing Tags: Leadership DIMENSION Source Type: research
The COVID-19 surge in New York City created an increased demand for palliative care (PC) services. In staff-limited settings such as safety net systems, and amid growing reports of healthcare worker illness, leveraging help from less-affected areas around the country may provide an untapped source of support. A national social media outreach effort recruited 413 telepalliative medicine volunteers (TPMV). After expedited credentialing and onboarding of 67 TPMV, a 2-week pilot was initiated in partnership with five public health hospitals without any previous existing telehealth structure.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Tags: COVID-19 for Fast Track Publication Source Type: research
IJERPH, Vol. 17, Pages 3853: A Methodological Review of Mixed Methods Research in Palliative and End-of-Life Care (2014–2019) International Journal of Environmental Research and Public Health doi: 10.3390/ijerph17113853 Authors: Sergi Fàbregues Quan Nha Hong Elsa Lucia Escalante-Barrios Timothy C. Guetterman Julio Meneses Michael D. Fetters Mixed methods research has been increasingly recognized as a useful approach for describing and explaining complex issues in palliative care and end-of-life research. However, little is known about the use of this methodology in the field and the ways in w...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
This study reviewed the timing of palliative care involvement for patients in a tertiary referral oncology hospital, and whether the use of a trigger tool prior to admission would hav e facilitated earlier referral.MethodsThis was a retrospective cohort study of cancer patients who died during an unplanned admission between November 2014 and October 2015. A literature review identified seven palliative care referral tools which were included in this analysis, and compared by identifying common themes. Each tool was applied to patients by reviewing electronic patient records. Timing of palliative referral and whether patien...
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
This study aims to investigate the impact of possible predictors of quality of life (QoL) in a group of Italian caregivers assisting a cancer patient in home palliative care.MethodsData from 570 adult informal caregivers and their cancer-affected relatives were collected. A multivariate regression analysis was conducted to assess the effect of three groups of variables on Caregivers Quality of Life Index-Cancer (CQOLC) scale: (a) socio-demographic characteristics of caregivers; (b) psychological characteristics of caregivers assessed by Profile Mood of States (POMS), Caregiver Burden Inventory (CBI), and Preparedness for C...
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
Conclusion: Congenital heart disease in the State of Jalisco is an important cause of mortality, with a high incidence and a very limited resolution capacity since the health services in the State of Jalisco for the care of these patients are insufficient and inadequate. It is essential to strengthen the health system for the care for these patients. PMID: 32459213 [PubMed - as supplied by publisher]
Source: Archivos de Cardiologia de Mexico - Category: Cardiology Authors: Tags: Arch Cardiol Mex Source Type: research
Conclusions: These results are of utmost importance as they highlight the need to increase physicians' awareness of BTcP and its management and the need to improve communication with patients and their caregivers. Our findings also indicate the need for future research on the possible misuse of opioids in BTcP patients and its causes. PMID: 32453602 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
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