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Joint palliative care and ethics consultations: an increasing trend?

29 July 2013
  • Doctors hands

Is palliative care becoming increasingly recognised as an essential part of treatment decisions at the end of life?

A report in the American Medical News presents the case of a 58-year-old Russian man, admitted to a cancer centre in the United States with advanced oesophageal cancer and reduced oral intake.

What ensued was a conflict between his family and the health care professionals caring for him in deciding whether parenteral nutrition should be commenced.

The family of Russian immigrants refused to allow the care team to let their loved one 'starve to death', recounting their own experiences of food shortages in Russia. Yet the medical professionals explained during a series of meetings that parenteral nutrition would offer slim benefits for the patient for a significant cost.

After the doctors called for an ethics consultation, it was in fact the palliative care team who were able to ease the family’s concerns, giving the patient intravenous glucose while starting comfort care.

Dr Andrew Shuman, a head and neck surgical oncologist and ethics consultant at Memorial Sloan-Kettering Cancer Center in New York, has noticed a growing trend in the effective joint working of ethics consultations and palliative care teams.

Referring to this case study, Dr Shuman said: “The ethics consultants were critical in helping doctors understand why the family was so adamant that the man not be starved to death, and palliative care was essential in allowing for the death to happen as painlessly as possible.”

Dr Shuman is the lead author of a recent study of more than 200 cases at two comprehensive cancer centres in the US where ethics consultations were requested. According to the study, in 41% of those cases, palliative care consultations also were requested.

This US case study and research is just a small example of this type of collaborative work, but is it also becoming trend elsewhere in the world?

Read the full article published on amednews.com which considers palliative care’s role in solving end of life conflicts. 

See more articles in In the media

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