Residents' perceptions about surrogate decision makers' financial conflicts of interest in ventilator withdrawal.

Abstract:

PURPOSE:There have been no studies to date that examine physicians' decisions to withdraw life-sustaining treatment for patients based on their surrogates' financial gain. The authors' objective was to ascertain physician attitudes about withdrawing life-sustaining treatment when financial considerations are involved. METHODS:A survey was developed and pretested containing eight scenarios in which a terminally ill patient's spouse had a decision to make regarding withdrawal of the ventilator, which was deemed medically futile. Nested variables included agreement or disagreement between the spouse and patient, decision to withdraw or continue the ventilator, and financial gain or no financial gain for the spouse. The authors surveyed all internal medicine residents at the University of California, San Diego in the autumn of 2011 and winter of 2012. The responses on each of the three variables for which respondents were likely to withdraw the ventilator were analyzed via student's t-tests. RESULTS:Residents were more likely to withdraw the ventilator when requested to do so than when it was requested to be continued. They were also more likely to withdraw the ventilator when there was agreement in the decision between the spouse and the patient. Residents were more likely to withdraw the ventilator when the spouse would not benefit financially. CONCLUSIONS:Internal medicine residents make some decisions about whether to withdraw life-sustaining treatment based on financial considerations. There needs to be ongoing communication with residents about end-of-life decisions where conflicts may exist between the surrogate decision makers and patients or physicians.

journal_name

J Palliat Med

authors

Wastila LJ,Farber NJ

doi

10.1089/jpm.2013.0361

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

533-9

issue

5

eissn

1096-6218

issn

1557-7740

journal_volume

17

pub_type

杂志文章
  • Religious coping is associated with the quality of life of patients with advanced cancer.

    abstract:BACKGROUND:For patients confronting a life-threatening illness such as advanced cancer, religious coping can be an important factor influencing their quality of life (QOL). OBJECTIVE:The study's main purpose was to examine the association between religious coping and QOL among 170 patients with advanced cancer. Both p...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2006.9.646

    authors: Tarakeshwar N,Vanderwerker LC,Paulk E,Pearce MJ,Kasl SV,Prigerson HG

    更新日期:2006-06-01 00:00:00

  • Statewide efforts in promoting palliative care.

    abstract:BACKGROUND:In 2002, Means to a Better End: A Report of Dying in America Today, a Robert Wood Johnson Foundation (RWJF) report, was issued that included grades for each state on their ability to provide end-of-life care. Most states, including California, rated as mediocre and the report called for extensive efforts at ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2007.0291

    authors: Virani R,Malloy P,Ferrell BR,Kelly K

    更新日期:2008-09-01 00:00:00

  • Parental bereavement needs in the pediatric intensive care unit: review of available measures.

    abstract:BACKGROUND:Pediatric intensive care units (PICUs) are highly technological settings in which advanced care is used to restore health to critically ill children; however, they are also places where children die. Understanding the needs of parents bereaved in this setting is essential for better family care. OBJECTIVE:T...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2010.0453

    authors: Meert KL,Schim SM,Briller SH

    更新日期:2011-08-01 00:00:00

  • Exploring Factors Contributing to Medication Errors with Opioids in Australian Specialist Palliative Care Inpatient Services: A Multi-Incident Analysis.

    abstract:BACKGROUND:Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medicatio...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0578

    authors: Heneka N,Shaw T,Rowett D,Lapkin S,Phillips JL

    更新日期:2018-06-01 00:00:00

  • Men as caregivers at the end of life.

    abstract:BACKGROUND:Few studies have focused on men as caregivers at the end-of-life. The objective of this secondary data analysis was to examine the experiences of men involved in end-of-life caregiving, focusing on caregiver strain. METHODS:We used a random sample of Oregon death certificates to telephone survey family care...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2005.8.1167

    authors: Fromme EK,Drach LL,Tolle SW,Ebert P,Miller P,Perrin N,Tilden VP

    更新日期:2005-12-01 00:00:00

  • The Effect of 5 Minutes of Mindful Breathing to the Perception of Distress and Physiological Responses in Palliative Care Cancer Patients: A Randomized Controlled Study.

    abstract:BACKGROUND:Palliative cancer patients suffer from high levels of distress. There are physiological changes in relation to the level of perceived distress. OBJECTIVE:To study the efficacy of 5 minutes of mindful breathing (MB) for rapid reduction of distress in a palliative setting. Its effect to the physiological chan...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1089/jpm.2016.0046

    authors: Ng CG,Lai KT,Tan SB,Sulaiman AH,Zainal NZ

    更新日期:2016-09-01 00:00:00

  • A Nationwide Study of Young Adults' Perspectives on Participation in Bereavement Research.

    abstract:: Background: Young adults represent a minority in research; they are often considered too young or too old for participation. There is sparse information, especially in bereavement research, regarding how this age group perceives research participation and what they conside...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2018.0630

    authors: Udo C,Lövgren M,Sveen J,Bylund-Grenklo T,Alvariza A,Kreicbergs U

    更新日期:2019-10-01 00:00:00

  • Evaluation of an educational intervention to encourage advance directive discussions between medicine residents and patients.

    abstract:INTRODUCTION:Most medical schools are remiss in preparing physicians in end-of-life communication skills. As a result, many residents are uncomfortable with approaching the patient, have not developed the skills required to discuss the patients' wishes, and avoid end-of-life conversations. OBJECTIVE:To evaluate an edu...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2006.9.964

    authors: Furman CD,Head B,Lazor B,Casper B,Ritchie CS

    更新日期:2006-08-01 00:00:00

  • 30-day readmissions among seriously ill older adults.

    abstract:BACKGROUND:Inpatient palliative consultation are generally provided to seriously ill hospitalized patients with the intent to alleviate pain and suffering and develop a plan of care for the patient. Although numerous benefits of this service have been documented, little is known about hospital readmission rates and fac...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2012.0259

    authors: Enguidanos S,Vesper E,Lorenz K

    更新日期:2012-12-01 00:00:00

  • Role of acupressure in symptom management in patients with end-stage renal disease: a systematic review.

    abstract:BACKGROUND:Acupressure is a widely used adjunct for various symptoms in patients with nonchronic kidney disease. However, its role for symptom management in end-stage renal disease (ESRD) populations is not clear. OBJECTIVE:To summarize and critically evaluate the evidence available from randomized clinical trials (RC...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2009.0363

    authors: Kim KH,Lee MS,Kang KW,Choi SM

    更新日期:2010-07-01 00:00:00

  • Current approaches to diagnosing and managing constipation in advanced cancer and palliative care.

    abstract::Constipation is common in advanced cancer. Despite this, clinicians' understanding of the underlying changes affecting the colon and the rest of the gastrointestinal tract are limited. Two case histories are used to illustrate the problems encountered when the current approaches to diagnosing and managing altered bowe...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2009.0274

    authors: Clark K,Urban K,Currow DC

    更新日期:2010-04-01 00:00:00

  • Post-Traumatic Stress Disorder Symptoms from Multiple Stressors Predict Chronic Pain in Cancer Survivors.

    abstract:: Background: Despite the association between chronic pain and post-traumatic stress disorder (PTSD), little is known about the longitudinal course of pain and PTSD during cancer treatment. Objectives: We examined the prevalence ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0458

    authors: Sager ZS,Wachen JS,Naik AD,Moye J

    更新日期:2020-09-01 00:00:00

  • Diagnostic classifications and resource utilization of decedents served by the Department of Veterans Affairs.

    abstract:BACKGROUND:Given the volume and cost of inpatient care during the last year of life, there is a critical need to identify patterns of dying as a means of planning end-of-life care services, especially for the growing number of older persons who receive services from the Veterans Health Administration (VHA). METHODS:A ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2006.0256

    authors: Duffy SA,Copeland LA,Hopp FP,Zalenski RJ

    更新日期:2007-10-01 00:00:00

  • Methadone as the Initial Long-Acting Opioid in Children with Advanced Cancer.

    abstract:BACKGROUND:Methadone is an attractive medication for treating children with advanced cancer with pain as it is the only long-acting opioid available as a liquid. However, it is not frequently used due to concerns about potential toxicities and side effects. OBJECTIVE:Evaluate the efficacy and safety of methadone as th...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0712

    authors: Madden K,Mills S,Dibaj S,Williams JL,Liu D,Bruera E

    更新日期:2018-09-01 00:00:00

  • Exploring Opportunities for Primary Outpatient Palliative Care for Adults with Cystic Fibrosis: A Mixed-Methods Study of Patients' Needs.

    abstract:BACKGROUND:Persons with cystic fibrosis (CF) experience high morbidity and mortality, yet little is known about their palliative care needs and how clinicians may address these needs. OBJECTIVES:(1) To identify palliative care and advance care planning needs of patients with CF and their families; and (2) to identify ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2017.0259

    authors: Hobler MR,Engelberg RA,Curtis JR,Ramos KJ,Zander MI,Howard SS,Goss CH,Aitken ML

    更新日期:2018-04-01 00:00:00

  • Research methods priorities in geriatric palliative medicine.

    abstract::Continuing the momentum of geriatric palliative medicine research achieved during the past decade requires a focus on research methods priorities that span the continuum of research from small pilot studies testing new interventions to large multisite studies evaluating implementation of proven interventions and model...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2013.9492

    authors: Aldridge Carlson MD

    更新日期:2013-08-01 00:00:00

  • Racial, cultural, and ethnic factors influencing end-of-life care.

    abstract::Past efforts in the palliative and end-of-life care field have been laudably directed at increasing the cultural competence of providers and institutions and improving outreach to multicultural communities. Today, however, we face new challenges with regard to racial, cultural, and ethnic factors at the end of life. W...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2005.8.s-58

    authors: Crawley LM

    更新日期:2005-01-01 00:00:00

  • Family Caregiver Perspectives on End-of-Life Dreams and Visions during Bereavement: A Mixed Methods Approach.

    abstract:: Background: End-of-life dreams and visions (ELDVs) are prevalent experiences that provide comfort and meaning to dying individuals. Limited research has examined the impact of ELDVs on the bereaved. Objective: This study aimed ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2019.0093

    authors: Grant PC,Depner RM,Levy K,LaFever SM,Tenzek KE,Wright ST,Kerr CW

    更新日期:2020-01-01 00:00:00

  • Evidence-based approach to management of fever in patients with end-stage dementia.

    abstract::Alzheimer's dementia and related dementias are incurable illnesses for which curative treatment currently does not exist, and the efficacy of remittive treatment is extremely limited. Persons with advanced dementia commonly develop fever and are at high risk for death. We preformed a systematic review of outcome follo...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/109662103322144664

    authors: Pinderhughes ST,Morrison RS

    更新日期:2003-06-01 00:00:00

  • Advance care planning: challenges and approaches for pediatricians.

    abstract:BACKGROUND:There is increasing recognition of the value of advance care planning for children with life-limiting conditions. It is important that we acknowledge and reflect on the challenges that this work presents in order to optimize practice. OBJECTIVE:Our aim was to review advance care planning for children with l...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2013.0374

    authors: Heckford E,Beringer AJ

    更新日期:2014-09-01 00:00:00

  • Physician- and nurse-reported effects of intravenous hydration therapy on symptoms of terminally ill patients with cancer.

    abstract:PURPOSE:To clarify physician- and nurse-reported effects of intravenous hydration therapy on symptoms of terminally ill patients with cancer. METHODS:A cross-sectional questionnaire survey of Japanese physicians and nurses. The respondents were requested to report their clinical observations about improvement or deter...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2004.7.683

    authors: Morita T,Shima Y,Miyashita M,Kimura R,Adachi I,Japan Palliative Oncology Study Group.

    更新日期:2004-10-01 00:00:00

  • Factors associated with falls in patients with cancer hospitalized for palliative care.

    abstract:INTRODUCTION:In geriatrics, most risk factors associated with falls have been identified and management strategies developed accordingly. This is not the case in palliative care. The incidence rate of falls, the consequences related to falls, and other related factors were determined in elderly cancer patients hospital...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2007.0241

    authors: Pautex S,Herrmann FR,Zulian GB

    更新日期:2008-07-01 00:00:00

  • Bedside ultrasound-guided celiac plexus neurolysis with bilateral paramedian needle entry technique can be an effective pain control technique in advanced upper abdominal cancer pain.

    abstract::The celiac plexus block is an approved method for the relief of upper abdominal cancer pain. Classically, fluoroscopy-guided posterior approach to the celiac plexus block has been used. Computed tomography-guided anterior approach and endoscopic ultrasound-guided approach have also been utilized. An ultrasound-guided ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2008.0082

    authors: Bhatnagar S,Gupta D,Mishra S,Thulkar S,Chauhan H

    更新日期:2008-11-01 00:00:00

  • Taking Psychedelics Seriously.

    abstract:BACKGROUND:Psychiatric research in the 1950s and 1960s showed potential for psychedelic medications to markedly alleviate depression and suffering associated with terminal illness. More recent published studies have demonstrated the safety and efficacy of psilocybin, MDMA, and ketamine when administered in a medically ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,评审

    doi:10.1089/jpm.2017.0684

    authors: Byock I

    更新日期:2018-04-01 00:00:00

  • Being aware of the prognosis: how does it relate to palliative care patients' anxiety and communication difficulty with family members in the Hong Kong Chinese context?

    abstract::Chinese family members play an important role in end-of-life decision making. Culturally, they may believe that a patient's awareness of a poor prognosis could harm his or her well-being, and thus they may avoid telling the truth to the patient. To examine this cultural belief empirically, this study aimed to explore ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2011.0099

    authors: Chan WC

    更新日期:2011-09-01 00:00:00

  • Reduction in symptoms for homebound patients receiving home-based primary and palliative care.

    abstract:BACKGROUND:Increasing numbers of patients are living with multiple, chronic medical conditions and functional impairments that leave them homebound. Home-based primary and palliative care (HBPC) programs provide access to health care services for this vulnerable population. Homebound patients have high symptom burden u...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2012.0546

    authors: Ornstein K,Wajnberg A,Kaye-Kauderer H,Winkel G,DeCherrie L,Zhang M,Soriano T

    更新日期:2013-09-01 00:00:00

  • Improving access to palliative care through an innovative quality improvement initiative: an opportunity for pay-for-performance.

    abstract:BACKGROUND:Improving access to palliative care is an important priority for hospitals as they strive to provide the best care and quality of life for their patients. Even in hospitals with longstanding palliative care programs, only a small proportion of patients with life-threatening illnesses receive palliative care ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1089/jpm.2011.0301

    authors: Bernacki RE,Ko DN,Higgins P,Whitlock SN,Cullinan A,Wilson R,Jackson V,Dahlin C,Abrahm J,Mort E,Scheer KN,Block S,Billings JA

    更新日期:2012-02-01 00:00:00

  • Evaluation of spiritual needs of patients with advanced cancer in a palliative care unit.

    abstract:INTRODUCTION:Spiritual needs play an important role in palliative care as both a clinical dimension and a therapeutic strategy. However, recent studies have shown that the management of this dimension still remains a challenge at the clinical level of palliative care. GOALS:Our goal was to evaluate the spiritual needs...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2013.0569

    authors: Vilalta A,Valls J,Porta J,Viñas J

    更新日期:2014-05-01 00:00:00

  • Work Experiences of Patients Receiving Palliative Care at a Comprehensive Cancer Center: Exploratory Analysis.

    abstract:BACKGROUND:Employment-related issues have been largely overlooked in cancer patients needing palliative care. These issues may become more relevant as cancer evolves into more of a chronic illness and palliative care is provided independent of stage or prognosis. OBJECTIVE:To characterize the employment situations of ...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2016.0478

    authors: Glare PA,Nikolova T,Alickaj A,Patil S,Blinder V

    更新日期:2017-07-01 00:00:00

  • Association between Receipt of Emotional Support and Caregivers' Overall Hospice Rating.

    abstract:: Background: A major goal of hospice care is to provide individually tailored emotional and spiritual support to caregivers of hospice patients. Objectives: Examine the association between reported emotional support and caregive...

    journal_title:Journal of palliative medicine

    pub_type: 杂志文章

    doi:10.1089/jpm.2020.0324

    authors: Parast L,Elliott MN,Haas A,Teno J,Bradley M,Weech-Maldonado R,Anhang Price R

    更新日期:2020-10-06 00:00:00