decision making

… higher costs in LA for the seriously ill related to 35% more hospital beds as well as more traditional hospice delivery model. Quality measures favored San Diego. Related editorial describes this medical torture. Related editorial in today’s NEJM.

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… Fineberg etal present an empirically derived model of family conferences. Core aspects include conference organization, negotiation, personal stance and emotional work … all working toward meaningful connections with those involved. “Emotion work during the family conference appears to function as a crucial gatekeeper to achieving the desired outcome for the meeting.” Fineberg etal. Communication with Families […]

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… MacAuley’s excellent essay on “Patients who make ‘wrong’ choices” … ”Ironically, for all of palliative care’s talk of total suffering, we may be unwilling to accept that a patient’s emotional suffering over choosing a palliative course of treatment may be more severe than eventual projected physical suffering from an aggressive course … In the […]

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… Loprinzi and colleagues review a series of articles from the Journal of Clinical Oncology which addresses how to have difficult conversations (giving bad news, making life decisions). A recurrent theme highlights the importance of the physician working through his/her own needs and issues … eg “The article presents data from behavioral research that documents […]

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… a study of the different factors that patients with ALS consider in deciding on assisted ventilation. “(1) the meaning of the intervention— participants made a sharp distinction between non-invasive ventilation, which they viewed as a means to relieve symptoms of respiratory failure, and invasive ventilation, which they viewed as taking over their breathing and […]

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