Tag Archives: end-of-life

Caprio (CHS- 2012)Anthony J. Caprio, MD, CMD serves as the medical director and an Associate Professor for the Division of Aging, in the Department of Family Medicine for the Carolinas Healthcare System, Charlotte, North Carolina

 

The Institute of Medicine (IOM), a non-profit institution which provides objective analysis and recommendations to address problems related to medical care in the United States, issued the 2014 report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The IOM report proposed changes to U.S. policy and payment systems to increase access to palliative care services, improve quality of care, and improve patient and family satisfaction with care at the end of life.

The release of the IOM report was regarded by many U.S. healthcare professionals as a significant step forward in identifying gaps in the delivery of care for seriously ill and terminally ill patients. Specific recommendations were outlined as a “call to action” to improve end-of-life care. Hospice and palliative care physicians, in particular, rallied behind the report. ...continue reading

Dees_MMarianne Dees is a family physician and academic researcher at Radboud University Medical Centre in the Netherlands

 

Let's take a look at appropriate end of life care.

The case of Mr. Jones

Mr. Jones, aged 88, was referred to the hospital for the fourth time that year with dyspnoea. He was diagnosed with pneumonia. His medical history mentioned myocardial infarction, chronic heart failure, and a pacemaker. Two years earlier he had made a written will with a non-resuscitation and non-intensive care statement. The next day he became progressively dyspnoeic and developed kidney failure. He was transferred to the ICU ...continue reading

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shannon-loughs-profileShannon Lough is a news journalist for the CMAJ

I found out my grandpa had a stroke on Thursday night. He was doing work in the backyard where he collapsed; my nanny found him 40 minutes later and called an ambulance. Too much time had passed. This was his second stroke, the first occurred 10 years ago just moments before he was due to depart on a cruise ship to Alaska. Emergency crews attended to him right away and his recovery was almost seamless.

This time it was different. My family told me to stay put in Ottawa for the night, but in the morning my brother called and told me I should come right away. It took about four and a half hours to reach the hospital in Mississauga where my grandpa, who I affectionately named Pa as a toddler, lay with tubes and patches attached to his body. When my mum told Pa that I had arrived, he opened his steel blue eyes for a moment with a look mixed with confusion and – I hoped – even acknowledgement. Then his eyes shut, and I never saw them again.

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Kirsten Patrick is Deputy Editor at CMAJ

 

Today is a momentous day for physicians in Canada. No matter what your opinion about whether or not physician assisted dying is morally right, it will be a human right henceforth under certain circumstances.

We have aired a broad spectrum of views on this forum in the lead up to the Supreme Court of Canada’s unanimous decision on Carter vs. the Attorney General, released this morning. Even CMAJ’s editors are divided in their personal opinions. We have discussed our personal views in many an editorial meeting, and CMAJ’s Editor-In-Chief, John Fletcher, put me on the spot to declare my position publicly when we were recording the podcast for the November 18th issue of the journal.

Many Canadian physicians will feel unhappy about the decision, perhaps even angry ...continue reading

The December 9th issue summary podcast is presented by Dr. John Fletcher, editor-in-chief, and Dr. Diane Kelsall, deputy editor.

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Dr. John Fletcher, editor-in-chief, CMAJ

Dr. Diane Kelsall, deputy editor, CMAJ

 

 

 

 

 

 

Dr. Fletcher and Dr. Kelsall discuss the following topics:

  • What matters to patients and their families in end-of-life discussions
  • Ibuprofen versus morphine for post-fracture pain in children
  • How to engage in deprescribing meds
  • Adverse health effects of solitary confinement
  • Importance of head-tilt chin-lift in CPR
  • Pap smears
  • Diagnosis in progressive headache
  • Holiday Reading highlights

And more....

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