Mark Pfeifer, MD and Barbara A. Head, PhD, CHPN, ACSW
Interdisciplinary support, securing reliable information from a patient’s health record, and taking a “who, what, when, where, and how” approach to conversation can improve care planning with dying patients and their loved ones.
AMA J Ethics. 2018;20(8):E724-731. doi:
Barriers to effective prognosis conversations include knowledge deficits, misconceptions, cultural differences, and lack of motivation. These can be addressed head-on by good communication interventions.
AMA J Ethics. 2018;20(8):E757-765. doi:
Clinical momentum—increasingly aggressive treatment in intensive care settings that can violate a patient’s wishes—is charged by ritually intensifying efforts to “save” a patient, reimbursement patterns that privilege acute interventions, and technology-driven health care.
AMA J Ethics. 2018;20(8):E732-737. doi:
Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.
AMA J Ethics. 2018;20(8):E699-707. doi:
Peter T. Hetzler III and Lydia S. Dugdale, MD, MAR
Countering overmedicalization of death requires acknowledging that dying patients are living patients. It also requires persistent focus on health and wholeness, especially at the end of life, and a solid interdisciplinary approach to supporting dying patients.
AMA J Ethics. 2018;20(8):E766-773. doi: