Are Physicians Ethically Obligated to Address Hospice as an Alternative to “Usual” Treatment of Advancing End-Stage Disease?

Authors

  • Frederick A Smith Long Island Jewish Medical Center (LIJMC), Lake Success, NY North Shore University Hospital (NSUH), Manhasset, NY

DOI:

https://doi.org/10.5915/43-3-9209

Keywords:

Palliative Care, Hospice, End-Stage Disease, Informed Consent

Abstract

DOI: http://dx.doi.org/10.5915/43-3-9209

Video

Hospice care is ideally suited to meet the psychosocial and spiritual needs of dying patients, providing the opportunity to settle financial, property and inheritance issues; to mend lacerations in important lifetime relationships, including forgiving and asking forgiveness; and to assure a degree of autonomous control over the environment and the social and spiritual processes that attend one’s death. Physicians are not only imprecise in prognosticating a patient’s time till death; they tend to be over-optimistic in their predictions. A “NO” answer to the question, “Would I be surprised if this patient died in the next year?” is a reasonable starting-point for discussing Hospice care as a potential treatment plan, now or in the futureFor patients who are failing, with declining prospects for 1-year survival, physicians have a duty to present palliative care in Hospice as an alternative to the recurrent hospital interventions that are typical in the last 6 to 12 months of life.

Author Biography

Frederick A Smith, Long Island Jewish Medical Center (LIJMC), Lake Success, NY North Shore University Hospital (NSUH), Manhasset, NY

MD, FACP

North Shore University Hospital (NSUH), Manhasset, NY

Long Island Jewish Medical Center (LIJMC), Lake Success, NY

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Published

2011-09-20

Issue

Section

Conference Proceedings