Advance Care Planning


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Cancer diagnosis: The most-difficult conversation

Posted by Palliative Care Physician on November 3, 2012 at 1:05 AM Comments comments (0)


The conversations nobody wants to have shape lives. Delicate and highly personal, they are as different as we are.


They decide questions as weighty as “One more round of chemo that might give me some more time, or live out the rest of my life without the problems it will surely bring?”


At their best, discussions about a cancer diagnosis, prognosis and the end of treatment are gentle, honest and respectful. At their worst, they are abrupt and don’t honor the needs of the individual...

Our Unrealistic Attitude about Death, Through a Doctor's Eyes

Posted by Palliative Care Physician on February 19, 2012 at 12:30 AM Comments comments (0)

I know where this phone call is going. I’m on the hospital wards, and a physician in the emergency room downstairs is talking to me about an elderly patient who needs to be admitted to the hospital. The patient is new to me, but the story is familiar: He has several chronic conditions — heart failure, weak kidneys, anemia, Parkinson’s and mild dementia — all tentatively held in check by a fistful of medications. He has been falling more frequently, and his appetite has fallen off, too. Now a stroke threatens to topple this house of cards...

POLST: A Path to Dignity at the End of Life

Posted by Palliative Care Physician on November 8, 2011 at 9:40 AM Comments comments (0)

Record numbers of people are crossing the threshold into old age, and many are living well into their 80s and 90s. New medical procedures and drugs become available every day, and quality of care and of life in the weeks and months before death is becoming a more common topic in professional and popular literature. Questions abound related to the use of invasive technology to extend life when the burden of treatment is great, and whether it is appropriate to “do something ” just because something can be done...

LA Times, 10/24/11; The promise and pitfalls of palliative care

Posted by Palliative Care Physician on October 25, 2011 at 11:25 AM Comments comments (0)

What if a new medication for severely ill patients had no role in curing them but made them feel much better despite being sick? Let's say this elixir were found to decrease the pain and nausea of cancer patients, improve the sleep and energy of heart failure patients, prolong the lives of people with kidney failure, drive down healthcare expenditures and ease the burdens of caregivers?...