Journal of pain and symptom management
-
J Pain Symptom Manage · Aug 2018
Exploring Canadian Physicians' Experiences Providing Medical Assistance in Dying: A Qualitative Study.
Medical assistance in dying (MAiD) allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physicians' attitudes toward MAiD or describe patient characteristics, there are few studies that explore the professional challenges faced by physicians who provide MAiD. ⋯ Physicians described relationship, financial, and workload challenges to providing MAiD. We provide several recommendations to address these challenges and help ensure the sustainability of MAiD in countries that provide this service.
-
J Pain Symptom Manage · Aug 2018
"Suffering" in Palliative Sedation: Conceptual Analysis and Implications for Decision Making in Clinical Practice.
Palliative sedation is an increasingly used and, simultaneously, challenging practice at the end of life. Many controversies associated with this therapy are rooted in implicit differences regarding the understanding of "suffering" as a prerequisite for palliative sedation. ⋯ By contrast, the objective and gradual account fits well with the need for an objective basis for clinical decisions in the context of palliative sedation but runs the risk of falling short when considering the individual and subjective experience of suffering at the end of life. We will conclude with a plea for the necessity of further combined conceptual and empirical research to develop a sound and feasible understanding of suffering, which can contribute to consistent decision making about palliative sedation.
-
J Pain Symptom Manage · Aug 2018
From Fear to Confidence: Changing Providers' Attitudes About Pediatric Palliative and Hospice Care.
Children have limited access to hospice care: few existing hospice programs have dedicated pediatric teams, and adult hospice providers feel inadequately trained to care for children. ⋯ A two-day, high-intensity low-cost community-based education program can improve adult providers' knowledge of and skill level with pediatric care, leading to a change in attitude from fear to confidence. This model has the potential to increase access to pediatric hospice care as it uses existing adult hospice infrastructure.