Articles: palliative-care.
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To evaluate the palliative benefit of stent insertion in a group of patients with central airways obstruction due to terminal cancer. ⋯ Despite terminal disease and the fact that, in our country, patients may legally refuse any treatment and formally ask for euthanasia, the palliative benefit of stent placement should always be considered. All patients had immediate symptomatic relief afterwards. Retrospectively, the GPs responsible for terminal care at home still considered stent insertion worthwhile in 58% (7 of 12 patients) of cases. Stent placement should always be considered as part of the treatment of terminal cancer patients with imminent suffocation.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Dec 2001
Review[Intensive care - palliative care. Contradiction or supplement? Considerations on ethical issues and principles in the treatment of dying patients].
Over the last five decades the progress in intensive care has extended the limitations of controlling the process of dying and given doctors more influence in determining the time of death. More recently, palliative care has emerged as a new approach in response to the ethical dilemmas of modern medicine, which accepts that dying is a natural process that should not be hastened or delayed through medical interventions. While in Germany in 1999 more than 50 000 people have died in intensive care units, only a small number of 8000 patients have died in palliative care. ⋯ The approach of palliative care with its strong focus on alleviating the suffering of the terminally ill, has influenced the ethical debate of dying in intensive care. Although intensive care and palliative care have different aims and priorities, there are common problems of decision-making which could benefit from a shared orientation and interdisciplinary debate. Both the interpretation of a dying parent's will as well as withdrawing or withholding treatment in patients who are unable to decide for themselves should not merely be guided by the debate on active and passive euthanasia, but rather take into account the appropriateness or inappropriateness of medical actions in the specific situation.
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Palliative services in Australia have grown and evolved rapidly over the past 20 years. They now offer care to people facing life-limiting illness and to their families long before the stage of terminal care. ⋯ There is still unmet need, particularly among people with non-cancer illnesses and in particular regions. Choices about place of care (community or inpatient setting) may be limited by factors such as funding policies for medications.
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The increasing duration of life from disease diagnosis to death in cancer and chronic non-malignant illnesses argues for a revised approach to end-of-life care that incorporates the principles of palliative care from an earlier stage (ie, a stage at which curative and/or life-prolonging treatments are still being provided). The provision of active treatment and comfort measures/death preparation in parallel has been called the "mixed management model" of end-of life care.