Palliative Care

Compassion in medicine: How palliative care changes lives

Conditions
August 20, 2024

Health care providers dedicate years to rigorous education and training to optimize medical care, aiming to heal and treat illness. However, historically, there has been a significant gap in training regarding the transition from a treatment-focused approach to focusing on providing comfort in the face of serious illness and death. This leaves health care professionals unprepared to navigate the complexities of end-of-life care. Despite their good intentions, health are providers …

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End-of-life issues in dementia care [PODCAST]

Podcast
July 30, 2024
YouTube video

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Join us as we welcome psychiatrist Lewis Cohen to discuss his book, Winter’s End: Dementia and Dying Well. In this episode, we explore the ethical dilemmas, legal challenges, and emotional impacts surrounding life-shortening …

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Palliative care is plagued by misunderstanding

Physician
July 26, 2024

During a recent palliative conference, the discussion turned to the challenges of translating our work to the public and our colleagues. Despite the growth of our field and increasing access, there remains major confusion about palliative care and hospice. Much of the misunderstanding originates from within the medical profession. Having worked in the palliative care and hospice arena for nearly two decades, I have seen many examples of the confusion …

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How to live when you know you are dying

Physician
July 1, 2024

We had been meeting for a number of months when she posed the question. We met in person one time, but other than that single appointment, all of our meetings were virtual. She had metastatic cancer. She didn’t actually want to know that her cancer had returned. The metastatic disease had been found when they couldn’t complete her colonoscopy and ordered a scan to see why. She helped me understand …

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Grandpa’s remains are helping push up daisies

Conditions
May 26, 2024

“Rejoin the natural cycle: to know that the last gesture you’ll make will be gentle and beneficial just feels like the right thing to do.”
– Recompose founder Katrina Spade

I love gardening and watching things grow, so I found the idea of human composting an intriguing concept. For those who find cremation unconventional or even unsettling, the process of disposing of the remains of a deceased loved one has taken a …

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Assisted suicide legislation: ethical considerations [PODCAST]

Podcast
May 21, 2024
YouTube video

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Join us as we delve into the complex terrain of end-of-life care and the contentious debate surrounding assisted suicide legislation. Cardiologist Joseph E. Marine offers unique insights into the ethical, medical, and societal …

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On being a doctor and an advocate

Physician
April 27, 2024

I opened my internal medicine practice almost four decades ago to serve a growing urban community. I gravitated toward the underserved geriatric population as they were vulnerable patients and eventually moved into the bygone realm of house calls for home-bound seniors.

This enhanced my learning curve, as house calls are not taught in medical school or residency yet bridge the continuity gap between hospitalization and patients returning home after an acute …

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Advance directives amidst COVID: a critical look

Physician
April 12, 2024

Are advance directives any better than they were four years ago when COVID was surging? Are patients still comfortable with being placed on ventilators? Do physicians better understand how to treat COVID as a serious illness? 

Physicians provide emergency measures unless there’s an advance directive to the contrary. Only one-third of Americans have advance directives when “down for the count” with serious illness.

Most people prefer to die at …

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Fighting for choice in dementia deaths

Conditions
April 4, 2024

Last month, the daughters of Wendy Miller, a 68-year-old author of three bestselling books about her experience with dementia, posted online her final words: “In the end, I died simply by deciding not to eat or drink anymore.”

Her stark statement reminded me of my interviews with Dan Winter, 62, which had begun nine months before he, too, took his own life. Alzheimer’s disease was slowly disassembling Dan’s rich and …

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Palliative and hospice care in hospitals and clinics: the good, the bad, and the ugly

Physician
April 1, 2024

I walk into the patient’s hospital room during evening rounds. He looks pale and tired, having recently completed a round of chemotherapy for his stage IV pancreatic cancer. His wife is at the bedside, scared and concerned about her husband’s rapid decline. I sit down to discuss goals of care when the patient immediately says, “I can’t do this anymore.” His wife responds immediately to the patient: “Of course you …

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Finding peace in the face of loss: a father’s journey with hospice

Physician
March 28, 2024

How do you make sense of someone dying? The only way I know is to put it into some context so that, if possible, some good can come of it.

Some of you may have known about my dad’s Parkinson’s disease. He’s had a fairly rapid decline over the past four months, and now he’s rapidly declining again. He has been on home hospice for the past three months. He has …

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From doctor to family: Witnessing both sides of end-of-life care

Physician
March 27, 2024

We all have those moments in medicine when we know that care has become more futile. Then we do everything in our power to educate, support, gently guide, and give permission to patients and families. There are moments that treating for a cure goes against our tenet to “first do no harm.”

I never would have imagined that I would be on the family side of these debates. I had a …

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Assisted suicide: Safeguards debated as bioethicist warns of unintended consequences

Conditions
March 19, 2024

At a time when many states are considering assisted suicide legislation, I was interested to encounter the perspective of the well-known bioethicist Arthur Caplan who recently expressed his support for these laws on these pages.

While I appreciate Caplan’s endorsement of protecting doctors’ ability to refuse, as a matter of conscience, to participate in assisted death, I admire his insistence on restrictions or safeguards within these laws to …

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Assisted suicide is the wrong prescription

Physician
March 15, 2024

America expends much time, effort, and resources when people become seriously ill, bringing many face-to-face with their own mortality. For patients and their families, it is an emotional and difficult time under the best of circumstances. As a cardiologist, I participate in the decision-making that comes at this time, and it has provided me with the honor of delivering care that has allowed patients to rebound from acute illness and …

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Ditch the guilt and stress: Embrace your core values like this inspiring doctor mom

Physician
March 12, 2024

Kim Downey:

I recently had an enlightening conversation with Dr. Sarah Wittry. We enjoyed learning about all that we share in common!

As a physical therapist, I was delighted to hear that Dr. Wittry’s medical career began in physiatry/PM&R.

Having friends and relatives who have benefited from hospice care, I have tremendous respect for her current work in palliative medicine and hospice.

We spoke of how it has felt to each of us to …

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Medical aid in dying legislation for end-of-life care [PODCAST]

Podcast
March 1, 2024
YouTube video

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Join Thaddeus Mason Pope, an expert in medical law and clinical ethics, as we delve into the complex landscape of medical aid in dying (MAID) legislation. Explore the evolution of MAID legislation over …

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Medical aid in dying: time for evidence-based legislation

Conditions
January 16, 2024

Medical aid in dying (MAID) is poised to be one of the hottest political health care issues of 2024. As in 2023, more than a dozen states will hold both impassioned hearings in legislative chambers and equally fervent debates in the community. Already, nearly twenty states have introduced bills to authorize MAID this year. They seek to join the eleven states that already authorize MAID for 73 million Americans (California, …

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Breaking the silence on caregiver stress [PODCAST]

Podcast
January 10, 2024
YouTube video

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Join R. Lynn Barnett, a patient advocate. We’ll explore the world of caregiving, its challenges, and the profound impact it has on individuals and families. Discover valuable insights on caregiver stress, self-care, and the importance of respite …

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Palliative care and the garden of hope

Physician
January 10, 2024

My grandmother had a beautiful garden that she expanded through years of effort in her terraced backyard. Despite rocky soil and areas of deep shade, her flowers blossomed, and the garden thrived. I do not know if her skills as a gardener were innate or learned through trials and failures, but I know my garden could certainly benefit from her guidance now.

In the medical field, there is a long-held misconception …

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Rosalynn Carter’s impact on caregivers

Conditions
December 25, 2023

I’m writing this in November, which is National Caregiver Month. It’s also Alzheimer’s Awareness Month. But regardless of when you’re reading this, if you’re a caregiver, every month is “caregiver month.”

Ironically, it’s also just a few days after the former first lady, Rosalynn Carter, passed away. She was acutely and astutely aware of the role of the caregiver and the toll that it can take on you. She so insightfully …

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