Palliative care: patient’s autonomy in the end-of-life situation

Management of Hypoglycemia in Nondiabetic Palliative Care Patients: A Prognosis-Based Approach

Palliative Care Research and Treatment ◽

10.4137/pcrt.s38956 ◽

2016 ◽

Vol 10 ◽

pp. PCRT.S38956

Author(s):

Victor C. Kok ◽

Ping-Hsueh Lee

Keyword(s):

Palliative Care ◽

End Of Life ◽

Terminal Illness ◽

Physical Symptoms ◽

Autonomic Response ◽

Hypoglycemic Episode ◽

Family Expectations ◽

Existential Suffering ◽

Hypoglycemic Attack ◽

Patient’S Autonomy

Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%–60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode. Although it is not difficult to diagnose and confirm a true hypoglycemia when it is suspected clinically, an episode of hypoglycemic attack may go unnoticed in some patients in a hospice setting. Current trends in palliative care focus on providing treatments based on a prognosis-based framework, involving shared decision-making between the patient and caregivers, after considering the prognosis, professional recommendations, patient's autonomy, family expectations, and the current methods for treating the patient's physical symptoms and existential suffering. This paper provides professional care teams with both moral and literature support for providing care to nondiabetic patients presenting with hypoglycemia.

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Ευθανασία: Ηθικά διλήμματα πολιτισμικής αυτοσυνειδησίας

Bioethica ◽

10.12681/bioeth.19726 ◽

2017 ◽

Vol 3 (2) ◽

pp. 81

Author(s):

Κωνσταντίνος Κορναράκης (Konstantinos Kornarakis)

Keyword(s):

Palliative Care ◽

End Of Life ◽

Personal Experience ◽

Fear Of Death ◽

Patient’S Autonomy ◽

Theological Thinking

This paper focuses on the anthropological background of Euthanasia’s cultural profile, claiming that a cultural reception of Euthanasia should previously deal with anthropological questions such as patient’s autonomy and its relation to existential freedom, the fear of death, the meaning of personal experience of pain in shaping one’s own freedom and the cardinal importance of community’s role in patient’s palliative care. The theological thinking can contribute in this interscientific dialogue on the end of life, re-opening the question of the ontology of person and consequently the question of eschatology.

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Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0207 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1356-1362

Author(s):

Laurence Tan Lean Chin ◽

Yu Jun Lim ◽

Wan Ling Choo

Keyword(s):

Palliative Care ◽

End Of Life ◽

Multidisciplinary Team ◽

Biopsychosocial Model ◽

Family Members ◽

Clinical Decisions ◽

Goals Of Care ◽

Complex Needs ◽

Aspiration Risk ◽

Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

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