End-of-life decisions are being made daily in Intensive Care Units worldwide. The spectrum of options varies from full-continued care, withholding treatment, withdrawing treatment, and active life-ending procedures depending on the institutional practices and legal framework. Considering the complexity of the situation and the legalities involved, it is important to have a structured approach toward these sensitive decisions. It does make sense to have a protocol that ensures proper documentation and helps ease the physicians involved in such decisions. Clear documentation in the format of a checklist would ensure consistency and help the entire medical team to be uniformly informed about the end-of-life plan.
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http://dx.doi.org/10.4103/0972-5229.169339 | DOI Listing |
Sci Rep
January 2025
Division of Pulmonology, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214, Gdańsk, Poland.
Chronic obstructive pulmonary disease (COPD) exacerbations frequently cause patient consultations in both out- and inpatient settings. Recent data suggest that only 40-60% of exacerbations are of bacterial origin and mandate antibiotic treatment. However, a reliable tool to justify prescribing antibiotics for COPD exacerbation is still lacking.
View Article and Find Full Text PDFMedicine (Baltimore)
November 2024
Department of Internal Medicine, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Background: Chronic kidney disease (CKD) patients face critical decisions in choosing kidney replacement therapy such as hemodialysis (HD) or peritoneal dialysis (PD), which significantly affect their quality of life and health outcomes. Recent studies highlight the importance of shared decision-making (SDM) in helping patients understand their treatment options and make informed choices. SDM not only improves patient satisfaction and autonomy but also emphasizes the need for comprehensive pre-dialysis education to support optimal treatment selection.
View Article and Find Full Text PDFNeurocrit Care
January 2025
Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA.
Background: There have been growing sentiments that the Uniform Determination of Death Act needs to be revised. One suggestion is to include a conscience clause, that is, allowing patients to "opt-out" of brain death determination. Understanding public attitudes toward a conscience clause may help inform policymakers and future proposed revisions.
View Article and Find Full Text PDFJ Public Health Manag Pract
November 2024
Author Affiliations: Office of Epidemiology, Missouri Department of Health and Senior Services, Jefferson City, Missouri (Mr Quay, Ms Harbert, and Dr Garikapaty); and Bureau of Health Care Analysis and Data Dissemination, Missouri Department of Health and Senior Services, Jefferson City, Missouri (Mr Schramm).
There are multiple surveillance systems working to address the issue of maternal mortality in Missouri. These surveillance systems have key methodological differences in their definitions, terminology, inclusion criteria, and purpose. This study aims to provide an understanding of the practical effects of these programmatic differences regarding what cases are included and how this can impact the interpretations of the data and influence policy decisions.
View Article and Find Full Text PDFCurr Opin Crit Care
January 2025
Department of Critical Care Medicine.
Purpose Of Review: Neuroprognostication after acute brain injury (ABI) is complex. In this review, we examine the threats to accurate neuroprognostication, discuss strategies to mitigate the self-fulfilling prophecy, and how to approach the indeterminate prognosis.
Recent Findings: The goal of neuroprognostication is to provide a timely and accurate prediction of a patient's neurologic outcome so treatment can proceed in accordance with a patient's values and preferences.
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