• Rachel Hadler, Lara India, Angela M Bader, Orly N Farber, Melanie L Fritz, Fabian M Johnston, Nader N Massarweh, Ravi Pathak, Sandra H Sacks, Margaret L Schwarze, Jocelyn Streid, William E Rosa, and Rebecca A Aslakson.
• Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA.
• J Palliat Med. 2024 Jul 15.

AbstractMany seriously ill patients undergo surgical interventions. Palliative care clinicians may not be familiar with the nuances involved in perioperative care, however they can play a valuable role in enabling the delivery of patient-centered and goal-concordant perioperative care. The interval of time surrounding a surgical intervention is fraught with medical, psychosocial, and relational risks, many of which palliative care clinicians may be well-positioned to navigate. A perioperative palliative care consult may involve exploring gaps between clinician and patient expectations, facilitating continuity of symptom management or helping patients to designate a surrogate decision-maker before undergoing anesthesia. Palliative care clinicians may also be called upon to direct discussions around perioperative management of modified code status orders and to engage around the goal-concordance of proposed interventions. This article, written by a team of surgeons and anesthesiologists, many with subspecialty training in palliative medicine and/or ethics, offers ten tips to support palliative care clinicians and facilitate comprehensive discussion as they engage with patients and clinicians considering surgical interventions.

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