• Curr. Opin. Neurol. · Feb 2014

    Review

    Ethical considerations in stroke patients.

    • Adam G Kelly, Bogachan Sahin, and Robert G Holloway.
    • Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA.
    • Curr. Opin. Neurol. 2014 Feb 1; 27 (1): 61-5.

    Purpose Of ReviewMedical decision-making in stroke patients can be complex and often involves ethical challenges, from the perspective of healthcare providers as well as patients and their families. Awareness of these challenges and knowledge of current ethical topics in stroke may improve the quality of care provided to stroke patients.Recent FindingsPredictive scores are increasingly available to estimate prognosis following stroke, though their usefulness in decision-making for individual patients remains unclear. Medical decisions requiring a surrogate decision-maker can be challenging; surrogates may also be susceptible to systematic biases in their decision-making. Variations in care are common and possibly related to under-utilization or over-utilization of resources. However, patient preferences may explain some of the variability as well. Early mortality may be related to patient and family preferences regarding life-sustaining measures rather than the provision of care that is not well tolerated or evidence-based.SummaryEthical challenges are common in the care of stroke patients. An effective understanding of these topics is essential for clinicians to deliver patient-centered, preference-sensitive care.

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