The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Jan 2005
Cardiopulmonary resuscitation is not addressed in the admitting medical records for the majority of patients who undergo CPR in the hospital.
Cardiopulmonary resuscitation (CPR) is routinely performed on patients who develop cardiopulmonary arrest in the hospital. In some situations, it is performed on terminally or critically ill patients where death is predicted to be inevitable despite CPR. Since prior consent is not required for this procedure, CPR may be performed without patient consent or foreknowledge. ⋯ This study investigated the frequency of occurrence of a CPR discussion at the time of hospital admission for patients who undergo CPR during hospitalization. Results showed that CPR is infrequently addressed in the hospital orders or medical records in patients who undergo CPR during their hospital stay. In addition, the severity of illness at the time of admission does not appear to influence whether physicians discuss CPR with patients and their families.
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Am J Hosp Palliat Care · Jan 2005
ReviewPacemaker and defibrillator deactivation in competent hospice patients: an ethical consideration.
The Denver Community Bioethics Committee (DCBC) is an independent, community-based group that undertakes ethics consultations for any individual or organization. Its members include adult protection professionals, physicians, elder-law attorneys, chaplains, nurses, social workers, and lay persons. ⋯ The hospice had encountered concerns from some physicians and cardiac care clinicians that deactivating such devices treads the fine line between legitimate withdrawal of burdensome treatment and assisted death. Although the specific deliberations of the DCBC are confidential, this article summarizes contributions from the committee's discussion, as well as independent research undertaken by the author.
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Am J Hosp Palliat Care · Jan 2005
Multicenter StudyEnd-of-life care: perspectives of family members of deceased patients.
This study was undertaken to determine the opinions of family members of deceased patients regarding end-of-life care. This multisite cross-sectional survey was administered to 969 volunteer participants during 1997 to 2000. Eligible participants included immediate family members of deceased patients at five local institutions in a regional health system. ⋯ Respondents were more satisfied with communication from nursing staff (88 percent) than physicians' communication (78 percent, p < 0.001, Bowker's test). Respondents indicated higher overall satisfaction with nursing (90 percent) and pastoral care (87 percent), than with physician care (81 percent, p < 0.001 and p = 0.006, Bowker's test). A unique survey instrument can be used to measure family perceptions and opinions regarding end-of-life care.