Help, It's a Mess:Palliative Care Tips for Common Ethical/Decision Issues in Serious Illness



Date & Location
Wednesday, November 20, 2024, 12:00 PM - Wednesday, November 19, 2025, 11:59 PM

Target Audience
Specialties - Anesthesiology, Cardiovascular Disease , Critical Care Medicine, Emergency Medicine, Gastroenterology, Geriatric Medicine , Hematology and Oncology, Hospitalist, Internal Medicine, Interventional Cardiology, Muscoskeletal Radiology, Nephrology, Neurology, Neuromuscular Medicine, Nursing, Obstetrics and Gynecology, Oncology, Orthopaedic Sports Medicine, Orthopaedic Trauma, Orthopedic Surgery, Pain Medicine, Pediatrics, Pharmacy, Physical Medicine and Rehabilitation, Physical Therapy, Preventive Medicine, Psychiatry, Pulmonary Disease, Radiology Diagnostic, Rheumatology, Social Work, Surgery General, Urology

Overview

To educate healthcare providers about the facts behind some common complex serious illness decisions and discuss ways to approach those conversations with patients.

Launch Date: November 20, 2024

Expiration Date: November 19, 2025


Objectives
At the conclusion of this activity, participants should be able to:

  1. Have a better understanding of the palliative care approach to complex serious illness decision making and discussions regarding artificial hydration/nutrition, code status, and capacity concerns.
  2. Have a basic framework of how to initiate these complex discussions with their patients.

Registration

How to obtain CE Credit:


Please note, you have to watch the entire video in order to receive any CE credit for this online activity.

Click the Tests tile > Launch Video to view the module (create an IUH account if you don't already have one).

Credit will be awarded 30 days post completion.


Accreditation

 

In support of improving patient care, this activity has been planned and implemented by Indiana University School of Medicine and IU Health. Indiana University School of Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians
Indiana University School of Medicine designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

References:

Calcedo-Barba A, Fructuoso A, Martinez-Raga J, Paz S, Sánchez de Carmona M, Vicens E. A meta-review of literature reviews assessing the capacity of patients with severe mental disorders to make decisions about their healthcare. BMC Psychiatry. 2020;20(1). doi:https://doi.org/10.1186/s12888-020-02756-0

Friedrichsen M, Lythell C, Waldréus N, et al. Ethical challenges around thirst in end-of-life care –experiences of palliative care physicians. BMC Medical Ethics. 2023;24(1). doi:https://doi.org/10.1186/s12910-023-00943-8

Kingdon A, Spathis A, Brodrick R, Clarke G, Kuhn I, Barclay S. What is the impact of clinically assisted hydration in the last days of life? A systematic literature review and narrative synthesis. BMJ Supportive & Palliative Care. 2020;11(1):68-74. doi:https://doi.org/10.1136/bmjspcare-2020-002600

Kotze C, Roos JL. End-of-life decision-making capacity in an elderly patient with schizophrenia and terminal cancer. South African Family Practice. 2020;62(1). doi:https://doi.org/10.4102/safp.v62i1.5111

Lavin K, Davydow DS, Downey L, et al. Effect of Psychiatric Illness on Acute Care Utilization at End of Life From Serious Medical Illness. Journal of Pain and Symptom Management. 2017;54(2):176-185.e1. doi:https://doi.org/10.1016/j.jpainsymman.2017.04.003

Lokker ME, Heide A van der, Oldenmenger WH, Rijt CCD van der, Zuylen L van. Hydration and Symptoms in the Last Days of Life. BMJ Supportive & Palliative Care. 2019;11(3). doi:https://doi.org/10.1136/bmjspcare-2018-001729

Raijmakers NJH, van Zuylen L, Costantini M, et al. Artificial nutrition and hydration in the last week of life in cancer patients. A systematic literature review of practices and effects. Annals of Oncology. 2011;22(7):1478-1486. doi:https://doi.org/10.1093/annonc/mdq620

Sánchez-Sánchez E, Ruano-Álvarez MA, Díaz-Jiménez J, Díaz AJ, Ordonez FJ. Enteral Nutrition by Nasogastric Tube in Adult Patients under Palliative Care: A Systematic Review. Nutrients. 2021;13(5):1562. doi:https://doi.org/10.3390/nu13051562

Sutherland R. Dying Well-Informed: The Need for Better Clinical Education Surrounding Facilitating End-of-Life Conversations. PubMed. 2019;92(4):757-764.

·van Vliet LM, Epstein AS. Current State of the Art and Science of Patient-Clinician Communication in Progressive Disease: Patients’ Need to Know and Need to Feel Known. Journal of Clinical Oncology. 2014;32(31):3474-3478. doi:https://doi.org/10.1200/jco.2014.56.0425


Additional Information

For questions about accessibility or to request accommodations please contact the IUSM CME office at 317-274-0104 or [email protected]. One week advance notice will allow us to provide seamless access. Please ensure to specify the accommodations you need in order to participate.


Credits
AMA PRA Category 1 Credits™ (1.00 hours), ABS CC (1.00 hours), Non-Physician Attendance (1.00 hours)