Nathan Cherny, Norman Levan Chair of Humanistic Medicine; Associate Professor of Medicine (BGU); Director, Cancer Pain and Palliative Medicine Service, Department of Medical Oncology, Shaare Zedek Medical Center, Israel.
I was recently contacted by the family of a 70-year-old man with pancreatic cancer who was referred for inpatient palliative care. He had a resolving cholangitis and was on antibiotics. The family was distraught to hear that the hospice did not provide antibiotics, do blood tests, administer blood or even check vital signs. Incredulous, I called to speak with the physician in the hospice who explained that the hospice aims to ensure patients are comfortable and not suffering, but that it does not provide life-supporting therapies (of any sort).
This philosophy does not seem consistent with providing individualised, goal- focused care. In the end, the patient was transferred to another hospice (60 km away).
The encounter has left me wondering how common is the phenomenon of hospices:
- not monitoring vital signs (for anyone)
- not doing blood tests
- not treating infections
- not providing tube feeding
- not providing BiPAP.
Please help me to understand the prevalence of this and the rationale?
Let’s hear your views…
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