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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
1
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pubmed:dateCreated |
1997-3-28
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pubmed:abstractText |
Critical care physicians are frequently called on to negotiate issues of medical management with patients, their families, and other physicians. These decisions frequently revolve around end-of-life care. Recent data suggest that such discussions are manageable. In one study, 57% of patients and surrogates agreed immediately to a physician's recommendation to limit intensive care and 90% agreed within 5 days, while multiple treating physicians came to consensus about such limits within 4 days in 92% of cases. If conflicts are rare, they are strongly felt. They arise when any one of the parties to a decision insists on continued care against the considered judgment of another. Since the alternative to aggressive ICU care is usually the death of the patient, it seems difficult to reconcile a physician's refusal to treat with patient autonomy. The concept of a fiduciary offers a model of the physician-patient relationship in which the physician commits himself to the patient's best interests but retains a role in defining those interests. This model offers significant benefits over medical futility in negotiating conflicts over end-of-life care.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:status |
MEDLINE
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pubmed:month |
Feb
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pubmed:issn |
1063-7389
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
5
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
62-71
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pubmed:dateRevised |
2005-11-16
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pubmed:meshHeading |
pubmed-meshheading:9017680-Conflict (Psychology),
pubmed-meshheading:9017680-Critical Care,
pubmed-meshheading:9017680-Decision Making, Organizational,
pubmed-meshheading:9017680-Ethics, Medical,
pubmed-meshheading:9017680-Family,
pubmed-meshheading:9017680-Female,
pubmed-meshheading:9017680-Humans,
pubmed-meshheading:9017680-Male,
pubmed-meshheading:9017680-Medical Futility,
pubmed-meshheading:9017680-Middle Aged,
pubmed-meshheading:9017680-Negotiating,
pubmed-meshheading:9017680-Physician's Role,
pubmed-meshheading:9017680-Physician-Patient Relations,
pubmed-meshheading:9017680-Terminal Care
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pubmed:year |
1997
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pubmed:articleTitle |
Resolving conflicts surrounding end-of-life care.
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pubmed:affiliation |
Dartmouth Medical School, Hanover, NH, USA.
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pubmed:publicationType |
Journal Article,
Review,
Case Reports
|