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AMA J Ethics. 2018 Aug 1;20(8):E782-786. doi: 10.1001/amajethics.2018.782.

The Role of Hope, Compassion, and Uncertainty in Physicians' Reluctance to Initiate Palliative Care.

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The founder and executive director of the NORSE Institute.


This article addresses whether physicians' close ties to their patients might play an unexamined role in their reluctance to initiate palliative care. In cases characterized by uncertainty, physicians' emotional investment in their patients and patients' families might unduly promote decisions to continue aggressive treatment rather than transition to comfort care. Continued evaluation and communication of patient status, including scheduled objective consultations, can align compassionate actions with patients' best interests. This argument and analysis are based on a case of new onset refractory status epilepticus (NORSE).

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