between 33%-46% of admissions in the emergency department(ed) are advanced or end-stage cancer patients. they usually stay in emergency for days for management of their symptoms (commonly pain and respiratory distress) or for terminal care. barriers for delivering palliative care services in the ed:- traditional attitude among the ed staff that practice life saving approaches for every patient ...

Acute and critical care nurses routinely encounter ethical "quandaries" such as providing perceived futile care. Other everyday ethically important occurrences may go unrecognized, however, thus diminishing their importance to moral nursing practice. This column presents a framework that may assist in developing specific skills to recognize and engage in both critical and everyday ethical situa...

Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, thos...

A recent review in the BMJ has drawn attention to major concerns about ‘Do Not Attempt Cardio-Pulmonary Resuscitation’ (DNACPR) forms.1 One of these concerns is with the distressing number of deaths that are surrounded by futile attempts at cardio-pulmonary resuscitation (CPR). Such attempts occur for a number of reasons. Some patients with terminal illnesses, or who are elderly and frail, do n...