Public and professional discourses in American society about what constitutes a "good death" have flourished in recent decades, as illustrated by the pivotal SUPPORT study and the growing palliative care movement. This paper examines a distinctive medical discourse from high-technology academic medical centers through an analysis of how physicians who are specialists in internal medicine tell s...

The issue of medical futility requires a well-defined process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not ser...

despite a lot of efforts and investigations worldwide, dnr is still a controversial issue in many countries. in iran although significant achievements are reached in different fields; end of life care is hardly considered as a scientific necessity. development and implementation of clear policies for dnr orders is required to prevent futile prolongation of death, psychological stress to the pat...

322 and family) of good end of life care. Currently the physician may ‘inadvertently fall into the trap of prognostic paralysis’ [1]. The clinical question ‘would I be surprised if this patient died within the next year’ has been advocated as a useful prompt for care planning, discussion with the patient and family, and in decision making [4]. COPD is a chronic incurable disease, and many patie...

Religion is an important element of end-of-life care on the paediatric intensive care unit with religious belief providing support for many families and for some staff. However, religious claims used by families to challenge cessation of aggressive therapies considered futile and burdensome by a wide range of medical and lay people can cause considerable problems and be very difficult to resolv...

BACKGROUND Trauma strikes unexpectedly, frequently in the young and fit. When trauma victims arrive in the emergency room all possible steps, including surgery, are often undertaken in an attempt to achieve a successful outcome. However, for patients presenting in extremis, with cardiac arrest or exsanguinating blunt chest injury, the results of resuscitation and emergency surgery are extremely...

introduction: ambulatory care is an inseparable part of health care system. it is commonly considered as the entrance of the patient to the health care system. high qualify ambulatory care has an important role in reducing mortality and morbidity rates. on the other hand, quality of information has an important role in the quality and safety of ambulatory health care. it is hence necessary to p...

introduction: feedback cards are recommended as a feasible tool for structured written feedback delivery in clinical education while effectiveness of this tool on the medical students’ performance is still questionable. the purpose of this study was to compare the effects of structured written feedback by cards as well as verbal feedback versus verbal feedback alone on the clinical performance ...

OBJECTIVE To determine whether trends toward decreasing use of cardiopulmonary resuscitation at the time of death and increasing frequency of forgoing life-sustaining treatment had continued, as few studies quantifying mode of death for hospitalized infants have been conducted in the last 10 years. DESIGN Retrospective descriptive study. SETTING Regional referral neonatal intensive care uni...