Added text to state that patients who preferred to die at home were more likely to do so (56% vs. 37%; odds ratio [OR], 2.21).
Added text to state that patients were less likely to die at home (OR, <1) if there was moderate or severe pain (43% vs. 69%; OR, 0.56) or higher functional status as measured by the Palliative Performance Scale (OR, 0.53).
Revised text to state that a significant proportion of patients die within 14 days of transfusion, which raises the possibility that transfusions may be harmful or that transfusions were inappropriately given to dying patients.
Added text to state that it has been suggested that clinicians may encourage no escalation of care because of concerns that the intensive medical treatments will prevent death, and therefore the patient will have missed the “opportunity to die” (cited Cochrane as reference 1).
Added text to state that the patient or surrogates may choose to withdraw all life-sustaining treatment if there is no improvement during the limited trial. Also added text to state that from an ethical standpoint, withdrawing treatment is equivalent to withholding such treatment, and both actions are justified for unwarranted or unwanted intensive care.
Revised text to state that if the clinician anticipates that a distressing symptom will improve with time, then the clinician should discuss with the patient any recommendations about a deliberate reduction in the depth of sedation to assess whether the symptoms persist. Also added text to state that deliberate reductions in the depth of sedation may be appropriate if there is a desire for communication with loved ones.
ver historia personal en: www.cerasale.com.ar [dado de baja por la Cancillería Argentina por temas políticos, propio de la censura que rige en nuestro medio]//
weblog.maimonides.edu/farmacia/archives/UM_Informe_Autoevaluacion_FyB.pdf - //
weblog.maimonides.edu/farmacia/archives/0216_Admin_FarmEcon.pdf - //
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