Open AccessDeep Brain Stimulation at End of Life: Clinical and Ethical Considerations
Author(s) -
Lauren R. Sankary,
Paul J. Ford,
André G. Machado,
Laura Hoeksema,
Renato V. Samala,
David Harris
Publication year - 2020
Publication title -
journal of palliative medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.986
H-Index - 90
eISSN - 1096-6218
pISSN - 1557-7740
DOI - 10.1089/jpm.2019.0129
Subject(s) - deep brain stimulation , medicine , neurosurgery , end of life care , parkinson's disease , motor symptoms , palliative care , intensive care medicine , physical medicine and rehabilitation , disease , psychiatry , nursing
Deep brain stimulation (DBS) is an implanted neurological device effective in treating motor symptoms of Parkinson disease (PD), such as tremor, rigidity, and bradykinesia. More than 150,000 patients worldwide have been implanted with DBS devices. Questions arise at the end of life concerning how to provide best care for patients with DBS, including its continued benefit or potential complications, yet, no published articles provide guidance for hospice providers regarding the management of DBS devices in end-of-life care. With contributions from hospice physicians, a neurosurgeon, and ethicists, this article provides recommendations to address clinical and ethical challenges in optimizing DBS for patients with PD nearing the end of life.