Open AccessEthics in the Treatment of Advanced Heart Failure: Palliative Care and End‐of‐Life Issues
Author(s) -
Tanner Craig E.,
Fromme Erik K.,
Goodlin Sarah J.
Publication year - 2011
Publication title -
congestive heart failure
Language(s) - English
Resource type - Journals
eISSN - 1751-7133
pISSN - 1527-5299
DOI - 10.1111/j.1751-7133.2011.00245.x
Subject(s) - medicine , palliative care , preparedness , advance care planning , intensive care medicine , heart failure , quality of life (healthcare) , psychological intervention , end of life care , medical emergency , nursing , political science , law
Congest Heart Fail. 2011;17:235–240. © 2011 Wiley Periodicals, Inc. Advanced heart failure (HF) is a life‐shortening condition, yet there are increasing treatments and implantable devices available to clinicians to manage patients with advanced HF. Planning for adverse events and the end of life, formulated as “preparedness planning,” can be integrated into HF care early in illness. Discussions that acknowledge the uncertainty of HF course and length of life and incorporate patient and family goals and values facilitates this planning. Clear processes for weighing potential benefits and burdens of interventions and therapies should accompany decision‐making. Device implantation decision‐making can acknowledge alternative avenues of care to the device and identify situations in which the device might be deactivated in the future. Symptom assessment and management potentially improve quality of life in patients with advanced HF. Management of symptoms should integrate HF therapies as well as other treatments. Collaboration between HF providers, palliative care clinicians, and, if appropriate, hospice clinicians will improve care for HF patients and their families.