What Matters in the End: Care at the End of Life in Otolaryngology (AMW)
2020 AAO-HNSF Annual Meeting & OTO Experience
Otolaryngologists often care for patients at the end of their life but are rarely comfortable with switching from curative treatment to a palliative treatment paradigm. In addition, otolaryngologists are often uncomfortable treating common conditions that arise in this patient population, including chronic pain, and depression/anxiety. Discussions surrounding end of life issues often arise in residency, but current residency education models provide little formal education on how to approach patients at the end of life. Recent evidence suggests that only about 5% of terminal Otolaryngology patients receive palliative care consultation, indicating an opportunity for quality improvement in this setting. This session will describe the most current research on end of life care and discuss how the principles of palliative care can be applied to patients to improve the quality of care Otolaryngologists provide. Foundational ethical principles of autonomy, beneficence, non-maleficence, and justice will be described so that surgeons have tools to approach difficult patient encounters. A case-based approach will be used to illustrate how Otolaryngologists experienced with treating terminal patients approach patient care in this situation. Cases will be used as a springboard to discuss the unique considerations for otolaryngology patients at the end of life, such as disfigurement, communication difficulties and dysphagia in head and neck cancer, and issues of substituted judgement in terminal pediatric patients. Finally, a framework on how to approach terminal patients through a 'best-case, worst-case' tool will be shared as a practical take-away for improving care at the bedside.
Credits
CME:1.0, MOC:1.0
Description
Otolaryngologists often care for patients at the end of their life but are rarely comfortable with switching from curative treatment to a palliative treatment paradigm. In addition, otolaryngologists are often uncomfortable treating common conditions that arise in this patient population, including chronic pain, and depression/anxiety. Discussions surrounding end of life issues often arise in residency, but current residency education models provide little formal education on how to approach patients at the end of life. Recent evidence suggests that only about 5% of terminal Otolaryngology patients receive palliative care consultation, indicating an opportunity for quality improvement in this setting. This session will describe the most current research on end of life care and discuss how the principles of palliative care can be applied to patients to improve the quality of care Otolaryngologists provide. Foundational ethical principles of autonomy, beneficence, non-maleficence, and justice will be described so that surgeons have tools to approach difficult patient encounters. A case-based approach will be used to illustrate how Otolaryngologists experienced with treating terminal patients approach patient care in this situation. Cases will be used as a springboard to discuss the unique considerations for otolaryngology patients at the end of life, such as disfigurement, communication difficulties and dysphagia in head and neck cancer, and issues of substituted judgement in terminal pediatric patients. Finally, a framework on how to approach terminal patients through a 'best-case, worst-case' tool will be shared as a practical take-away for improving care at the bedside.Learning Objectives: 1. Review the principles of medical ethics as they relate to terminal otolaryngology patients. 2. Recognize the unique challenges in otolaryngology patients at the end of life, especially for head and neck cancer. 3. Give examples of the role of palliative care in the treatment of otolaryngology patients at the end of life.Faculty: Andrew Redmann, MD(I have no relationships to disclose), Andrew Shuman, MD(I have no relationships to disclose), Susan McCammon, MD(I have no relationships to disclose), Roger Cole, MD(I have no relationships to disclose).
Courses in package:
