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Perspective
Less Is More
June 2017

Early Palliative Care in Advanced Illness: Do Right by Mama

Author Affiliations
  • 1Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Alabama at Birmingham, Birmingham
  • 2Health Services, Outcomes, and Effectiveness Research Training Program, University of Alabama at Birmingham, Birmingham
  • 3Center for Palliative and Supportive Care, Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham
  • 4School of Nursing, University of Alabama at Birmingham, Birmingham
JAMA Intern Med. 2017;177(6):761-762. doi:10.1001/jamainternmed.2017.0764

As the on-call pulmonary critical care fellow, I listened to a family member plead with me to “do right by Mama.”

The emergency department team consulted me for possible intensive care unit (ICU) admission on a frail octogenarian with metastatic lung cancer and pneumonia. The treatment algorithm for impending respiratory failure suggested imminent intubation; however, the most valuable lesson pulmonary critical care fellows learn when rescuing patients with respiratory distress is deciding when not to intubate.

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