Clinical ethics consultation in patients with head and neck cancer Journal Article


Authors: Shuman, A. G.; McCabe, M. S.; Fins, J. J.; Kraus, D. H.; Shah, J. P.; Patel, S. G.
Article Title: Clinical ethics consultation in patients with head and neck cancer
Abstract: Background The purpose of this study was to describe the impact of clinical ethics consultations among patients with head and neck cancer in order to better anticipate and manage clinical challenges. Methods A database was queried to identify patients with head and neck cancer for whom ethics consultation was performed at a comprehensive cancer center (n = 14). Information from the database was verified via data abstraction and analyzed qualitatively and quantitatively. Results Common requests for ethics consultation involved code status (6 of 14) and withdrawal/withholding life-sustaining treatments (6 of 14). Common contextual features were interpersonal conflicts (6 of 14) and communication barriers (5 of 14). Airway management concerns were frequent (5 of 14). Whereas 21% of patients had do not resuscitate (DNR) orders before ethics consultation, 79% were DNR subsequently. Conclusion Ethics consultations among patients with head and neck cancer reflect distinctive complexities inherent to their disease, but are entirely consistent with global clinical ethical themes. Consideration of communication barriers, social isolation/stigma, symptom control, and airway management are critical. © 2012 Wiley Periodicals, Inc.
Keywords: adult; clinical article; aged; conference paper; palliative care; data base; patient identification; cancer center; head and neck cancer; consultation; interpersonal communication; medical ethics; treatment refusal; clinical ethics; respiration control; end of life care; life sustaining treatment; ethics consultation
Journal Title: Head & Neck
Volume: 35
Issue: 11
ISSN: 1043-3074
Publisher: John Wiley & Sons, Inc.  
Date Published: 2013-11-01
Start Page: 1647
End Page: 1651
Language: English
DOI: 10.1002/hed.23204
PROVIDER: scopus
PUBMED: 23161591
DOI/URL:
Notes: --- - "Export Date: 2 December 2013" - "CODEN: HEANE" - "Source: Scopus"
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MSK Authors
  1. Dennis Kraus
    268 Kraus
  2. Snehal G Patel
    415 Patel
  3. Jatin P Shah
    725 Shah
  4. Andrew Gregg Shuman
    24 Shuman
  5. Mary McCabe
    108 McCabe