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(Chest. 2005;128:3599-3610.)
© 2005 American College of Chest Physicians

Palliative and End-of-Life Care for Patients With Cardiopulmonary Diseases*

American College of Chest Physicians Position Statement

Paul A. Selecky, MD, FCCP; Col Arn H. Eliasson, MC, USA, FCCP; Richard I. Hall, MD, FCCP; Roslyn F. Schneider, MD, FCCP; Basil Varkey, MD, FCCP; ACCP Ethics Committee; D. Robert McCaffree, MD, FCCP, Chair

* From the Hoag Memorial Hospital (Dr. Selecky), Newport Beach, CA; Walter Reed Army Medical Center (Dr. Eliasson), Washington, DC; Queen Elizabeth II HSC (Dr. Hall), Halifax, Nova Scotia; Beth Israel Medical Center (Dr. Schneider), New York, NY; Medical College of Wisconsin (Dr. Varkey), Milwaukee, WI.

Correspondence to: Paul A. Selecky, MD, FCCP, Hoag Memorial Hospital, One Hoag Dr, PO Box 6100, Newport Beach, CA 92658-6100; e-mail: pselecky{at}hoaghospital.org

Abstract

Acute and chronic pulmonary and cardiac diseases often have a high mortality rate, and can be a source of significant suffering. Palliative care, as described by the Institute of Medicine, "seeks to prevent, relieve, reduce or soothe the symptoms of disease or disorder without effecting a cure... Palliative care in this broad sense is not restricted to those who are dying or those enrolled in hospice programs." The American College of Chest Physicians strongly supports the position that such palliative and end-of-life care of the patient with an acute devastating or chronically progressive pulmonary or cardiac disease and his/her family should be an integral part of cardiopulmonary medicine. This care is best provided through an interdisciplinary effort by competent and experienced professionals under the leadership of a knowledgeable and compassionate physician. To that end, it is hoped that this statement will serve as a framework within which physicians may develop their own approach to the management of patients requiring palliative care.

Key Words: advance directives • hospice care • palliative care • right to die • spirituality • terminal care




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