On Being Fired: Experiences of Patient-Initiated Termination of the Patient–Physician Relationship in Palliative Medicine

Smith, Alexander K.; Buss, Mary K.; Giansiracusa, David F.; Block, Susan D.

doi:10.1089/jpm.2006.0244

Cited by 12 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Involving local legal and social support groups and seeking out more information resources may have helped illuminate issues concerning custody of the child and educating the medical team about relevant cultural issues (see Web Resources). 22…”

Section: Appreciating Diversity and Commonality Within The Latino Communitymentioning

confidence: 99%

Palliative Care for Latino Patients and Their Families

Smith

Sudore²,

Pérez‐Stable³

2009

JAMA

Self Cite

124

121

View full text Add to dashboard Cite

Latinos account for 15% of the US population, a proportion projected to grow to 30% by the year 2050. Although there is tremendous diversity within this community, commonalities of language, beliefs, attitudes, and behaviors unite Latinos, making them more similar than different. For non-Latino and non-Spanish-speaking clinicians, communication barriers and cultural misunderstandings can impede the care of dying Latino patients and their families. We present the case of a young, pregnant, Spanish-speaking woman from Guatemala diagnosed with a fatal leukemia. As illustrated by this case, Latino immigrants face a number of external challenges to optimal end-of-life care: (1) geographic distance as well as political and economic realities often separate patients from their valued families; (2) undocumented immigrants are frequently uninsured, and fear of deportation may create a barrier to accessing health services; (3) language and literacy barriers; and (4) concerns about discrimination. Other Latino issues that may be more pronounced in end-of-life settings include cultural themes and religious and spiritual influences. We recommend that professional interpreters must be used for discussions about goals of care with Spanish-speaking patients and families, or when negotiating conflict between the patient, family, and the health care team. Concrete suggestions are provided for clinicians in working with interpreters, eliciting culturally-based attitudes and beliefs, and implementing universal strategies for clear health communication.

show abstract

Section: Appreciating Diversity and Commonality Within The Latino Communitymentioning

confidence: 99%

Palliative Care for Latino Patients and Their Families

Smith

Sudore²,

Pérez‐Stable³

2009

JAMA

Self Cite

124

121

View full text Add to dashboard Cite

show abstract

“…Good relationships are associated with better clinical outcomes [3,4]. Both parties value relationships [5,6] and are upset when they break down [7][8][9][10]. Despite their acknowledged importance, good relationships have proved difficult to define.…”

Section: Introductionmentioning

confidence: 99%

Integrative qualitative communication analysis of consultation and patient and practitioner perspectives: Towards a theory of authentic caring in clinical relationships

Salmon

Mendick

Young

2011

Patient Education and Counseling

View full text Add to dashboard Cite

“…A good relationship is the foundation for working through difficult decisions in palliative care. Starting a palliative care consult without first building a relationship leads to misunderstanding, defensiveness, and in some cases, being fired (Smith et al 2007).…”

Section: Palliative Carementioning

confidence: 99%

Serving the Very Sick, Very Frail, and Very Old: Geriatrics, Palliative Care, and Clinical Ethics

Smith¹,

Micco²

2017

Perspectives in Biology and Medicine

Self Cite

View full text Add to dashboard Cite

How can we provide the best care for growing numbers of very frail, very sick, or very old people? The disciplines of geriatrics, palliative care, and clinical ethics each have a good deal to offer to improve care for elders, yet each field is saddled with heavy historical baggage. Using a case as a springboard, we address specific strengths and shortcomings of each field, and what these disciplines can learn from each other. Geriatrics is currently largely focused on prevention of disability, cognitive impairment, and death; it should reorganize around a palliative approach to providing care for elders living with multiple chronic conditions, disability, and dementia. Palliative care, while paying some attention to the spectrum of advanced illness, concentrates primarily on cancer; it should expand its central purpose to include providing supportive care to elders with serious illness and their caregivers. Ethics committee members and consultants principally stress individual autonomy; they need to expand their approach and develop longitudinal relationships with patients and family members, routinely incorporating them in deliberations and the crafting of recommendations. However, improving these three disciplines will only go so far toward improving the care of very frail, very sick, or very old people. What is most needed is longitudinal care provided by interdisciplinary primary care teams steeped in the core principles of all three disciplines.

show abstract

On Being Fired: Experiences of Patient-Initiated Termination of the Patient–Physician Relationship in Palliative Medicine

Cited by 12 publications

References 26 publications

Palliative Care for Latino Patients and Their Families

Palliative Care for Latino Patients and Their Families

Integrative qualitative communication analysis of consultation and patient and practitioner perspectives: Towards a theory of authentic caring in clinical relationships

Serving the Very Sick, Very Frail, and Very Old: Geriatrics, Palliative Care, and Clinical Ethics

Contact Info

Product

Resources

About