Monthly Archives: June 2011

Informed consent is not “Informed” if Prognosis is not disclosed


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TSAS-W: The best tool to assess wound-related pain and symptom management


The Toronto Symptom Assessment System for wounds (TSAS-W) was modeled after the highly successful ESAS tool. Ten metrics, measured using 11 point numeric scales quantify wound-related pain and symptoms. Their summation equates to the Global Wound Related Distress Score. TSAS-W … Continue reading

Posted in Wound Management | Tagged , , , , , | Leave a comment

Kennedy consipiracy: Who believes in the existence of the “Kennedy Ulcer” ???


Those of us who work in the fields of Palliative Medicine, Palliative Care, and Hospice Care do not believe in the existence of the “Kennedy Ulcer”. We believe that the cutaneous stigmata so called is actually due to venous stasis, promoted by immobility … Continue reading

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MD’s must Stop “Deeming” patients “Palliative” !


To “deem” is to consider, hold an opinion, believe, think or regard. A classic example of medical paternalism occurs when physicians “deem” a particular patient as being “palliative”. Moreover, when physicians “deem” a patient as “palliative” it is generally when the … Continue reading

Posted in Promoting PCC & PE | Tagged , , , , , , | Leave a comment

What is a “maintenance wound” ?


A “maintenance” wound is one that is being held in a static, stable, or stabilized state. It is a wound that is not demonstrating evidence of improving (healing) nor deteriorating. There are two main types of maintenance wounds: (1) Those  where … Continue reading

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Who makes a patient “Palliative”?


Despite the modern trend to promote patient-centered care and patient empowerment, it is shocking to witness flagrant examples of paternalism by physicians when THEY declare a patient to be “palliative”. In a truly patient-centered and patient-empowerment mode, it is actually the patient … Continue reading

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Why do we spend twice as much on futility than prevention?


North America spends at least 20% of its global healthcare budget on patients that are in their last month of life, yet less than 5% is spent on disease prevention. Much of this late-stage treatment represents clearly futile interventions and micromanagement that is usually … Continue reading

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