AAHPM Position Statements
Our Board of Directors approved the following position statements intended to raise awareness and express the views of the Academy on important issues related to hospice and palliative medicine.
Artificial Nutrition and Hydration Near the End of Life
Artificial nutrition and hydration (ANH) were originally developed to provide short-term support for patients who were acutely ill. For patients near the end of life, ANH is unlikely to prolong life and can potentially lead to medical complications and increase suffering.
Palliative Care Research
Many palliative care decisions and interventions lack sufficient evidence to either recommend or not recommend. Much remains to be learned that could improve care of these patients, and further research in this field is needed. Debate exists about whether patients with serious illness should be asked to participate in research.
Palliative care supports patients whose diseases are associated with significant burden. Distressing symptoms exist on a spectrum from the most easily treated to the most refractory. Although preservation of awareness at the end of life is viewed as a priority for many, for some, the relief of symptoms may outweigh the desire to be conscious.
Suffering near the end of life arises from many sources including loss of sense of self, loss of control, fear of the future, and/or fear of being a burden upon others, as well as refractory physical and non-physical symptoms. Excellent medical care, including state-of-the art palliative care, can address and help alleviate many sources of suffering. On occasion, however, patients seek the assistance of a physician to end their life.
Advisory Brief: Guidance on Responding on Requests for Physician-Assisted Dying
Physician-Assisted Dying (PAD) is defined as a physician providing, at the patient's request, a prescription for a lethal dose of medication that the patient can self-administer by ingestion, with the explicit intention of ending life. Although PAD has historically not been within the domain of standard medical practice, in recent years it has emerged as both an explicit and covert practice across various legal jurisdictions in the United States.
Witholding and Withdrawing Nonbeneficial Medical Interventions
Palliative care seeks to relieve suffering associated with life-limiting illness. As illness progresses, there also may be times when the burdens of medical interventions outweigh their benefits, when the intervention is nonbeneficial, or when its use is inconsistent with the patient’s goals.
Aligning Graduate Medical Education with the Changing Health Care Landscape
We encourage you to share these statements with your colleagues.