Hospice & Palliative Medicine

  • Breaking the pain contract: A better controlled-substance agreement for patients on chronic opioid therapy
    Daniel G. Tobin, MD, FACP, Kristine Keough Forte, MS, MA, DBioethics and Summer Johnson McGee, PhD, CPH
    Cleveland Clinic Journal of Medicine November 2016, 83 (11) 827-835; DOI: https://doi.org/10.3949/ccjm.83a.15172

    Common limitations of current pain treatment “contracts,” and strategies to improve them.

  • The ABCs of managing systolic heart failure: Past, present, and future
    Ike S. Okwuosa, MD, Oluseyi Princewill, MD, MPH, Chiemeke Nwabueze, MD, Lena Mathews, MD, Steven Hsu, MD, Nisha A. Gilotra, MD, Sabra Lewsey, MD, MPH, Roger S. Blumenthal, MD and Stuart D. Russell, MD
    Cleveland Clinic Journal of Medicine October 2016, 83 (10) 753-765; DOI: https://doi.org/10.3949/ccjm.83a.16006

    Digitalis, diuretics, and bedrest have given way to neurohormonal blockade and physical rehabilitation.

  • Evolution of heart failure management: Miles to go
    James B. Young, MD
    Cleveland Clinic Journal of Medicine October 2016, 83 (10) 766-768; DOI: https://doi.org/10.3949/ccjm.83a.16043

    Despite progress, too many patients still suffer, too many die too young, and the costs are still too great.

  • The fifth vital sign: A complex story of politics and patient care
    Brian F. Mandell, MD, PhD
    Cleveland Clinic Journal of Medicine June 2016, 83 (6) 400-401; DOI: https://doi.org/10.3949/ccjm.83b.06016

    Times have changed, and the diffi culties and complexities of trying to help patients with ongoing pain have increased.

  • This is not an acute coronary syndrome
    Adam M. May, MD, Korosh Sharain, MD, Jorge Brenes-Salazar, MD and Lawrence J. Sinak, MD
    Cleveland Clinic Journal of Medicine May 2016, 83 (5) 335-336; DOI: https://doi.org/10.3949/ccjm.83a.15060

    Stress cardiomyopathy—broken heart syndrome—typically affects older women exposed to a stressful life event.

  • Can patients opt to turn off implantable cardioverter-defibrillators near the end of life?
    M. Motaz Baibars, MD, M. Chadi Alraies, MD, FACP, Amjad Kabach, MD and Marc Pritzker, MD, FACC
    Cleveland Clinic Journal of Medicine February 2016, 83 (2) 97-98; DOI: https://doi.org/10.3949/ccjm.83a.15007

    Yes, it is reasonable to consider deactivation near the end of life if the patient or family wishes.

  • The ethics of ICDs: History and future directions
    Martin L. Smith, STD and Eric Kodish, MD
    Cleveland Clinic Journal of Medicine February 2016, 83 (2) 99-100; DOI: https://doi.org/10.3949/ccjm.83a.15122

    There is no ethical requirement that treatment, once started, must continue against the patient’s wishes.

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