title: Role of the Nasogastric Tube and Lingzhi (Ganoderma lucidum) in Palliative Care.
abstract: Decision-making on behalf of an incapacitated patient at the end of life is a complex process, particularly in family-centric societies. The situation is more complex when attempts are made to accommodate Eastern concepts of end-of-life care with more conventional Western approaches. In this case report of an incapacitated 74-year-old Singaporean man of Malay descent with relapsed Stage 4 diffuse large B cell lymphoma who was without an established lasting power of attorney, we highlight the difficult deliberations that ensue when the patient's family, acting as his proxy, elected to administer lingzhi through his nasogastric tube (NGT). Focusing on the questions pertaining to end-of-life decision-making in Asia, we consider the issues surrounding the use of NGT and lingzhi in palliative care (PC) and the implementation of NGT for administering lingzhi in a PC setting, particularly in light of a dearth of data on such treatment measures among PC patients.
authors.affiliation: Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Wang
authors.affiliation: Duke-NUS Graduate Medical School, Singapore, Singapore.
authors.forename: Youyi
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Duke-NUS Graduate Medical School, Singapore, Singapore; National Cancer Centre, Singapore, Singapore.
authors.forename: Lalit
authors.initials: L
authors.lastname: Radha Krishna
authors.affiliation: Duke-NUS Graduate Medical School, Singapore, Singapore; KK Women's and Children's Hospital, Singapore, Singapore. Electronic address: Rukshini.Puvanendran@kkh.com.sg.
authors.forename: Rukshini
authors.initials: R
authors.lastname: Puvanendran
mesh_terms: D000368:Aged; D001293:Attitude to Death; D003657:Decision Making; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005190:Family / Q000523:psychology; D017809:Fatal Outcome; D006801:Humans; D007441:Intubation, Gastrointestinal; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy; D008296:Malaysia / Q000208:ethnology; D008297:Male; D010166:Palliative Care / Q000941:ethics / Q000379:methods* / Q000523:psychology; D008517:Phytotherapy / Q000941:ethics / Q000379:methods* / Q000523:psychology; D020940:Reishi; D012846:Singapore; D013727:Terminal Care / Q000941:ethics / Q000379:methods / Q000523:psychology
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Traditional Chinese Medicine; ethics; lingzhi; nasogastric tube; palliative care