Palliative Care in Surgery: Defining the Research Priorities.
Given the acute and often life-limiting nature of surgical illness, as well as the potential for treatment to induce further suffering, surgical patients have considerable palliative care needs. Yet, these patients are less likely to receive palliative care than their medical counterparts and palliative care consultations often occur when death is imminent, reflecting poor quality end-of-life care. Surgical patients would likely benefit from early palliative care delivered alongside surgical treatment to promote goal-concordant decision making and to improve patients' physical, emotional, social, and spiritual well-being and quality of life. To date, evidence to support the role of palliative care in surgical practice is sparse and palliative care research in surgery is encumbered by methodological challenges and entrenched cultural norms that impede appropriate provision of palliative care. The objective of this article was to describe the existing science of palliative care in surgery within three priority areas and expose specific gaps within the field. We propose a research agenda to address these gaps and provide a road map for future investigation.
1 The Center for Surgery and Public Health at Brigham and Women's Hospital , Boston, Massachusetts.
Elizabeth J
EJ
Lilley
1 The Center for Surgery and Public Health at Brigham and Women's Hospital , Boston, Massachusetts.|2 Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
Zara
Z
Cooper
3 Department of Surgery, University of Wisconsin , Madison, Wisconsin.|4 Department of Medical History and Bioethics, University of Wisconsin , Madison, Wisconsin.
Margaret L
ML
Schwarze
5 Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey.
Anne C
AC
Mosenthal
D013502:General Surgery / Q000379:methods*; D006302:Health Services Research; D017051:Hospice Care / Q000379:methods*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D012106:Research; D012107:Research Design; D013727:Terminal Care / Q000379:methods*
goals of care; life-limiting illness; palliative care; palliative care research; surgical patients