Latest news with #palliativecare
Medscape
2 days ago
- Health
- Medscape
Earlier Palliative Cancer Care Cuts End-of-Life ED Visits
TOPLINE: A recent retrospective study found that earlier outpatient palliative care referrals for patients with advanced cancer were associated with a small increase in overall emergency department (ED) visits but significantly fewer end-of-life ED visits and improved advance care planning. METHODOLOGY: ED visits near end of life are common among patients with advanced cancer and often indicate unmet needs. Although early outpatient palliative care can improve symptom management and care coordination as well as prevent unnecessary ED visits, it is crucial to distinguish patients who require ED visits from those better managed with planned care. To understand how earlier palliative care referrals may impact end-of-life ED visits, researchers conducted a retrospective cohort study of 3560 patients with advanced cancer (median age, 68 years; 60.2% men) referred to outpatient palliative care at Seoul National University Hospital between 2018 and 2022. Patients received consultation-based palliative care services from a team of physicians, nurses, and social workers — provided 5 days per week, with telephone support available on weekdays. Researchers analyzed ED visits after outpatient palliative care referral, looking at the association between the timing of palliative care referral and end-of-life ED visits as well as the completion of advance care planning documentation in outpatient palliative care and ED settings. Researchers also analyzed end-of-life ED visits — defined as those occurring within 30 days before death — and factors associated with overall and end-of-life ED visits. TAKEAWAY: Overall, 25.8% of patients visited the ED, and 10.6% had an end-of-life ED visit. Earlier palliative care referral was associated with a 4% greater likelihood of an ED visit overall (odds ratio [OR], 1.04), possibly because these patients had longer follow-up, but a 16% reduced likelihood of an ED end-of-life visit (OR, 0.84). Factors associated with overall ED visits were age younger than 65 years (OR, 1.25), residence area (OR, 2.92), and planned treatment (OR, 2.60); factors associated with end-of-life visits were residence area (OR, 3.29), hematologic malignancy (OR, 2.79), and planned cancer treatment at referral (OR, 2.60). Among 2132 patients who completed advance care planning documentation after referral, 48.0% of ED visitors and 52.8% of nonvisitors completed it at outpatient palliative care clinics, while 20.0% of ED visitors completed it in the ED. End-of-life ED visits were more severe and were associated with longer median stays (11.6 vs 8.5 hours), higher rates of hospital admission or transfer (59.7% vs 41.5%), and higher rates of respiratory infections (13.5% vs 4.9%) than other ED visits. Regarding interventions, cardiopulmonary resuscitation was performed more frequently during end-of-life ED visits than overall ED visits (3.2% vs 1.2%), with mechanical ventilation and vasopressors used nearly twice as often during end-of-life ED visits. IN PRACTICE: A substantial proportion of patients with advanced cancer visited the ED, including during the final month of life. Earlier palliative care referrals were associated with fewer end-of-life ED visits, 'emphasizing the importance of timely integration of [palliative care] to reduce unnecessary interventions and ensure goal-concordant care,' the authors wrote. The researchers also noted that the findings underscore the need for structured advance care planning discussions across care settings to enhance the quality of end-of-life care. SOURCE: This study, led by Ye Sul Jeung, MD, Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Republic of Korea, was published online in JAMA Network Open. LIMITATIONS: The single-center design limited the generalizability of the findings to other settings. This study could not capture data from other EDs where patients may have sought care, potentially leading to incomplete information. Moreover, this study did not consider the complex decision-making processes leading to ED visits, and lacked data on symptom burden or home circumstances to assess the necessity of the visits. DISCLOSURES: This research was supported by a grant from the Patient-Centered Clinical Research Coordinating Center, funded by the Ministry of Health and Welfare, Republic of Korea. The authors disclosed having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
RNZ News
5 days ago
- Business
- RNZ News
Award-winning journalist Peter Ryan dies, leaving 'significant legacy'
Peter Ryan. Photo: Supplied / Peter Ryan Former ABC journalist and Walkley Award-winner Peter Ryan OAM has died aged 64 in Sydney, his family has confirmed. Ryan retired from the ABC in June after 45 years in the industry, as he moved into palliative care. He had metastatic thyroid cancer, first diagnosed in 2014, and wanted to focus on his wife Mary Cotter, daughter Charlotte, and other family and friends. Ryan's many career highlights included being the ABC's Washington bureau chief, head of TV news and current affairs in Victoria, executive producer of Business Breakfast, founding editor of Lateline Business, which later became The Business, and the ABC's business editor. He was a senior business correspondent from 2016 until he retired. ABC News director Justin Stevens said Peter left a "significant legacy." "Through his mentorship, friendship, and professionalism, he directly touched the lives of many at the ABC," he said. "Through his journalism, he had a profound impact on the lives of Australians and our society. It was a privilege to know him and work alongside him." In 2017, Ryan won a Walkley award for his exposé on the Commonwealth Bank scandal. His coverage contributed to the calling of the banking royal commission, and in 2018, he was the National Press Club finance journalist of the year for his coverage of the commission. Ryan began his career as a copyboy and cadet on Sydney's Daily Mirror before he joined the ABC and took on foreign correspondent, senior manager, and executive producer roles. In 2022, he was recognised with the Order of Australia medal for his significant service to journalism. When Ryan retired, Treasurer Jim Chalmers said: "Peter Ryan is an absolute legend. Every day as you wake up and you think about what's happening in the economy, if you only needed to listen to one voice to be sure that you got its essential elements, it would be Peter's." When he left the ABC, Ryan wrote a note for "younger and older colleagues alike". He ended with "a few words of editorial advice": "Avoid cynicism - be passionate," he said. "A good team can often be a very small team - I've worked in some of the best. "Be proactive - come to the table with a great story so no-one else comes up with a dud that might waste your time. "Work closely with top people - shut up and absorb like a sponge. "Maintain a fastidious contact book - some low-profile contacts could soon move into higher-powered roles or, more importantly, work in backrooms where the big decisions are often made. "Show up to work early and prove that you're ready to take on the big story of the day. Try to have a Plan B in your back pocket just in case your original brilliant idea doesn't go anywhere and the EP comes walking your way. "Finally: Be kind and caring to people who need it." -ABC
ABC News
5 days ago
- Business
- ABC News
Walkley Award-winning ABC journalist Peter Ryan dies, leaving 'significant legacy'
Former ABC journalist and Walkley Award-winner Peter Ryan OAM has died aged 64 in Sydney, his family has confirmed. Ryan retired from the ABC in June after 45 years in the industry, as he moved into palliative care. He had metastatic thyroid cancer, first diagnosed in 2014, and wanted to focus on his wife Mary Cotter, daughter Charlotte, and other family and friends. Ryan's many career highlights included being the ABC's Washington bureau chief, head of TV news and current affairs in Victoria, executive producer of Business Breakfast, founding editor of Lateline Business, which later became The Business, and the ABC's business editor. He was a senior business correspondent from 2016 until he retired. ABC News director Justin Stevens said Peter left a "significant legacy." "Through his mentorship, friendship, and professionalism, he directly touched the lives of many at the ABC," he said. "Through his journalism, he had a profound impact on the lives of Australians and our society. It was a privilege to know him and work alongside him." In 2017, Ryan won a Walkley award for his exposé on the Commonwealth Bank scandal. His coverage contributed to the calling of the banking royal commission, and in 2018, he was the National Press Club finance journalist of the year for his coverage of the commission. Ryan began his career as a copyboy and cadet on Sydney's Daily Mirror before he joined the ABC and took on foreign correspondent, senior manager, and executive producer roles. In 2022, he was recognised with the Order of Australia medal for his significant service to journalism. When Ryan retired, Treasurer Jim Chalmers said: "Peter Ryan is an absolute legend. Every day as you wake up and you think about what's happening in the economy, if you only needed to listen to one voice to be sure that you got its essential elements, it would be Peter's." When he left the ABC, Ryan wrote a note for "younger and older colleagues alike". He ended with "a few words of editorial advice": "A good team can often be a very small team — I've worked in some of the best. "Be proactive — come to the table with a great story so no one else comes up with a dud that might waste your time. "Work closely with top people — shut up and absorb like a sponge. "Maintain a fastidious contact book — some low-profile contacts could soon move into higher-powered roles or, more importantly, work in backrooms where the big decisions are often made. "Show up to work early and prove that you're ready to take on the big story of the day. Try to have a Plan B in your back pocket just in case your original brilliant idea doesn't go anywhere and the EP comes walking your way.
CTV News
14-07-2025
- CTV News
German doctor goes on trial for 15 murders
The 40-year-old palliative care specialist, named by German media as Johannes M., is alleged to have killed 12 women and three men between September 2021 and July 2024 while working in Berlin.
ABC News
14-07-2025
- Health
- ABC News
German doctor accused of murdering his patients and covering up evidence in fires stands trial
The criminal trial of a German doctor accused of murdering 15 of his patients in palliative care has begun in Berlin. The prosecutor's office brought charges against the 40-year-old doctor "for 15 counts of murder with premeditated malice and other base motives" before a Berlin state court. Prosecutors are seeking not only a conviction and a finding of "particularly serious" guilt, but also a lifetime ban on practising medicine and subsequent preventive detention. Murder charges in Germany carry a maximum sentence of life in prison. If a court establishes that the defendant bears particularly severe guilt, that means he wouldn't be eligible for release after 15 years. Parallel to the trial, the prosecutor's office is investigating dozens of other suspected cases in separate proceedings. The man, who has only been identified as Johannes M in line with German privacy rules, is also accused of trying to cover up evidence of the murders by starting fires in the victims' homes. He has been in custody since August 6. The doctor was part of a nursing service's end-of-life care team in the German capital and was initially suspected in the deaths of just four patients. That number has crept higher since last summer, and prosecutors are now accusing him of the deaths of 15 people between September 22, 2021, and July 24 last year. The victims' ages ranged from 25 to 94, and most died in their own homes. The doctor allegedly administered an anaesthetic and a muscle relaxer to the patients without their knowledge or consent. The cocktail of drugs then allegedly paralysed the respiratory muscles. Prosecutors claim that the alleged victims experienced respiratory arrest and death within minutes. The doctor did not agree to an interview with a psychiatric expert ahead of the trial, German news agency Deutsche Presse-Agentur (DPA) reported. The expert will therefore observe the defendant's behaviour in court and hear statements from witnesses in order to give an assessment of the man's personality and culpability. So far, it is unclear what the palliative care physician's motive might have been, DPA reported. The victims named in the indictment were all seriously ill, but their deaths were not imminent. The defendant will not make a statement to the court for the time being, his defence lawyer Christoph Stoll said, according to DPA. The court has initially scheduled 35 trial dates for the proceedings until January 28, 2026. According to the court, 13 relatives of the deceased are represented as co-plaintiffs. There are several witnesses for each case, and around 150 people in total could be heard in court, DPA reported. Among the cases now being heard in court is that of a 56-year-old woman who died in September. On September 5, the doctor allegedly administered an anaesthetic and a muscle relaxant to the physically weakened woman in her home without any medical need. Fearing discovery, he then allegedly made an emergency call and falsely stated that he had found the woman in a "condition requiring resuscitation," according to the indictment. Rescue workers were able to resuscitate the woman and took her to hospital, DPA reported. The indictment said that "in continuation of his plan of action and in the knowledge of the injured party's living will", according to which the woman did not want any life-prolonging measures, the doctor is said to have called one of her daughters and apologised for violating this will. With the consent of both daughters, artificial respiration was discontinued and the woman died on September 8 in a Berlin hospital. An investigation into further suspected deaths is continuing. A specially-established investigation team in the homicide department of the Berlin State Criminal Police Office and the Berlin public prosecutor's office investigated a total of 395 cases. In 95 of the cases, initial suspicion was confirmed and preliminary proceedings were initiated. In five cases, the initial suspicion was not substantiated. In 75 other cases, investigations are still ongoing in separate proceedings. Five exhumations are still planned for this separate procedure, prosecutors said. Among the cases still being investigated is the death of the doctor's mother-in-law, who was suffering from cancer, court spokesman Sebastian Büchner said. Local media reported that she died during a visit by the doctor. In 2019, a German nurse who murdered 87 patients by deliberately bringing about cardiac arrests was given a life sentence. Earlier this month, German investigators in the northern town of Itzehoe said they were examining the case of a doctor who has been suspected of killing several patients. AP
