John M Luce

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Increasingly in the United States and other countries, medical decisions, including those at the end of life, are made using a shared decision-making model. Under this model, physicians and other clinicians help patients clarify their values and reach consensus about treatment courses consistent with them. Because most critically ill patients are(More)
Positive end-expiratory pressure (PEEP) is used to improve oxygenation in patients with the adult respiratory distress syndrome. Nevertheless, this treatment may increase intracranial pressure (ICP) and be detrimental to certain neurosurgical patients. This clinical situation was simulated by administering PEEP to dogs with normal and elevated ICP.(More)
OBJECTIVE The purpose of this study was to determine the extent to which data entry forms, guidelines, and other materials used for documentation in intensive care units (ICUs) attend to 6 key end-of-life care (EOLC) domains: 1) patient and family-centered decision making, 2) communication, 3) continuity of care, 4) emotional and practical support, 5)(More)
A moribund and debilitated patient arrives in an emergency department and is placed on life support systems. Subsequently it is determined that she has a 'living will' proscribing aggressive measures should her condition be judged 'terminal' by her physicians. But, as our round table of authorities reveal, the concept of 'terminal' means different things to(More)
OBJECTIVE There are numerous challenges to successfully integrating palliative care in the intensive care unit. Our primary goal was to describe and compare the quality of palliative care delivered in an intensive care unit as rated by physicians and nurses working in that intensive care unit. DESIGN Multisite study using self-report questionnaires. (More)
15 patients with first episodes of Pneumocystis carinii pneumonia and the acquired immunodeficiency syndrome were treated with only aerosolised pentamidine, which they inhaled for 20 minutes every day for 21 days. 13 of the 15 responded to therapy. Mean PaO2 (mm Hg) and vital capacity (% predicted) were 67.9 and 50.8 before therapy and 80.1 and 67.9 after(More)
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