Need help finding a palliation issue

I am not sure what you mean by "palliation" issue. Like palliative care? If so, a big topic right now is "Death with Dignity" and whether people with terminal illnesses should be able to decide when they want to die. Might be too much of an ethical issue to really be able to support only one side, however you could support both sides and explain the changes/consequences both might have on society and healthcare.

Opps sorry. yes Palliative care. I was thinking to do something like that, as that is a very interesting topic, but I feel that everyone in my class is going to do that. So I just wanted to see if there were other topics out there. I may wind up just doing that topic. Thank you =)

If you want a different topic, you could talk about the "burnout" associated with nurses/healthcare workers who experience it and what could be done to release emotions when dealing with palliative patients.

Or if you are interested in peds, palliative care in in the pediatric population, pediatric issues seem to always be a very pressing issue. An example would be like the story/book/movie that is portrayed in "My Sister's Keeper". The mom, definitely wanted the daughter with cancer to do every treatment possible, no matter the stage, but the daughter wanted to stop treatment. However, the daughter was still a minor; should her wishes have more power over her legal guardian, her mom?

If you want a different topic, you could talk about the "burnout" associated with nurses/healthcare workers who experience it and what could be done to release emotions when dealing with palliative patients.

Or if you are interested in peds, palliative care in in the pediatric population, pediatric issues seem to always be a very pressing issue. An example would be like the story/book/movie that is portrayed in "My Sister's Keeper". The mom, definitely wanted the daughter with cancer to do every treatment possible, no matter the stage, but the daughter wanted to stop treatment. However, the daughter was still a minor; should her wishes have more power over her legal guardian, her mom?

I once had a 17 10/12 yr old female with terminal brain cancer who had a scan that showed progression... Mom wanted to continue treatment, she did not. To the point where she started trying to pull her port needle out. Ethics team agreed with the patient.

The issue I have in this situation is should we even be offering these treatments to parents whose children are nearing the end of their lives? I have seen it go both ways from the medical side. I have seen doctors scouring the globe to find a phase I trial they can offer parents whose child is on his 5th relapse of leukemia in 3 years. The phase I trial will never help this child- he is going to die and may suffer unnecessarily in the process. At the same time, phase I trials are needed before we progress to phase II and III trials. And I've seen doctors tell parents "there is nothing more that can be done" and offer only for the child to be admitted to the hospital on comfort care or to go home with hospice.

How about when palliative care is clearly indicated--either the patient wants it or can't speak for himself--and the family still wants "everything done?"

How about when palliative care is clearly indicated--either the patient wants it or can't speak for himself--and the family still wants "everything done?"

Any time something like this comes up, I will always, always, always remember a patient from one day in clinical. My clinical instructor sent me to the MICU for the day. The patient was a young-ish (40s or 50s) man with end stage multiple myeloma. He was a life long bachelor and his parents had passed so his siblings were next-of-kin. In his chart, was a copy of a living will. "I do not want CPR. I do not want a feeding tube. I do not want a ventilator." He was intubated, a full code with tubes in every orifice of his body- central line, ET tube, NG tube, foley, rectal tube. When I asked the nurse while all these interventions were being done when the man had clearly stated his wishes in his living will she said that the siblings "thought he would want everything done." If my family ever did that to me, I'd haunt the hell out of them after I finally died.