Palliative Care in the Context of NORSE and FIRES
Summary:
The complexity, severity, and uncertainty of NORSE and FIRES can raise sensitive questions around communication and decision-making, including the potential role of palliative care. This evolving field is especially relevant in critical care settings, where physicians and families often navigate uncharted territory.
Two notable publications address these challenges directly:
“Communication Challenges in NORSE” – Published in Mayo Clinic Proceedings (May 2019), this article explores the nuances of discussing care goals in the context of NORSE. Read the article: Mayo Clinic Proceedings
“The Role of Hope, Compassion, and Uncertainty in Physicians’ Reluctance to Initiate Palliative Care” – Published in AMA Journal of Ethics (2018), this article examines emotional and systemic barriers to integrating palliative care in complex neurological cases. Read the article: AMA Journal of Ethics
Recommended Reading List (curated by Teneille Gofton, MD, FRCPC, Western University, Canada):
These key texts explore the integration of palliative care into neurological and intensive care settings:
Boersma et al. Palliative care and neurology: Time for a paradigm shift. Neurology, 2014; 83(6):561–7
Hua M, Wunsch H. Integrating palliative care in the ICU. Curr Opin Crit Care, 2014; 20:673–680
Cook D, Rocker G. Dying with Dignity in the Intensive Care Unit. N Engl J Med, 2014; 370:2506–14
Kelley A, Morrison R. Palliative Care for the Seriously Ill. N Engl J Med, 2015; 373:747–55
Frontera JA et al. Integrating Palliative Care Into the Care of Neurocritically Ill Patients: A Report from the Improving Palliative Care in the ICU Project Advisory Board. Crit Care Med, 2015; 43(9):1964–77
