Cancer Care Ethics in the Emergency Center
The emergency center (EC) is a technical, specialized, fast-paced environment where time is of the essence. Falling into a process by which the need for immediate response overshadows the need for ethical examination of important aspects of patient care is easy. Our purpose is to provide clinicians with some ethical considerations that can be made and reduce challenges to caring for the cancer patient in the EC. Cancer patients are often seen in ECs because of issues at the end of life, uncontrolled physical pain, and psychosocial or coping issues. This chapter deals with some of these and other common issues, including delirium, quickly changing condition, and possible drug-seeking behaviors for coping. Also considered are clinician responses to these as well as issues to recognize when assisting patients and their surrogates with decision-making during these difficult times. Case examples, discussion of the ethical challenges, and suggestions for the clinician and health care team are used to highlight and examine some of the ethical dilemmas faced in the EC.
KeywordsEthics Informed consent Decision-making Refusal Drug-seeking Delirium Pain
The authors express their appreciation to John T. Patlan, M.D., Associate Professor in the Department of General Internal Medicine at MD Anderson, for sharing his knowledge and wisdom during the writing of this chapter.
- American College of Emergency Physicians, American Pain Society, American Society for Pain Management Nursing, Emergency Nurses Association. Optimizing the treatment of pain in patients with acute presentations. https://www.acep.org/Clinical---Practice-Management/Optimizing-the-Treatment-of-Pain-in-Patients-with-Acute-Presentations/ (2012).
- American College of Emergency Physicians. American College of Emergency Physicians’ policy compendium. http://www.acep.org/content.aspx?id=83797 (2012).
- American College of Emergency Physicians. Code of ethics for emergency physicians. http://www.acep.org/Content.aspx?id=29144 (2011).