Promoting Excellence : National Workgroups : Surgeons Palliative Care Workgroup

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Palliative Care By The Surgeon articles

Mission Statement: To facilitate introduction of the precepts and techniques of palliative care to surgical practice and education in the United States and Canada by bringing together surgeons with demonstrated interest in palliative care to share resources, strategies, and expertise, and in so doing, act as a catalyst for change.

The Surgeons Palliative Care Workgroup began its work in September 2001 and completed its Recommendations to the Field summary in November 2002. Co-chaired by Geoffrey P. Dunn, MD, FACS (Medical Director of the Great Lakes Hospice, Erie, Pennsylvania), and Robert A. Milch, MD, FACS (Medical Director of the Center for Hospice and Palliative Care, Cheektowaga, New York), the 25-person workgroup's primary focus has been to raise awareness of practicing surgeons about roles and responsibilities that surgeons can assume in assisting patients with serious, life-threatening conditions. This mandate is consistent with the Principles Guiding Care at the End of Life developed by the American College of Surgeons Committee on Ethics and approved by the College's Board of Regents in February 1998.

Although the Surgeons Workgroup did not solely rely on work by subcommittee to accomplish its goals, six subcommittees were formed. To wit:

The workgroup's final meeting was held in Chicago from November 3-4, 2002. Recommendations to the Field will be posted on the Promoting Excellence and Surgeons Palliative Care Web sites after publication. The Executive Summary was published in the May 2003 issue of the Journal of the American College of Surgeons and the entire report will be published in the October 2003 edition of JACS.

Workgroup Products

  • Recommendations to the Field Summary
    Office of Promoting Excellence in End-of-Life Care: Surgeons' Palliative Care Workgroup Report to the Field. Journal of the American College of Surgeons. October 2003. Vol. 197, No. 4: 661-686.
    pdf PDF 211 KB / 26 pages


  • Journal of American College of Surgeons (JACS) (circulation: 65,000 surgeons) has featured a 20-plus article series on palliative care in surgery, the editor of which is workgroup co-chair Geoffrey Dunn, MD. You may view these articles by clicking on the download links below. JACS has compiled these articles into a publication titled Palliative Care By The Surgeon: A Compendium. For more information visit www.journalacs.org and www.sciencedirect.com. Reprinted with permission from the American College of Surgeons (Journal of American College of Surgeons).

Palliative Care By The Surgeon
Journal of the American College of Surgeons
(Monthly Series addressing End-of-Life Issues written for and by Surgeons.)

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Piotrowski MM, Paterson C, Mitchinson A, Kim HM, Kirsh M, Hinshaw DB. Massage as adjuvant therapy in the management of acute postoperative pain: A preliminary study in men. Journal of the American College of Surgeons. December 2003. Vol. 197, No. 6: 1037-1046.
pdf PDF 151 KB / 10 pages

Eachempati SR, Miller FG, Fins JJ. The surgical intensivist as mediator of end-of-life issues in the care of critically ill patients. Journal of the American College of Surgeons. November 2003. Vol. 197, No. 5: 847-853.
pdf PDF 92 KB / 7 pages

Buchman TG. Invited commentary. Journal of the American College of Surgeons. November 2003. Vol. 197, No. 5: 853-854.
pdf PDF 55 KB / 2 pages

Mosenthal AC, Murphy PA. Trauma care and palliative care: Time to integrate the two? Journal of the American College of Surgeons. September 2003. Vol. 197, No. 3: 509-516.
pdf PDF 108 KB / 8 pages

Baluss ME, Lee KF. Legal considerations for palliative care in surgical practice. Journal of the American College of Surgeons. August 2003. Vol. 197, No. 2: 323-330.
pdf PDF 106 KB / 8 pages

MacDonald N, Easson A, Mazurak V, Dunn G, Baracos V. Understanding and managing cancer cachexia. Journal of the American College of Surgeons. July 2003. Vol. 197, No. 1: 143-161.
pdf PDF 214 KB / 19 pages

Buchman T, Ray S, Wax M, Cassell J, Rich D, Niemczycki MA. Families' perceptions of surgical intensive care. Journal of the American College of Surgeons. June 2003. Vol. 196, No. 6: 977-983.
pdf PDF 96 KB / 7 pages

Surgeons Palliative Care Workgroup. Robert Wood Johnson Foundation Office of Promoting Excellence in End-of-Life Care: executive summary of the report from the field. Journal of the American College of Surgeons. May 2003. Vol. 196, No. 5: 807- 815.
pdf PDF 102 KB / 9 pages

Hinshaw, D, Pawlik T, Mosenthal A, Civetta J, Hallenbeck J. When do we stop, and how do we do it? Medical futility and withdrawal of care. Journal of the American College of Surgeons. Apr. 2003. Vol. 196, No. 4: 621-651.
pdf PDF 263 KB / 31 pages

Krouse R, Easson A, Angelos P. Ethical considerations and barriers to research in surgical palliative care. Journal of the American College of Surgeons. Mar. 2003. Vol. 196, No. 3: 469-474.
pdf PDF 95 KB / 6 pages

Thompson, A. The importance of opioid tolerance: a therapeutic paradox. Journal of the American College of Surgeons. Feb. 2003. Vol. 196, No. 2: 321-324.
pdf PDF 70 KB / 4 pages

Easson, A. Clinical research for surgeons in palliative care: challenges and opportunites. Journal of the American College of Surgeons. Jan. 2003. Vol. 196, No. 1: 141-151.
pdf PDF 142 KB / 11 pages

Dunn, G. Is this a bad day, or one of the last days? : How to recognize and respond to approaching demise. Journal of the American College of Surgeons. Dec. 2002. Vol. 195, No. 6: 879- 887.
pdf PDF 111 KB / 9 pages

Wax, M. Dilemmas within the surgical intensive care unit. Journal of the American College of Surgeons. Nov. 2002. Vol. 195, No. 5: 721-728.
pdf PDF 93 KB / 8 pages

Hinshaw D. The spiritual needs of the dying patient. Journal of the American College of Surgeons. Oct. 2002; Vol. 195, No. 4: 565-568.
pdf PDF 76 KB / 4 pages

McCahill L, Krouse R, Chu D, Juarez G, Uman G, Ferrell B, Wagman L. Decision making in palliative surgery. Journal of the American College of Surgeons. Sept. 2002; Vol. 195, No. 3: 411-422.
pdf PDF 114 KB / 4 pages

Hinshaw D, Carnahan J, Johnson D. Depression, anxiety, and asthenia in advanced illness. Journal of the American College of Surgeons. Aug. 2002; Vol 195, No. 2: 271-277.
pdf PDF 88 KB / 4 pages

Krouse R, Laurence M, Easson A, Dunn G. When the sun can set on an unoperated bowel obstruction: management of malignant bowel obstruction. Journal of the American College of Surgeons. July 2002; Vol. 195, No. 1: 117-128.
pdf PDF 127 KB / 4 pages

Huffman J, Dunn G. The paradox of hydration in advanced terminal illness. Journal of the American College of Surgeons. June 2002; Vol 194, No. 6: 835-839.
pdf PDF 82 KB / 4 pages

Buchman T. Palliative care symposium: who should manage the dying patient?: rescue, shame, and the surgical ICU dilemma. Journal of the American College of Surgeons. May 2002; Vol. 194, No. 5: 665-673.
pdf PDF 98 KB / 4 pages

Dunn G, Milch R, Mosenthal A, Lee K, Easson A, Huffman J. Palliative care by the surgeon: how to do it. Journal of the American College of Surgeons. April 2002; Vol. 194, No. 4: 509-537.
pdf PDF 235 KB / 29 pages

Mosenthal A. Management of dyspnea at the end of life: relief for patients and surgeons. Journal of the American College of Surgeons. March 2002; Vol. 194, No. 3: 337-386.
pdf PDF 107 KB / 10 pages

Eason A, Hinshaw D, Johnson D. The role of tube feeding and total parenteral nutrition in advanced illness. Journal of the American College of Surgeons. Feb. 2002; Vol. 194, No. 2: 225-228.
pdf PDF 62 KB / 4 pages

Mosenthal A, Lee K, Huffman J. Palliative care in the surgical intensive care unit. Journal of American College of Surgeons. Jan. 2002; Vol. 194, No. 1: 75-83.
pdf PDF 106 KB / 9 pages

Lee K, Ray J, Dunn G. Chronic pain management and the surgeon: barriers and opportunities. Journal of the American College of Surgeons. Dec. 2001; Vol. 193, No. 6: 689-701.
pdf PDF 135 KB / 13 pages

Dunn G. Patient assessment in palliative care: how to see the "big picture" and what to do when "there Is no more we can do" Journal of the American College of Surgeons. Nov. 2001; Vol. 193 No. 5: 565-573.
pdf PDF 101 KB / 9 pages

Milch R, Dunn G. Communication: part of the surgical armamentarium. Journal of the American College of Surgeons. Oct. 2001; Vol. 193, No. 4; 449-451.
pdf PDF 74 KB / 4 pages

Dunn G, Milch R. Introduction and historical background of palliative care: where does the surgeon fit in? Journal of the American College of Surgeons. Sept. 2001; Vol. 193, No. 3: 325-328.
pdf PDF 105 KB / 5 pages

Updated October 15, 2003

Surgeons Palliative Care Workgroup Membership
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Promoting Excellence in End-of-Life Care is a national program of The Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit PromotingExcellence.org for more resources.

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