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When a Chance to Cut Is Not a Chance to Cure: A Future for Palliative Surgery?

When a Chance to Cut Is Not a Chance to Cure: A Future for Palliative Surgery? In the context of healthcare reform, Surgery stands at a critical juncture. Attempting to rein in healthcare spending, legislators and payers can be expected to closely examine the legitimacy and necessity of a variety of medical treatments, including surgical procedures. Among these procedures, the most at risk for dismissal based on perceived ineffectiveness or lack of need may be those performed near the end of life, when the potential benefit of surgical intervention may seem negligible. While procedures may be performed for a variety of reasons toward the end of life—some indeed being inappropriate and/or unnecessary—palliative surgery plays an important role in the management of incurable disease. The purposes of this article are to: describe the place for palliative surgery in the armamentarium of palliative care; discuss potential challenges to patients’ access to palliative surgery that may arise from health policy or quality initiatives based on poor evidence; and outline a strategy for (a) systematically differentiating palliative surgeries from other, potentially expendable surgeries performed near the end of life, and (b) defining a plan for generating the evidence base to support best practice. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annals of Surgical Oncology Springer Journals

When a Chance to Cut Is Not a Chance to Cure: A Future for Palliative Surgery?

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References (15)

Publisher
Springer Journals
Copyright
Copyright © 2011 by Society of Surgical Oncology
Subject
Medicine & Public Health; Surgery; Oncology; Surgical Oncology
ISSN
1068-9265
eISSN
1534-4681
DOI
10.1245/s10434-011-1787-z
pmid
21584829
Publisher site
See Article on Publisher Site

Abstract

In the context of healthcare reform, Surgery stands at a critical juncture. Attempting to rein in healthcare spending, legislators and payers can be expected to closely examine the legitimacy and necessity of a variety of medical treatments, including surgical procedures. Among these procedures, the most at risk for dismissal based on perceived ineffectiveness or lack of need may be those performed near the end of life, when the potential benefit of surgical intervention may seem negligible. While procedures may be performed for a variety of reasons toward the end of life—some indeed being inappropriate and/or unnecessary—palliative surgery plays an important role in the management of incurable disease. The purposes of this article are to: describe the place for palliative surgery in the armamentarium of palliative care; discuss potential challenges to patients’ access to palliative surgery that may arise from health policy or quality initiatives based on poor evidence; and outline a strategy for (a) systematically differentiating palliative surgeries from other, potentially expendable surgeries performed near the end of life, and (b) defining a plan for generating the evidence base to support best practice.

Journal

Annals of Surgical OncologySpringer Journals

Published: May 17, 2011

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