Welcome to the first Surgical Palliative Care Journal Club, the second of a six-part series focused on the integration of palliative care into the practice of surgery.  Join us as we discuss the first study of how to best integrate palliative medicine principles into the care of trauma ICU patients.  We then tackle the question:  Why are surgeons often unwilling to discontinue life-sustaining treatments in the post-operative period?   We discuss a 2013 study about “surgical buy-in” and review alternatives to making “informal contracts” with patients before surgery.  

References:
Mosenthal AC, Murphy PA, Barker LK, et al. Changing the culture around end-of-life care in the trauma intensive care unit. J Trauma. 2008;64(6):1587-1593. doi:10.1097/TA.0b013e318174f112.

Schwarze ML, Redmann AJ, Alexander GC, Brasel KJ. Surgeons expect patients to buy-in to post-operative life support preoperatively: results of a national survey. Crit Care Med. 2013;41(1):1-8. doi: 10.1097/CCM.0b013e31826a4650.

Dr. Red Hoffman (@redmdnd) is an acute care surgeon and associate hospice medical director in Asheville, North Carolina, host of the Surgical Palliative Care Podcast (@surgpallcare) and co-founder of the recently launched Surgical Palliative Care Society (www.spcsociety.org). 

Dr. Zara Cooper (@zaracMD) is an acute care surgeon at Brigham and Women’s Hospital where she serves as Kessler Director for the Center of Surgery and Public Health (@csph_bwh).  She is Associate Professor of Surgery at Harvard Medical School, associate faculty at Adriane Labs, and adjunct faculty at the Marcus Institute for Aging Research. 

Dr. Amanda Stastny (@manda_plez) is a PGY-2 in the General Surgery program at Mountain Area Health Education Center (MAHEC) in Asheville, NC.

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