Affiliation: University of Toronto
- Ethical considerations for classifying patients as 'palliative' when calculating Hospital Standardised Mortality RatiosJames Downar
Department of Medicine, University Health Network, Toronto, Canada
J Med Ethics 36:387-90. 2010..Finally, we propose an organisational ethics framework, and six specific suggestions for hospitals to use when publishing statistics such as the HSMR...
- The "surprise question" for predicting death in seriously ill patients: a systematic review and meta-analysis.James Downar
CMAJ 189:E484-E493. 2017..Further studies are needed to develop accurate tools to identify patients with palliative care needs and to assess the surprise question for this purpose...
- Guidelines for the withdrawal of life-sustaining measuresJames Downar
Divisions of Critical Care Medicine and Palliative Care, University of Toronto, Toronto, Canada
Intensive Care Med 42:1003-17. 2016..Hence, we sought to develop guidelines for the process of withdrawing life-sustaining measures in the clinical setting...
- Standardized patient simulation versus didactic teaching alone for improving residents' communication skills when discussing goals of care and resuscitation: A randomized controlled trialJames Downar
1 Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada
Palliat Med 31:130-139. 2017..Communication skills are important when discussing goals of care and resuscitation. Few studies have evaluated the effectiveness of standardized patients for teaching medical trainees to communicate about goals of care...
- The desirability of an Intensive Care Unit (ICU) clinician-led bereavement screening and support program for family members of ICU Decedents (ICU Bereave)James Downar
Divisions of Critical Care and Palliative Care, Department of Medicine, University of Toronto, Toronto, ON, Canada M5G 2C4 Electronic address
J Crit Care 29:311.e9-16. 2014..We determined the desirability and need for an intensive care unit-based bereavement screening and support program for these FMs...
- Changes in end of life care 5 years after the introduction of a rapid response team: a multicentre retrospective studyJames Downar
Critical Care and Palliative Care, University Health Network, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada Electronic address
Resuscitation 84:1339-44. 2013..We sought to study the effect of introducing an RRT on EOLC at our institutions, and compare the EOLC care received by patients who were consulted by the RRT with that of patients who were not consulted by the RRT...
- Rapid response teams, do not resuscitate orders, and potential opportunities to improve end-of-life care: a multicentre retrospective studyJames Downar
Critical Care and Palliative Care, University Health Network, 9N 926, Toronto, Canada, M5G 2C4
J Crit Care 28:498-503. 2013..To learn more about the role of the RRT in EOLC at our institutions, we conducted a retrospective review...
- Survival duration among patients with a noncancer diagnosis admitted to a palliative care unit: a retrospective studyJames Downar
University Health Network, Toronto, Ontario, Canada
J Palliat Med 15:661-6. 2012..Anecdotally, PCUs further restrict admission of patients with noncancer diagnoses out of fear that they will "oversurvive" and reduce bed availability. This raises concerns that noncancer patients have unequal access to PCU resources...
- Using standardized family members to teach communication skills and ethical principles to critical care traineesJames Downar
Faculty of Medicine, University of Toronto, Ontario, Canada
Crit Care Med 40:1814-9. 2012..We sought to determine the effectiveness of standardized family members for improving communication skills and ethical and legal knowledge of senior intensive care unit trainees...
- Pro/con debate: should synthetic colloids be used in patients with septic shock?James Downar
Department of Medicine, Divisions of Critical Care and Palliative Medicine, University of Toronto, Toronto, Canada
Crit Care 13:203. 2009..You have been asked by the hospital chief of staff whether there should be a suspension of the use of synthetic colloids until further information is available. You need to make a decision...
- Even without our biases, the outlook for prognostication is grimJames Downar
University Health Network, Toronto, Ontario, Canada
Crit Care 13:168. 2009..But even if we were flawless prognosticators, we would still be left with the larger ethical problem of what to do with prognostic information. In order to translate prognosis into recommendation, we need to know about patient values...
- What should we say when discussing "code status" and life support with a patient? A Delphi analysisJames Downar
Division of Palliative Care, Toronto General Hospital, Toronto, Ontario, Canada
J Palliat Med 13:185-95. 2010..Some authors have published effective communication styles, but there are currently no published guidelines for the content of a discussion about resuscitation or goals of care...
- Palliating a pandemic: "all patients must be cared for"James Downar
Department of Medicine, University of Toronto, Toronto, Ontario M5G 2C4, Canada
J Pain Symptom Manage 39:291-5. 2010..The authors present a mathematical and ethical justification for a palliative care surge plan and outline some of the key elements that should be included in such a plan...
- Why do patients agree to a "Do not resuscitate" or "Full code" order? Perspectives of medical inpatientsJames Downar
Department of Medicine, University of Toronto, 200 Elizabeth St 9N 926, Toronto M5G 2C4, Canada
J Gen Intern Med 26:582-7. 2011....
- The impact of the Rasouli decision: a Survey of Canadian intensivistsDavid Cape
Department of Medicine, University of Toronto, Toronto, Canada
J Med Ethics 42:180-5. 2016..How intensive care unit (ICU) physicians perceive this ruling is unknown...