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Gastrostomy and mechanical ventilation in amyotrophic lateral sclerosis: how best to support the decision-making
Krzysztof Barć1, Magdalena Kuźma-Kozakiewicz2,3,4
1Department of Neurology, University Clinical Centre of Medical University of Warsaw, ul. Stefana Banacha 1a, 02-097 Warsaw, Poland.
Abstract:
The unfavourable outcome of amyotrophic lateral sclerosis (ALS) confronts patients with challenging decisions regarding life-sustaining measures. The decision-making process is usually triggered by medical consultations and patient-dependent factors. This may largely depend on the physician's depth of knowledge and professional experience. This paper presents an overview of the life-sustaining methods used in ALS and their effects on disease progression, survival and quality of life of patients and their caregivers. It is intended to aid physicians in their discussions with patients. We interrogate all the positive and negative facets of life-sustaining measures that may allow for optimisation of the decision-making process and care provision.
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