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Palliative psychiatry and futility in psychiatric care are under-addressed. This study presents 3 cases of patients with psychosis experiencing fatal outcomes, highlighting the importance of palliative care and interdisciplinary collaboration.

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Area of Science:

  • Psychiatry
  • Palliative Care
  • Medical Ethics

Background:

  • End-of-life care discussions are common in medicine, but palliative psychiatry and futility in psychiatric care remain underexplored.
  • Psychiatric conditions can complicate end-of-life care, presenting unique challenges for patients and clinicians.
  • The concept of futility in psychiatric treatment is particularly complex and requires careful consideration.

Purpose of the Study:

  • To explore the complexities of end-of-life care in psychiatry through case studies.
  • To illustrate scenarios where psychiatric conditions intersect with fatal medical outcomes.
  • To emphasize the role of palliative care and interdisciplinary collaboration in managing these challenging cases.

Main Methods:

  • Presentation of three distinct clinical cases.
  • Detailed description of patient presentations, including primary psychosis, secondary psychosis, and factitious disorder.
  • Analysis of the collaborative approach between psychiatric and medical teams.

Main Results:

  • Case 1: A patient with treatment-resistant schizophrenia who self-starved.
  • Case 2: A patient with small cell lung cancer experiencing psychosis due to a paraneoplastic syndrome.
  • Case 3: A patient with self-induced aplastic anemia from chemotherapy ingestion.

Conclusions:

  • Collaborative teamwork between psychiatric and medical professionals is crucial for optimal patient and family support during end-of-life care.
  • Palliative care integration can significantly benefit patients facing fatal prognoses, even when psychiatric symptoms are primary or secondary.
  • Addressing futility in psychiatry requires a multidisciplinary approach focused on patient well-being and support.