{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T21:26:15Z","timestamp":1771104375913,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T00:00:00Z","timestamp":1705622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100015483","name":"McDonald Agape Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>For older persons with delirium at the end of life, treatment involves complex trade\u2010offs and highly value\u2010sensitive decisions. The principles of beneficence, nonmaleficence, respect for autonomy, and justice establish important parameters but lack the structure necessary to guide clinicians in the optimal management of these patients. We propose a set of ethical rules to guide therapeutics\u2014the canons of therapy\u2014as a toolset to help clinicians deliberate about the competing concerns involved in the management of older patients with delirium at the end of life. These canons are standards of judgment that reflect how many experienced clinicians already intuitively practice, but which are helpful to articulate and apply as basic building blocks for a relatively neglected but emerging ethics of therapy. The canons of therapy most pertinent to the care of patients with delirium at the end of life are as follows: (1) restoration, which counsels that the goal of all treatment is to restore the patient, as much as possible, to homeostatic equilibrium; (2) means\u2010end proportionality, which holds that every treatment should be well\u2010fitted to the intended goal or end; (3) discretion, which counsels that an awareness of the limits of medical knowledge and practice should guide all treatment decisions; and (4) parsimony, which maintains that only as much therapeutic force as is necessary should be used to achieve the therapeutic goal. Carefully weighed and applied, these canons of therapy may provide the ethical structure needed to help clinicians optimally navigate complex cases.<\/jats:p>","DOI":"10.1111\/jgs.18766","type":"journal-article","created":{"date-parts":[[2024,1,19]],"date-time":"2024-01-19T05:53:57Z","timestamp":1705643637000},"page":"1964-1972","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Drugs, delirium, and ethics at the end of life"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9395-5380","authenticated-orcid":false,"given":"Columba","family":"Thomas","sequence":"first","affiliation":[{"name":"Kennedy Institute of Ethics Georgetown University  Washington DC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yesne","family":"Alici","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center  New York New York USA"},{"name":"Weill Cornell Medical College  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Breitbart","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Bruera","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Rehabilitation, and Integrative Medicine The University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3008-5941","authenticated-orcid":false,"given":"Liz","family":"Blackler","sequence":"additional","affiliation":[{"name":"Ethics Committee, Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel 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