Unilateral DNR? Gina Piscitello, Erin DeMartino, Will Parker
GeriPal - A Geriatrics and Palliative Medicine Podcast
Release Date: 02/19/2026
Who Should Deliver Palliative Care in Liver Disease? Chris Woodrell, Manisha Verma, Marie Bakitas
GeriPal - A Geriatrics and Palliative Medicine Podcast
Who's better at delivering palliative care to patients with liver disease: palliative care specialists, or hepatologists who have received liver disease-specific palliative care training? That’s the question we take a deep dive into on this week's podcast by breaking down the We’ve invited three of the trial's authors, , , and , to discuss this cluster-randomized clinical trial spanning 19 U.S. medical centers. We’ll discuss: Why was this trial done? Do we really need to run a separate palliative care trial for every single organ disease? What kind of specialized palliative...
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Why you should care about the shakeup at NIH: Sean Morrison, Ken Covinsky, Stacy Fischer
GeriPal - A Geriatrics and Palliative Medicine Podcast
Emergency Podcast! Our guests Sean Morrison, Ken Covinsky, and Stacy Fischer believe that you should care deeply about the proposed shakeup at the National Institutes of Health. Major at the would affect a huge range of government grants, from Headstart to Transportation to the National Science Foundation, as well as the National Institutes of Health (NIH), the subject of today’s podcast. You dear listeners should all care. You should care because you care for older adults, or you’re a researcher who studies palliative care, or you're a chaplain who visited with the family of...
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How We Limit Non-beneficial Life Sustaining Treatments: Jason Batten, Liz Dzeng, Teva Brender
GeriPal - A Geriatrics and Palliative Medicine Podcast
Today’s podcast is a natural follow up to our podcasts on and .Today we talk about a new study about how clinicians , published in JAMA Network Open. Do they adhere to society guidelines, which allow as permissible approaches only shared decision-making and following institutional policy. Or do they take alternative approaches, like not offering interventions, not mentioning interventions, or simply stating a plan to limit interventions? Turns out doctors are using these alternative approaches frequently. Our guests are Jason Batten, Liz Dzeng, and Teva Brender, all clinicians, all of...
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Elder Mistreatment Prevention and Solutions: Carrie Rubenstein, Julia Hiner, & Tony Rosen
GeriPal - A Geriatrics and Palliative Medicine Podcast
Today we revisit a topic we last discussed in a : elder mistreatment. Our guests today are geriatricians Carrie Rubenstein and Julia Hiner, and Tony Rosen, an emergency medicine doctor. They talk about where we are now, in 2026, with elder mistreatment, including: Terminology: elder mistreatment vs. abuse and neglect The need to incorporate prevention and solutions into how we talk about mistreatment This is not rocket science. Studying elder mistreatment is much harder than rocket science. Highlighting the reasons they focus on elder mistreatment, including inspiring words for...
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CCRCs, ALFs, and Private Equity: John Burton, Bill Applegate, & Melissa Aldridge
GeriPal - A Geriatrics and Palliative Medicine Podcast
Two retired luminaries in geriatrics join us today to share their personal experiences. First, John Burton, a geriatrician and Director of the Division of Geriatric Medicine at Johns Hopkins for some 35 years, shares his journey moving into a Continuing Care Retirement Community (CCRC) during Covid. You can read about John’s early experiences in his JAGS commentary titled, The tone is bleak. John’s experience since Covid, as you’ll hear, is very positive. Many of the concerns he raised about isolation have been addressed. Second, we hear from Bill Applegate,...
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Search for Geriatrician Identity: Mary Tinetti, Helen Fernandez, Jerry Gurwitz, Ken Covinsky
GeriPal - A Geriatrics and Palliative Medicine Podcast
Our focus today is on the search for the geriatrician identity, a continuation of the conversation we started with Jerry Gurtwitz on the . Today’s conversation is prompted by multiple articles in JAGS: (1) an article with a title the same as this podcast; (2) an article by Helen Fernandez on “”, a new combined 4 year internal medicine residency and geriatrics fellowship track; and (3) an article by Mary Tinetti titled, “?” Of note, Mary’s article is a follow up to her 2017 in which she wrote: Those outside the field have difficulty understanding what geriatrics is and...
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The Interior Experience of Prescribing Medical Aid in Dying: Carly Zapata and Dani Chammas
GeriPal - A Geriatrics and Palliative Medicine Podcast
I had the privilege of learning from fellow Lisa Harris about a term she termed, “.” As an ob/gyn and abortion provider, Lisa found the debate around the legality of abortion so polarizing that it created a false dichotomy: you’re either for or against. Any talk about misgivings, uncertainty, ambiguity, or ambivalence was silenced. Talking about these issues in the face of polarization was deemed dangerous and undermining to one side or another. “How could you?” For Lisa’s work in finding common ground and embracing nuance she was awarded the for forging...
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Navigating Organ Donation Discussions: Toby Campbell, Nikole Neidlinger, Samantha Taylor
GeriPal - A Geriatrics and Palliative Medicine Podcast
While we have previously discussed t, we have yet to explore the complex landscape families face regarding organ donation. In this episode, we dive into the nuances of Donation after Brain Death (DBD) and Donation after Circulatory Death (DCD), and clarify the essential role of healthcare providers who are not part of an organ procurement organization. In this episode of the GeriPal Podcast, we step into a space in serious illness care that is often misunderstood, overlooked, or reduced to a simple "call the organ donation network" checklist item. Joining us are three experts to help us...
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Dermatology in Older Adults (GeriDerm): Daniel Butler and Eleni Linos
GeriPal - A Geriatrics and Palliative Medicine Podcast
In this episode of the GeriPal podcast, we dive into the fascinating world of geriatric dermatology, or “GeriDerm,” with two exceptional guests: and . First, we tackle the big question: how do we keep our skin healthy as we age? I see this on a daily basis with my own skin, but I’m unsure what to do about it, including whether we all need to use sun protection and moisturizers, and if so, which ones? Then we explore the lag time to benefit in dermatology by examining whether we need to treat every actinic keratosis and basal cell carcinoma aggressively, or whether...
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GeriPal Live from Sao Paulo! Eduardo Ferriolli, Marlon Aliberti, & Edison Iglesias
GeriPal - A Geriatrics and Palliative Medicine Podcast
Eric and I were delighted to be invited to Brazil to give a series of presentations in Sao Paulo at their annual geriatrics meeting. We met people doing important, interesting, and innovative work in Brazil and throughout Latin America. We got the audience to sing along, including (in another talk) the magnificent Brazilian song . For our final talk, a podcast in front of a live conference audience, we asked our 3 guests, Eduardo Ferriolli, Marlon Aliberti, & Edison Iglesias to select a recent article to discuss. We talked about: (selected by Eduardo). What is it? What...
info_outlineDo you think your hospital should allow unilateral DNR orders? Under what circumstances? Through what process? Do you think that when you obtain the assent of a family to not code their loved one, that assent DNR should be counted as a unilateral DNR order? Should we document unilateral DNR and the rationale? Why for DNR, when we don’t document unilateral dialysis not offered, or unilateral no ECMO offered? Is the assent of a family member to a statement that we will not code their loved one a nudge, and is the assent approach ethical? Reasonable people will disagree, as we do on this podcast.
Our guests today are Gina Piscitello, Erin DeMartino, and Will Parker, authors of a terrific viewpoint in JAMA about the need to address inadequate documentation of unilateral DNR orders. You might recall Gina was a guest on our lively podcast about slow codes, and we pick up where that podcast left off.
We highlight the many clinical, practical, and ethical issues at stake, including Gina’s finding that during Covid, 3% of critically ill patients receiving pressors had a unilateral DNR order. Black patients and those who spoke Spanish had higher rates of unilateral DNR. That variation should trouble those in favor of unilateral DNR orders. We talk about variation Gina found at the state and health system level, and what exactly is concerning, the variation itself, or the lack of thought and care that went into some of these policies.
Are you a heartbreaker? Dream Maker? Love taker? Don’t you mess around with me. (song hint)
-Alex