Academy of Neurology Issues Revised Position Statement on Neuropalliative Care 

The American Academy of Neurology (AAN) has issued a revision of the ethical statement for neurologists on palliative care for neurologic diseases. The statement covers the importance of communication between doctor to patient.

The position statement emphasizes the discussion of prognosis of the disease with patients to instill security in order to set future goals. Regular conversations between doctor and patient, and possible family, should be scheduled in order to prepare for decision making as neurologic diseases progress.
Regular checkups are recommended for individuals who are in stroke recovery to improve communication skills and to make advance care planning. 

Treatment goals should be made earlier for individuals with ALS before physical weakness develops. When a person is paralyzed, finding ways to communicate, including alternative and augmentative communication, that best suit the individual's needs is recommended. 

When diagnosis and prognosis is yet to be determined in individuals with possible disorders of consciousness repeated evaluations may be necessary for decision-making capacity, disease trajectory, and psychologic state. Advanced care planning is essential for all progressive neurologic diseases.

The statement also explains the right to refuse life-sustaining treatments under the ethical principle of respect for autonomy. The doctor’s focus should remain on maintaining quality of life procedures and the patient’s comfort as much as possible for those in end-of-life care.

The Ethics, Law, and Humanities Committee, a joint committee of the AAN, American Neurological Association and Child Neurology Society, developed the statement.