Positions

Overview

  • Dr. Keith M. Swetz is a Professor of Medicine at the University of Alabama at Birmingham School of Medicine. He is Medical Director of UAB Medicine’s Supportive Care and Survivorship Clinic, and works as an attending physician at The Kirklin Clinic of UAB Hospital, The Kirklin Clinic at Acton Road, UAB Hospital, and at Birmingham VA Medical Center. He also serves at the Ambulatory Clinical Core Leader for the Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine at UAB.

    Dr. Swetz received his M.D. degree from the Penn State College of Medicine in Hershey, Pennsylvania. He completed his internal medicine residency at the Mayo Clinic, Rochester, Minnesota and a Hospice and Palliative Medicine fellowship at the Virginia Commonwealth University in Richmond, Virginia. Dr. Swetz also earned a Master of Arts degree in Bioethics and Health Policy from Loyola University Chicago in 2012, and has a strong interest in integrating palliative care into the care of patients with heart failure and left ventricular assist devices.

    He has a passion for patient-centered, ethical decision making, particularly as it relates to advanced medical technologies like cardiac devices and hemodialysis. He has written over 100 peer-reviewed manuscripts and presented on these topics locally, regionally, nationally, and internationally.

    Dr. Swetz is happily married and he and his wife, Jessica, have four wonderful children.
  • Selected Publications

    Academic Article

    Year Title Altmetric
    2020 Letter to the Editor Regarding “Prevalence and Predictors of Burnout Among Hospice and Palliative Care Professionals”Journal of Pain and Symptom Management.  59:e3-e5. 2020
    2019 Personal-Professional Boundaries and Ethical Issues in Palliative CareAmerican Journal of Bioethics.  19:60-62. 2019
    2019 Respecting autonomy and promoting the patient’s good in the setting of serious terminal and concurrent mental illnessYale Journal of Biology and Medicine.  92:597-602. 2019
    2019 Prevalence and Predictors of Burnout among Hospice and Palliative Care Clinicians in the US.Journal of Pain and Symptom Management2019
    2019 Physician Aid-in-Dying and Suicide Prevention in Psychiatry: A Moral Imperative Over a CrisisAmerican Journal of Bioethics.  19:68-70. 2019
    2019 Improving Communication in Heart Failure Patient CareJournal of the American College of Cardiology.  74:1682-1692. 2019
    2019 Excellent Patient Care Must Be Our Priority Always, No Matter What Is Said in the MediaJournal of Palliative Care.  34:75-77. 2019
    2019 Top Ten Tips Palliative Care Clinicians Should Know about Caring for Patients with Left Ventricular Assist DevicesJournal of Palliative Medicine.  22:437-441. 2019
    2019 Surgery without a surrogate: the low prevalence of healthcare power of attorney documents among preoperative patientsHospital practice (1995).  47:28-33. 2019
    2018 Caregivers of Patients Considering a Destination Therapy Left Ventricular Assist Device and a Shared Decision-Making Intervention: The DECIDE-LVAD TrialJACC: Heart Failure.  6:904-913. 2018
    2018 Protocol driven palliative care consultation: Outcomes of the ENABLE CHF-PC pilot studyHeart & Lung: The Journal of Acute and Critical Care.  47:533-538. 2018
    2018 Educate, Nurture, Advise, Before Life Ends Comprehensive Heartcare for Patients and Caregivers (ENABLE CHF-PC): Study protocol for a randomized controlled trialTrials.  19. 2018
    2018 Palliative Care and Pulmonary HypertensionAdvances in Pulmonary Hypertension.  17:25-31. 2018
    2018 Physician perspectives on palliative care for children with advanced heart disease: A comparison between pediatric cardiology and palliative care physiciansJournal of Palliative Medicine.  21:773-779. 2018
    2018 Palliative CareAnnals of Internal Medicine.  168:ITC33-ITC48. 2018
    2018 Challenges to Safe and Effective Pain Management in Patients With Super Obesity: Case Report and Literature ReviewJournal of Pain and Symptom Management.  55:1047-1052. 2018
    2018 Developing a toolkit to measure implementation of concurrent palliative care in rural community cancer centersPalliative and Supportive Care.  16:60-72. 2018
    2018 Are physician orders for life-sustaining treatments the answer to the end-of-life care quality conundrums in cancer care?Journal of Oncology Practice.  14:7-8. 2018
    2018 Stories Matter-And Shape Our Field Every DayJournal of Palliative Care.  33:3-4. 2018
    2017 Communication Education, Modeling, and Protocols Transform Clinicians to Agents of EmpowermentAmerican Journal of Bioethics.  17:40-42. 2017
    2017 Advanced Care Planning: Pearls, Perils, Pitfalls, and PromisesJournal of Oncology Practice.  13:670-671. 2017
    2017 Palliative Care Clinicians Caring for Patients Before and After Continuous Flow-Left Ventricular Assist DeviceJournal of Pain and Symptom Management.  54:601-608. 2017
    2017 Pediatric Cardiology Provider Attitudes About Palliative Care: A Multicenter Survey StudyPediatric Cardiology.  38:1324-1331. 2017
    2017 Surrogate Decision Making When Patients Cannot Decide within the Veterans Health Administration SystemJournal of Palliative Medicine.  20:1056. 2017
    2017 Deactivation of Left Ventricular Assist Devices: Differing Perspectives of Cardiology and Hospice/Palliative Medicine CliniciansJournal of Cardiac Failure.  23:708-712. 2017
    2017 Engaging patients and families to create a feasible clinical trial integrating palliative and heart failure care: Results of the ENABLE CHF-PC pilot clinical trialBMC Palliative Care.  16. 2017
    2017 Challenges and successes in non-operative management of highgrade malignant bowel obstructionAnnals of palliative medicine.  6:S95-S98. 2017
    2017 More chemo or home hospice? Narrative results from an N-of-1 trialAnnals of palliative medicine.  6:S108-S112. 2017
    2017 Palliative Medicine and Preparedness Planning for Patients Receiving Left Ventricular Assist Device as Destination Therapy—Challenges to Measuring Impact and Change in Institutional CultureJournal of Pain and Symptom Management.  54:231-236. 2017
    2017 Top 10 Facts You Need to Know about Palliative CareJournal of the Mississippi State Medical Association.  58:218-220. 2017
    2017 I Never Thought “That Person” Could Be Me …Journal of Pain and Symptom Management.  54:e3-e5. 2017
    2017 Addressing Palliative Care Clinician Burnout in Organizations: A Workforce Necessity, an Ethical ImperativeJournal of Pain and Symptom Management.  53:1091-1096. 2017
    2017 Deactivation of Ventricular Assist Devices: Perspectives and Experiences of Adult Cardiovascular ProvidersJournal of Cardiac Failure.  23:485-486. 2017
    2017 “It Is Like Heart Failure. It Is Chronic … and It Will Kill You”: A Qualitative Analysis of Burnout Among Hospice and Palliative Care CliniciansJournal of Pain and Symptom Management.  53:901-910.e1. 2017
    2017 DESCRIBING COLLABORATION BETWEEN CARDIOLOGY AND PALLIATIVE CARE: A NATIONAL SURVEY STUDY OF CURRENT PRACTICES, CHALLENGES AND BARRIERSJournal of the American College of Cardiology.  69:2543-2543. 2017
    2017 Palliation Versus Dialysis for End-Stage Renal Disease in the Oldest Old: What are the Considerations?Palliative Care : Research and Treatment.  10. 2017
    2017 Can Anyone Be Prepared Enough for Life With an LVAD-DT?American Journal of Bioethics.  17:14-16. 2017
    2017 Characterization of prostacyclin-associated leg pain in patients with pulmonary arterial hypertensionAnnals of the American Thoracic Society.  14:206-212. 2017
    2017 Future of the Palliative Care Workforce: Preview to an Impending CrisisAmerican Journal of Medicine.  130:113-114. 2017
    2017 Feeding tubes and health care service utilization in amyotrophic lateral sclerosis: Benefits and limits to a retrospective, multicenter study using big dataINQUIRY: The Journal of Health Care Organization, Provision, and Financing.  54. 2017
    2017 Physician Aid in Dying in the US South: What Does the Future Hold?Southern Medical Journal.  110:9-10. 2017
    2016 Palliative Care Consultation and Associated End-of-Life Care After Pacemaker or Implantable Cardioverter-Defibrillator DeactivationAmerican Journal of Hospice and Palliative Medicine.  33:966-971. 2016
    2016 Dying with a Left Ventricular Assist Device as Destination TherapyCirculation: Heart Failure.  9. 2016
    2016 Response to Legalized Physician-Assisted Death: Check Yourself before You Wreck YourselfJournal of Palliative Medicine.  19:902-903. 2016
    2016 Lack of Agreement With What We Think Is Right Does Not Necessarily Equal an Ethical Problem: Respecting Patients’ Goals of CareAmerican Journal of Bioethics.  16:13-15. 2016
    2016 Palliative care for patients with end-stage cardiovascular disease and devices: A report from the palliative careworking group of the geriatrics section of the American college of cardiologyJAMA Internal Medicine.  176:1017-1019. 2016
    2016 Reengineering Dialysis: The Role of Palliative MedicineJournal of Palliative Medicine.  19:652-655. 2016
    2016 Palliative Sedation and What Constitutes Active Dying: A Case of Severe Progressive Dystonia and Intractable PainAmerican Journal of Hospice and Palliative Medicine.  33:363-368. 2016
    2016 Applying Rasch analysis to evaluate measurement equivalence of different administration formats of the Activity Limitation scale of the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR)Health and Quality of Life Outcomes.  14. 2016
    2016 A National Survey of Palliative Care Services within INTERMACs CentersThe Journal of heart transplantation.  35:S164-S165. 2016
    2016 Bereaved caregiver perspectives on the end-of-life experience of patients with a left ventricular assist deviceJAMA Internal Medicine.  176:534-539. 2016
    2016 Prevalence and Predictors of Burnout Among Hospice and Palliative Care Clinicians in the U.S.Journal of Pain and Symptom Management.  51:690-696. 2016
    2016 Characterizing the Hospice and Palliative Care Workforce in the U.S.: Clinician Demographics and Professional ResponsibilitiesJournal of Pain and Symptom Management.  51:597-603. 2016
    2016 Prevalence and contents of advance directives in patients receiving home parenteral nutritionJournal of Parenteral and Enteral Nutrition.  40:399-404. 2016
    2016 Complex Care Options for Patients With Advanced Heart Failure Approaching End of LifeCurrent Heart Failure Reports.  13:20-29. 2016
    2016 Actions Can Speak Louder Than [Written] Words: Surrogate Decision Making Based on Stated PreferencesAJOB Neuroscience.  7:71-73. 2016
    2016 Pulmonary Hypertension and Palliative Care: What, When, Where, and Why?Advances in Pulmonary Hypertension.  15:26-31. 2016
    2015 The ethics of chronic dialysis for the older patient: Time to reevaluate the normsClinical Journal of the American Society of Nephrology.  10:2094-2099. 2015
    2015 Hospice and palliative medicine clinician views of deactivation of ventricular assist devices at the end of lifeJournal of Pain and Symptom Management.  50:e6-e8. 2015
    2015 Team-based Palliative and End-of-life Care for Heart FailureHeart Failure Clinics.  11:479-498. 2015
    2015 Safety and benefit of discontinuing statin therapy in the setting of advanced, life-limiting illness a randomized clinical trialJAMA Internal Medicine.  175:691-700. 2015
    2015 Decision-Making for Destination Therapy Left Ventricular Assist Devices: Implications for CaregiversCirculation: Cardiovascular Quality and Outcomes.  8:172-178. 2015
    2015 Metastatic renal cell carcinoma mimicking diverticulitis in a patient with chronic lymphocytic leukaemiaBMJ Case Reports.  2015. 2015
    2015 A survey of clinician attitudes and self-reported practices regarding end-of-life care in heart failurePalliative Medicine.  29:260-267. 2015
    2015 A video to improve patient and surrogate understanding of cardiopulmonary resuscitation choices in the ICU: A randomized controlled trialCritical Care Medicine.  43:621-629. 2015
    2015 Overview of palliative care and hospice servicesClinical Liver Disease.  6:30-32. 2015
    2015 Palliative sedation: Clinical practice challenges in Mexico and development of a national protocol for MexicoProgress in Palliative Care.  23:274-280. 2015
    2015 Pediatric Clinical Ethics Consultations at an Academic Medical Center: Does One Size Fit All?American Journal of Bioethics.  15:20-24. 2015
    2015 Total artificial heart #296Journal of Palliative Medicine.  18:985-986. 2015
    2014 A study to improve communication between clinicians and patients with advanced heart failure: Methods and challenges behind the working to improve discussions about defibrillator management trialJournal of Pain and Symptom Management.  48:1236-1246. 2014
    2014 Physician attitudes toward palliative care for patients with pulmonary arterial hypertension: Results of a cross-sectional surveyPulmonary Circulation.  4:504-510. 2014
    2014 Solitary cystic cerebellar metastasis in a patient with invasive transitional cell carcinoma of the bladderBMJ Case Reports2014
    2014 "It's not broke, so let's not try to fix it": Why patients decline a cardiovascular implantable electronic devicePacing and Clinical Electrophysiology.  37:1306-1314. 2014
    2014 Advance directives, advance care planning, and shared decision making: Promoting synergy over exclusivity in contemporary contextJournal of Pain and Symptom Management.  47. 2014
    2014 Beyond Transplantation: Considering Brain Death as a Hard Clinical EndpointAmerican Journal of Bioethics.  14:43-45. 2014
    2014 Choices for patients without a choice interviews with patients who received a left ventricular assist device as destination therapyCirculation: Cardiovascular Quality and Outcomes.  7:368-373. 2014
    2014 Ethical challenges with hemodialysis patients who lack decision-making capacity: Behavioral issues, surrogate decision-makers, and end-of-life situationsKidney International.  86:475-480. 2014
    2014 Features and outcomes of patients who underwent cardiac device deactivationJAMA Internal Medicine.  174:80-85. 2014
    2014 Preparedness planning before mechanical circulatory support: A "how-to" guide for palliative medicine cliniciansJournal of Pain and Symptom Management.  47. 2014
    2014 Resuscitation preferences in community patients with heart failureCirculation: Cardiovascular Quality and Outcomes.  7:353-359. 2014
    2014 Ten common questions (and their answers) on medical futilityMayo Clinic Proceedings.  89:943-959. 2014
    2014 The growth of palliative care.Minnesota Medicine.  97:39-43. 2014
    2013 Clinicians' attitudes regarding withdrawal of left ventricular assist devices in patients approaching the end of lifeEuropean Journal of Heart Failure.  15:1262-1266. 2013
    2013 Dialysis in the frail elderly - A current ethical problem, an impending ethical crisisJournal of General Internal Medicine.  28:1511-1516. 2013
    2013 Ethical Issues and Palliative Care in the Cardiovascular Intensive Care UnitCardiology Clinics.  31:657-668. 2013
    2013 "We as human beings get farther and farther apart": The experiences of patients with remote monitoring systemsHeart & Lung: The Journal of Acute and Critical Care.  42:313-319. 2013
    2013 Urinoma presenting as an abscess in an immunocompromised host: A case reportJournal of Medical Case Reports.  7. 2013
    2013 Deactivation of a left ventricular assist device at the end of life #269Journal of Palliative Medicine.  16:980-982. 2013
    2013 Mechanical circulatory support in advanced heart failure #205, 2nd ed.Journal of Palliative Medicine.  16:979-980. 2013
    2013 Changes in Catholic identity at Mayo Clinic Rochester: Isolated event or sign of the times?HEC Forum.  25:109-110. 2013
    2013 What makes a catholic hospital "catholic" in an age of religious-secular collaboration? the case of the Saint Marys Hospital and the Mayo ClinicHEC Forum.  25:95-107. 2013
    2013 Management of end-of-life care and of difficult behaviors associated with borderline personality disorderJournal of Pain and Symptom Management.  45:934-938. 2013
    2013 Health Care Ethics Consultation Competences and Standards: A Roadmap Still Needing a CompassAmerican Journal of Bioethics.  13:20-22. 2013
    2013 Patient and doctor attitudes and beliefs concerning perioperative do not resuscitate orders: Anesthesiologists' growing compliance with patient autonomy and self determination guidelinesBMC Anesthesiology.  13. 2013
    2013 Care of the frail elder: the nexus of geriatrics and palliative care.Minnesota Medicine.  96:39-42. 2013
    2013 End-of-life care in a population-based cohort of cancer patients: Clinical trial participation versus standard of careBMJ Supportive and Palliative Care.  3:181-187. 2013
    2013 Ethics committees and consultantsHandbook of Clinical Neurology.  118:25-34. 2013
    2013 Ten years past, ten years ahead.Minnesota Medicine.  96:26-28. 2013
    2012 Management of advanced heart failure in the elderly: Ethics, economics, and resource allocation in the technological eraCardiology Research and Practice.  1. 2012
    2012 Integrating technology into palliative care researchCurrent Opinion in Supportive and Palliative Care.  6:525-532. 2012
    2012 Physician perspectives and compliance with patient advance directives: The role external factors play on physician decision makingBMC Medical Ethics.  13. 2012
    2012 Troublesome symptoms in cancer survivors: Fatigue, insomnia, neuropathy, and painJournal of Clinical Oncology.  30:3687-3696. 2012
    2012 Moving beyond stigma - Are concurrent palliative care and management of pulmonary arterial hypertension irreconcilable or future best practice?International Journal of Clinical Practice.  66:2-4. 2012
    2012 Symptom burden, quality of life, and attitudes toward palliative care in patients with pulmonary arterial hypertension: Results from a cross-sectional patient surveyThe Journal of heart transplantation.  31:1102-1108. 2012
    2012 The end-of-life experience for a cohort of patients with pulmonary arterial hypertensionJournal of Palliative Medicine.  15:1065-1070. 2012
    2012 Difficult Cases of Pain and Nonpain Symptoms in Intractable Spinal Infections: A Case SeriesAmerican Journal of Hospice and Palliative Medicine.  29:493-496. 2012
    2012 Advance directives in community patients with heart failureCirculation: Cardiovascular Quality and Outcomes.  5:283-289. 2012
    2012 Radiation-associated sarcoma of the skull base after irradiation for pituitary adenomaRare Tumors.  4:18-20. 2012
    2012 Balancing evidence-based medicine, justice in health care, and the technological imperative: A unique role for the palliative medicine clinicianJournal of Palliative Medicine.  15:390-391. 2012
    2012 In the clinic Palliative care.Annals of Internal Medicine.  156. 2012
    2012 Are there alternatives to hemodialysis for the elderly patient with end-stage renal failure?Mayo Clinic Proceedings.  87:514-516. 2012
    2012 Clinical pearls in palliative medicine 2012Mayo Clinic Proceedings.  87:1118-1123. 2012
    2011 Meeting the needs of Somali patients at the end of life.Minnesota Medicine.  94:43-46. 2011
    2011 Palliative care and end-of-life issues in patients treated with left ventricular assist devices as destination therapyCurrent Heart Failure Reports.  8:212-218. 2011
    2011 Prognostication in severe traumatic brain injury in adults #239Journal of Palliative Medicine.  14:782-783. 2011
    2011 An exploratory pilot study of palliative medicine compared to anesthesia-pain consultation for pain in patients with cancerJournal of Supportive Oncology.  9:113-119. 2011
    2011 Surrogate decision-making and the need for advance care planning: issues raised by the Al Barnes case.Minnesota Medicine.  94:43-46. 2011
    2011 A novel program to promote competency and hospice and palliative medicine board certificationJournal of Palliative Medicine.  14:272-273. 2011
    2011 Medicine consultation for preparedness planning in patients receiving left ventricular assist devices as destination therapyMayo Clinic Proceedings.  86:493-500. 2011
    2011 Palliative care consultations in patients with cancer: A mayo clinic 5-year reviewJournal of Oncology Practice.  7:48-53. 2011
    2011 The use of advance directives among patients with left ventricular assist devices.Hospital practice (1995).  39:78-84. 2011
    2010 Palliative chemotherapy: When is it worth it and when is it not?Cancer Journal.  16:467-472. 2010
    2010 Clinical management of continuous-flow left ventricular assist devices in advanced heart failureThe Journal of heart transplantation.  29:1081. 2010
    2010 Ethical analysis of withdrawing ventricular assist device supportMayo Clinic Proceedings.  85:791-797. 2010
    2010 Ethical decision making with end-of-life care: Palliative sedation and withholding or withdrawing life-sustaining treatmentsMayo Clinic Proceedings.  85:949-954. 2010
    2010 Safe use of opioids to manage pain in patients with cirrhosisMayo Clinic Proceedings.  85:959. 2010
    2009 Maximal medical therapy and palliative care can work together: When are advanced care measures appropriate?Journal of Hospital Medicine.  4:453-456. 2009
    2009 Strategies for avoiding burnout in hospice and palliative medicine: Peer advice for physicians on achieving longevity and fulfillmentJournal of Palliative Medicine.  12:773-777. 2009
    2009 Large intrathoracic meningocele associated with neurofibromatosis type 1Mayo Clinic Proceedings.  84:769. 2009
    2007 In reply [2]Mayo Clinic Proceedings.  82:1577-1578. 2007
    2007 Report of 255 clinical ethics consultations and review of the literatureMayo Clinic Proceedings.  82:686-691. 2007

    Chapter

    Year Title Altmetric
    2019 Palliative Care in Heart Failure.  559-570. 2019
    2018 Palliative Care.  ITC33-ITC48. 2018
    2016 Supportive and Palliative Care and Issues in Cardio-Oncology.  433-441. 2016
    2016 Medical Ethics 2016
    2013 Medical Ethics.  769-778. 2013

    Research Overview

  • Advance care planning
    Life-sustaining treatments
    Serious illness
  • Education And Training

  • Mayo Clinic, Rochester Center for Clinical and Translation Science, Other 2016
  • Loyola University Medical Center, Maywood Bioethics and Health Policy, Other 2012
  • Doctor of Medicine, Pennsylvania State System of Higher Education 2003
  • Bachelor of Science or Mathematics in Biochemistry, Albright College 1999
  • Mayo School of Graduate Medical Education, Internship 2004
  • Mayo School of Graduate Medical Education, Residency 2006
  • Mayo Clinic, Rochester, Residency 2006
  • Virginia Commonwealth University, Postdoctoral Fellowship 2008
  • Virginia Commonwealth University Medical Center, Richmond, Postdoctoral Fellowship 2008
  • Full Name

  • Keith Swetz