Hi there, my brain is slightly slow and i can't think of what MND is at present. Did you have to consider only the aspect of physio treatment in a situation where palliative care is given or the whole aspect of medical treatment and all carers and Doctors?
For physio for example with elderly and /or neuro patients with poor or bad prognosis there's often the question of what good physio is doing if at all. The results, as it were will often not seem to amount to much if one goes on strict criterien and evidence based results and with the patients who are deteriorating there are ethical dilemmas. At this stage one I have to look at the whole aspect of well being to decide whether to continue treatment or not. (my situation is outpatient and domiciliaries) I doubt, and here I stick my neck out a long way maybe for some readers, if anyone has ever died because of no physio and only no physio. (in hospital ITU there are others who deal with respiration, not just us) Palliative care is not just withholding as it is giving care, and relief in some way but maybe there are other experts reading the site who could help more. Regards JM