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Make Access to Palliative Care the Default, Not an Option
The New York Times Opinion page recently published an article about a study in the Journal of the American Medical Association. The study was a systematic international comparison of end-of-life care for patients dying with cancer.
The good news is that the United States is actually not the worst. In fact, on some important measures, the U.S. provides the best in end-of-life care. Positive study findings include:
- Just 22 percent of Americans dying with cancer died in the hospital
- In the last six months of life, Americans spent the fewest days in the hospital
- America was not the most expensive country in which to die.
Study findings of concern were:
- Over 40 percent of Americans dying with cancer were admitted to the I.C.U. in the last six months of life
- Americans received more chemotherapy near the end of life, even though research shows that it may not improve the quality or length of life at that point
In the U. S., the next step needs to be empowering patients to make realistic choices about how and where they want to die. This can best be achieved by making access to palliative care the default, instead of just an option, for all patients with advanced and incurable cancer.
["Is It Better to Die in America or England?" New York Times, January 19, 2016]
Tips from our featured course
Palliative Care: A Structured Care Delivery System
Palliative care is both a philosophy of care and a highly structured care delivery system. It begins at the time a life-threatening or debilitating illness or injury is diagnosed and is appropriate across all stages of the illness trajectory.
[Palliative and End-of-Life Care, Module A, Advancing Palliative and End-of-Life Care]
Medicine Frequently Fails Those It is Supposed to Help
"The waning days of our lives are given over to treatments that addle our brains and sap our bodies for a sliver's chance of benefit. They are spent in institutions - nursing homes and intensive care units - where regimented, anonymous routines cut us off from all the things that matter to us in life.
Our reluctance to honestly examine the experience of aging and dying has increased the harm we inflict on people and denied them the basic comforts they most need."
Atul Gawande, MD, MPH
Surgeon, Author, and Public Health Researcher
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