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ACP-ASIM Launches New Series on End-of-Life Care
PHILADELPHIA—(May 5, 1999) The American College of Physicians-American Society of Internal Medicine (ACP-ASIM) is launching a new series of papers for physicians and other clinicians who care for dying patients. The first paper in the series, "Discussing Palliative Care with Patients," appears in the May 4 issue of Annals of Internal Medicine
. The new series grew out of ACP-ASIM's concern that care at the end of life is often a difficult issue for both the physician and patient, says Harold C. Sox, ACP-ASIM president and one author of an accompanying editorial in Annals. "Research has shown that physicians and other clinicians are often not well trained in end-of-life care, nor are patients and their families experienced or comfortable talking about end-of-life issues." Further, Sox says the College felt that much of the physician-assisted suicide debate results from fears of suffering and loss of control of care. ACP-ASIM felt that one way it could help improve end-of-life care in this country is to provide practical advice and guidance for clinicians who care for the dying.
In 1997, the College set up a Consensus Panel on End-of-Life Care to develop the papers under the direction of the College's College's new Center for Ethics and Professionalism. Bernard Lo, MD, professor of medicine and director of the Program in Medical Ethics at the University of California, San Francisco, was named chair of the panel of distinguished experts.
Lo lists the key issues the panel is addressing:
- better relief of physical symptoms;
- improved decision making about life-sustaining interventions;
- more meaningful discussions with patients and families about end-of-life issues such as sadness, grief, and fear of the unknown.
"Good end-of-life care can help dying patients achieve closure and find meaning in the final phase of their lives," says Lo.
The first paper, "Discussing Palliative Care with Patients," written by Lo, Timothy Quill, MD, and James Tulsky, MD, demonstrates how to elicit patient's concerns about their illnesses and the future, understand their needs, and attend to the psychosocial and spiritual aspects of suffering. This paper, as well as others in the series, employs case scenarios and can be used as training guides in conferences and seminars in hospitals, medical training programs and professional meetings.
Lois Snyder, JD, director of ACP-ASIM's Center for Ethics and Professionalism, says "Our goal is to provide very practical guidance and information about best practices that will start immediately to improve the care dying patients receive." The series of papers on end-of-life care receives support from the Greenwall Foundation.
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NOTES TO EDITOR: For a copy of the article, "Discussing Palliative Care with Patients," (page 744) and the editorial, "Care at the End of Life: Guiding Practice Where There are Not Easy Answers," (p. 772) in the May 4, 1999, issue of Annals of Internal Medicine, please call (215) 351-2656 or (800) 523-1546, ext. 2656. Full text will be available on Tuesday, May 4, 1999, on Internet at http://www.acponline.org.