LETTER
The Dying Experience
Michael P. Hahn, RRT
1 August 1997 | Volume 127 Issue 3 | Page 243
TO THE EDITOR:
Lynn and colleagues [1] provide further significant confirmatory data on the problems with terminal care. An abundance of medical literature clearly indicates that improvements are needed in end-of-life care. Emphasis should now be focused on implementing the changes necessary to improve this situation. I would like to offer the following suggestions, which may help improve terminal-care practice.
First, increase the use of inpatient palliative care on a widespread basis. Centers that have such services available have shown a high degree of overall satisfaction with this type of terminal care [2, 3]. These centers could offer physician and nursing fellowships through their facility to expand this type of practice nationally.
Second, persuade President Clinton or state legislators to require insurance companies to begin offering sufficient reimbursement for palliative care services. This measure would give health care providers the financial incentive to practice palliative care, rather than curative care, for patients facing imminent death.
Third, implement a national campaign for increasing the general public's knowledge about terminal-care practice. People cannot give truly informed consent about terminal-care options unless they are at least somewhat familiar with the consequences of their choices.
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Author and Article Information
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American Society for the Advancement of Palliative Care; Highland, CA 92346
1. Lynn J, Teno JM, Phillips RS, Wu AW, Desbiens N, Harrold J, et al. Perceptions by family members of the dying experience of older and seriously ill patients. Ann Intern Med. 1997; 126:97-106.
2. Campbell ML, Frank RR. Experience with end-of-life practice at a university hospital. Crit Care Med. 1997; 25:197-202.
3. Kellar N, Martinez J, Finis N, Bolger A, von Gunten CF. Characterization of an acute inpatient hospice palliative care unit in a U.S. teaching hospital. JONA. 1996; 26:16-20.
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