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Physicians Can Impact Quality of End-of-Life

Wed, 01/10/2001 - 1:00am — Karen Stevenson
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In a special article, done for the Mayo Clinic Cancer Center Quality of Life Working Group and published in the Mayo Clinic Proceedings, authors note that physicians as a group may prolong the end-of-life suffering with aggressive approaches to "cure" the patients? underlying disease rather than acknowledging that the time has come to provide the patient with palliative care services. But the physician can help alleviate the suffering of a patient by orchestrating a multidimensional approach to helping ensure the quality of life at the end.

The authors point out that the death process has changed over the years. Before the 1900s, most Americans died at home surrounded by their loved ones. Now, as many as 60% will die in hospitals, and about 25% will die in healthcare-related facilities such as nursing homes. The role of the physician has had an ever-expanding role in the manner which people die with so many Americans dying in hospitals and other health care facilities.

"With modern medicine emphasizing genetic manipulations, high technology, and cure at all costs, we often neglect what was once the most sacred aspect of being a physician: alleviating suffering," the authors write. "Therefore, we contend that the approach to a person dying in the hospital must change from simply postponing death to focusing medical interventions on maintaining quality of life to the end."

The Mayo Clinic authors conclude their article: "We believe that the principles that have been so successful in improving the quality of life for hospice patients must be adopted in hospitals and related facilities such as nursing homes so that suffering can be relieved where the vast majority of Americans continue to die."

In a special article, done for the Mayo Clinic Cancer Center Quality of Life Working Group and published in the Mayo Clinic Proceedings, authors note that physicians as a group may prolong the end-of-life suffering with aggressive approaches to "cure" the patients? underlying disease rather than acknowledging that the time has come to provide the patient with palliative care services. But the physician can help alleviate the suffering of a patient by orchestrating a multidimensional approach to helping ensure the quality of life at the end.

The authors point out that the death process has changed over the years. Before the 1900s, most Americans died at home surrounded by their loved ones. Now, as many as 60% will die in hospitals, and about 25% will die in healthcare-related facilities such as nursing homes. The role of the physician has had an ever-expanding role in the manner which people die with so many Americans dying in hospitals and other health care facilities.

"With modern medicine emphasizing genetic manipulations, high technology, and cure at all costs, we often neglect what was once the most sacred aspect of being a physician: alleviating suffering," the authors write. "Therefore, we contend that the approach to a person dying in the hospital must change from simply postponing death to focusing medical interventions on maintaining quality of life to the end."

The Mayo Clinic authors conclude their article: "We believe that the principles that have been so successful in improving the quality of life for hospice patients must be adopted in hospitals and related facilities such as nursing homes so that suffering can be relieved where the vast majority of Americans continue to die."