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Institute of Medicine Report On Dying In U.S. Praised by End-Of-Life Choice Organization

Group Agrees Healthcare System Must Be More Patient-Centered

Compassion & Choices praised a new report by the Institute of Medicine that was charged with examining the “mismatch between the services patients and families need and the services they can obtain.” The study, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, was released today.

“We know this Dying in America report reflects grave problems because we receive thousands of calls each year from dying people and their families,” said Compassion & Choices President Barbara Coombs Lee, an attorney who was an ER and ICU nurse for 25 years. “They turn to us because our healthcare system is not ‘patient-centered, family-oriented, and consistently accessible near the end of life,’ just as the Institute of Medicine acknowledges.”

Other findings in the Dying in America report include:

  • Both medical AND social factors are important in determining experience and outcome during serious illness. Policy and payment should change accordingly.
  • Providing the care that people want — and avoiding costly but futile care that they do not want — means better communication between patients or their families and the care team, as well as more emphasis on advanced care planning.
  • Improving the quality and availability of medical and social services for patients and their families could enhance quality of life through the end of life.
  • A palliative approach (which provides relief from pain and other symptoms, supports quality of life, and is focused on patients with serious advanced illness and their families) typically affords patients and families the highest quality of life for the most time possible.
  • Hospice is an important approach to addressing the palliative care needs of patients with limited life expectancy (six months or less) and their families.
  • There are inadequate numbers of palliative care specialists and too little palliative care knowledge among other clinicians who care for individuals with serious advanced illness.

“Most Americans want to die at home. But the sad truth is many don’t, because they fail to do advance care planning with their families and their physicians,” said Coombs Lee, who coauthored the nation’s first death-with-dignity law in Oregon. “Oregon’s death-with-dignity law has dramatically improved end-of-life care in the state. We think that’s because people in Oregon are more likely to think through their end-of-life wishes when they have real choices. And studies show that early admission to hospice care can extend the patient’s life and improve the quality.”

In addition to Oregon, death with dignity is authorized in Washington, Montana, Vermont and New Mexico. Compassion & Choices currently has campaigns to authorize death with dignity in California, Colorado, Connecticut, Massachusetts and New Jersey.

Even in states without death-with-dignity laws, there are options to ensure that no one suffers needlessly at life’s end. To learn more about these options, and what is available to you where you live, call Compassion & Choices’ End-Of-Life Consultation program toll free at 1.800.247.7421.


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