More than 2.5 million people die in the United States each year, most of them from progressive health conditions. Facing death is a profound challenge for patients, their relatives and friends, their caregivers, and health care institutions. Nearly 40 years of intensive work to improve care at the end of life has shown that aligning care with patients' needs and preferences in order to ease the dying process is surprisingly difficult — although there has been some incremental progress. Early optimism that the establishment of patients' legal and ethical rights to make decisions about their own care would lead to more appropriate end-of-life treatment faded in the face of sobering data showing that declaring these rights was not enough to alter treatment patterns and that systemic issues loomed large. This history has demonstrated the need to attack the problem at all levels, from individual rights, to family and caregiving relationships, to institutional and health systems reform.
Bruce Jennings, M.A. is a Voluntary Adjunct Assistant Professor/Faculty member of the Department of Health Policy, Center for Biomedical Ethics and Society, and he is Director of Bioethics at the Center for Humans and Nature, a nonprofit research center based in Chicago that studies environmental ethics and policy.
Read the full article published in The New England Journal of Medicine here
Forty Years of Work on End-of-Life Care — From Patients' Rights to Systemic Reform
Susan M. Wolf, J.D., Nancy Berlinger, Ph.D., and Bruce Jennings, M.A.
N Engl J Med 2015; 372:678-682February 12, 2015DOI: 10.1056/NEJMms1410321