Should We Practice What We Profess? Care near the End of Life  

Oleh:

Pizzo, Philip A. ; Walker, David M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 372 no. 07 (Feb. 2015), page 595-598.

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Perpustakaan FK Nomor Panggil: N08.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Physicians should be in a better position than people without medical training to judge the likely value of health care services available near the end of life. Yet several studies have revealed a disconnect between the way physicians themselves wish to die and the way the patients they care for do in fact die. Although physicians ought not assume that their views about dying should apply to others, public surveys and research studies have shown that 80% of Americans, like the large majority of surveyed physicians, say they'd like to die at home and avoid high-intensity care and hospitalization. Yet their wishes are too frequently overridden by the physicians caring for them, who undertake more medical interventions than patients desire. Physicians also sometimes find themselves responding to the wishes and demands of patients' families who want more medical therapy than medical providers believe is indicated or beneficial. In a study examining the care of more than 848,000 people who had died in 2000, 2005, or 2009 while covered by fee-for-service Medicare, Teno et al. noted that the rate of acute care hospitalization decreased from 32.6% in 2000 to 24.6% in 2009 but that use of intensive care in the last month of life increased from 24.3% to 29.2%.3 Although hospice use increased during this period, 28.4% of the decedents studied had used hospice for 3 days or less in 2009.

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