Care of the Dying Patient

Abstract

Family physicians have traditionally prided themselves on comprehensive and continuous provision of care throughout the human life cycle. When managing the terminal phases of illness, however, most clinicians have had little formal education directed at the experience of human suffering and dying.¹’² For many physicians the task and challenge of caring for a dying patient can seem overwhelming. The aging of the United States population, the development and widespread use of life-prolonging technologies, the ascendence of managed care emphasizing the central role of the primary care physician, media attention, the growing discomfort with futile treatment, the public’s interest in physician-assisted suicide and the demand for better palliation have all fueled a growing need for physicians to master the art and science of helping patients achieve death with dignity.^3–5 This need has led to a series of major initiatives to improve palliative care education for both clinicians and the public, including the Education for Physicians in End-of-Life Care Project of the American Medical Association, the Faculty Scholars in End-of-Life Care Program of the Department of Veteran Affairs, the Improving Residency Training in End-of-Life Care Program of the American Board of Internal Medicine, the Project on Death in America of the Soros Foundation, and the Last Acts Program of the Robert Wood Johnson Foundation.^3,6