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. For many physicians the task and challenge of caring for a dying patient can seem overwhelming. The aging of America, development and widespread use of life-prolonging technologies, the ascendency of managed care emphasizing the central role of the primary care physician, media attention, growing discomfort with futile treatment, and the public’s 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.
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References
Schonwetter RS, editor. Care of the terminally ill patient. Clin Geriatr Med 1996;12:237–433.
Cassel CK, Omenn GS, editors. Special issue: caring for patients at the end of life. West J Med 1995;163:224–305.
McCue JD. The naturalness of dying. JAMA 1995;273:1039–43.
Callahan D. The troubled dream of life: living with mortality. New York: Simon & Schuster, 1993.
Callahan D. Frustrated mastery: the cultural context of death in America. West J Med 1995;163:226–30.
Council on Scientific Affairs, American Medical Association. Good care of the dying patient. JAMA 1996;275:474–78.
Wanzer SH, Federman DD, Adelstein SJ, et al. The physician’s responsibility towards hopelessly ill patients. N Engl J Med 1989;320:844–9.
Waitzkin H. Doctor-patient communication—clinical implications of social scientific research. JAMA 1984;252: 2441–6.
Buckman R. How to break bad news: a guide for health care professionals. Baltimore: Johns Hopkins University Press, 1992.
Lynn J, Teno JM, Harrell FE. Accurate prognostication of death: opportunities and challenges for clinicians. West J Med 1995;163:250–7.
Evans C, McCarthy M. Prognostic uncertainty in terminal care: can the Karnofsky index help? Lancet 1985;1:1204–8.
Kubler-Ross E. On death and dying. New York: Macmillan, 1969.
Koenig BA, Gates-Williams J. Understanding cultural differences in caring for dying patients. West J Med 1995; 163:244–9.
World Health Organization. Cancer pain relief and palliative care. Geneva: WHO, 1990. Technical Report Series 804.
Berry ZS, Lynn J. Hospice medicine. JAMA 1993;270:220–3.
National Hospice Organization. Standards of hospice program of care. Arlington, VA: NHO, 1993.
Finucane TE, Harper M. Ethical decision-making near the end of life. Clin Geriatr Med 1996;12:369–77.
Support Principal Investigators. A controlled trial to improve care for seriously ill hospitalized patients—the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT). JAMA 1995;274:1591–8.
Emanuel EJ. Cost savings at the end of life: what do the data show? JAMA 1996;275:1907–14.
Morrison RS, Olson E, Mertz KR, Meier DE. The inaccessability of advance directives on transfer from ambulatory to acute care settings. JAMA 1995;274:478–82.
The Patient Self-Determination Act of 1990, §§ 4206, 4751 of the Omnibus Reconciliation Act of 1990, Pub L No. 101–508, November 5,1990.
Lynn J, Teno JM. After the Patient Self-Determination Act: the need for empirical research on formal advance directives. Hastings Cent Rep 1993;23:20–4.
Task Frce on Physician-Assisted Suicide of the Society for Health and Human Values. Physician-assisted suicide: toward a comprehensive understanding. Acad Med 1995;70: 583–90.
Searight HR. Assessing patient competence for medical decision making. Am Fam Physician 1992;45:751–9.
Dahl JL. Effective pain management in terminal care. Clin Geriatr Med 1996;12:279–300.
Jacox AK, Carr DB, Payne R, et al. Management of cancer pain: clinical practice guidelines. Rockville, MD: Agency for Health Care Policy and Research, 1994. AHCPR Publ. No. 94–0592.
American Pain Society. Principles of analgesic use in the treatment of acute pain and cancer pain. 3rd ed. Skokie, IL: APS, 1992.
Cleeland CS, Gonin R, Hatfield A, et al. Pain and its treatment in out-patients with metastatic cancer. N Engl J Med 1994;330:592–6.
Rousseau P. Non-pain symptom management in terminal care. Clin Geriatr Med 1996;12:313–28.
McCann RN, Hall WJ, Groth-Juncker A. Comfort care for terminally ill patients—the appropriate use of nutrition and hydration. JAMA 1994;272:1263–6.
American College of Physicians. Position paper: parenteral nutrition in patients receiving cancer chemotherapy. Ann Intern Med 1989;110:734–6.
Spratt ML, Denney DR. Immune variables, depression, and plasma cortisol over time in suddenly bereaved parents. J Neuropsychiatry Clin Neurosci 1991;3:299–306.
Ogle KS, Plumb JD. The role of the primary care physician in the care of the terminally ill. Clin Geriatr Med 1996;12:267–78.
Foley G, Whittam EH. Care of the child dying of cancer: Part I. CA 1990;40:327–54.
Foley G, Whittam EH. Care of the child dying of cancer: Part II. CA 1991;41:52–60.
Martinson IM. Improving the care of dying children. West J Med 1995;163:258–62.
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Celestino, F.S. (1998). Care of the Dying Patient. In: Taylor, R.B., David, A.K., Johnson, T.A., Phillips, D.M., Scherger, J.E. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2947-4_62
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DOI: https://doi.org/10.1007/978-1-4757-2947-4_62
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