Thursday, March 15, 2007

NYT and Washington Post EOL articles and more

Sometimes a lot of good stuff comes our way here at Pallimed but we just don't have time to get to a full commentary but we want to bring what we feel is important issues to the readers. Here are a few digest items from the past week, that I just need to get out of my to do box:

1) Washington Post writer Rob Stein wrote an insightful article on race and end of life issues. Catch it on Washington Post while it is free (a few more days I believe). Some of the highlights of the article:

"I think we need to be very attentive to attending to suffering in our patients and do everything we can to help minimize and ameliorate it," said Richard Payne, who runs Duke University's Institute on Care at the End of Life. "African Americans and other minorities are at greater risk of not dying well."
The article brought forward a point that Drew has made a few times here lately. Death is not pretty. It is a hard, transformative experience for all of those around it because of the difficult nature of the beast. This point about what is a 'good death,' highlights that we need to be patient adovcates in this field, as much as we are patient educators. A militant hospice philosophy is bound to end of being unsuccessful because it imposes the health care professionals values on another.

2) The New York Times (now available free to anyone with a .edu email! Not me.) has yet another pro-hospice article, this time focusing on pediatric/perinatal programs.

And if I really wanted to get on a box about shortages, I would begin to complain about the shortages of pediatric palliativists (that word grows on me everytime I use it). As an adult HPM doctor, I see the pediatric patients at home for our pediatric hospice program because they deserve access and need assistance just as much. And as much as people say 'kids are different, kids are more emotionally difficult, kids are not little adults' I have to disagree. They have much more in common with adults then we ever give them credit for, and palliative care principles apply just as well in the pediatric field. Not to say there is not more to learn, but if you are afraid of dealing with children and dying, but not adults and dying, is this ageism? (Another topic for another day, and besides not the point of the great piece by the NYT.)

If you have 7 minutes (you do, trust me) watch the video on the NYT website on perinatal hospices and the families that work with them.

Thanks to Tom Q, for the tip on this one and the next one.

3) On the pediatric front, CMAJ has a personal article by a nurse about her role in helping be present with infants and children at the end of life. Very short, very poignant.

4) the impact of Terri Schivao's care is still reverberating in the run up to the '08 Presedential Election. Mitt Romney has said the government should not have intervened as they did in Florida. The article on Lifenews.com is an interesting read, given the multiple references to euthanasia, again further making this complex issue even more difficult to understand with terms used in completely different situations then understood by classic medical ethics.

More in the next day or two, my twins are calling/screaming for me.

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