PHILADELPHIA -- (February 1, 2000) Dying patients are often depressed, yet depression - even "normal" grieving - often goes undiagnosed or unrecognized by the patient, family or the physician, according to the American College of Physicians-American Society of Internal Medicine (ACP-ASIM) End-of-Life Care Consensus Panel. In a new paper, the panel shows physicians how to identify and manage depression in the terminally ill patient and encourages them to do so.
The ACP-ASIM paper says that wise management of 'normal' grieving and treatment of more severe depression can improve the quality of the patient's life. The paper, "Assessing and Managing Depression in the Terminally Ill Patient," appears in the February 1, 2000, issue of Annals of Internal Medicine.
The paper discusses three hypothetical cases. One illustrates the assessment and management of normal or appropriate grieving; the second, the diagnosis and treatment of more severe depression; and the third, the assessment and management of patients with ideas of suicide. The paper points out that many symptoms of depression at the end of the life can be easily controlled with state-of-the-art psychosocial interventions and/or drug treatments.
The paper was written by Susan Block, MD, chief of adult psychosocial oncology at the Dana Farber Cancer Institute, and Assistant Professor of Medicine at Harvard Medical School, for the ACP-ASIM End-of-Life Care Consensus Panel. ACP-ASIM convened this panel of experts on end-of-life care in 1997 to develop ethical, policy and clinical recommendations that, if adopted, will lead to demonstrably better care at the end of life. The papers provide guidance to physicians caring for dying patients but are also useful for patients and families. To date, three other papers have been published and are available on the ACP-ASIM Web site (www.acponline.org/ethics).
ACP-ASIM is the nation's largest medical specialty organization, with a membership of 115,000 internal medicine physicians and medical students. Internists provide the majority of health care to adults in America. ACP-ASIM publishes the peer-reviewed journal Annals of Internal Medicine twice monthly.
NOTE TO EDITOR: The ACP-ASIM position paper will be available on the ACP-ASIM Web site (www.acponline.org) on February 1, 2000. For embargoed advance copies by fax, please call 215-351-2656.
For an interview with Susan Block, MD, member of ACP-ASIM End-of-life Care Consensus Panel and author of the paper, or Lois Snyder, JD, director, ACP-ASIM center for Ethics and Professionalism, call Susan Anderson, 1-800-523-1546, ext. 2653 or 215-351-2653.
Journal
Annals of Internal Medicine