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Physicians can do more to ensure quality of life for terminally ill patients

Mayo Clinic

Physicians can do more and involve additional people in the care of the terminally ill patients to ensure that their quality of life doesn't deteriorate in their final days.

The Mayo Clinic authors note that physicians as a group may prolong the end-of-life suffering with aggressive approaches to "cure" the patients' underlying disease rather than acknowledging that the time has come to provide the patient with palliative care services. However, strategies can be taken to reduce the suffering of a patient by orchestrating a multidimensional approach to helping ensure the quality of life at the end.

The special article, done for the Mayo Clinic Cancer Center Quality of Life Working Group, appears in Mayo Clinic Proceedings.

Before the 1900s, most Americans died at home surrounded by their loved ones. Currently, as many as 60 percent will die in hospitals, and up to an additional 25 percent will die in healthcare-related facilities such as nursing homes. The role of the physician has had an ever-expanding role in the manner which people die with so many Americans dying in hospitals and other health care facilities.

"With modern medicine emphasizing genetic manipulations, high technology, and cure at all costs, we often neglect what was once the most sacred aspect of being a physician: alleviating suffering," the authors write. "Therefore, we contend that the approach to a person dying in the hospital must change from simply postponing death to focusing medical interventions on maintaining quality of life to the end."

The term quality of life was defined as the physical, psychological, social and spiritual domains of health that are influenced by a person's experiences, beliefs, expectations and perceptions.

The Mayo Clinic authors conclude their article: "We believe that the principles that have been so successful in improving the quality of life for hospice patients must be adopted in hospitals and related facilities such as nursing homes so that suffering can be relieved where the vast majority of Americans continue to die."

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Source: Mayo Clinic Proceedings, Volume 75 Number 12, December 2000.

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