Medicare

“Most people envision their own death as a peaceful and an ideally rapid transition. But with the exception of accidents or trauma or of a few illnesses that almost invariably result in death weeks or months after diagnosis, death comes at the end of a chronic illness or the frailty accompanying old age. Few people really have the opportunity to know when their death will occur.”

That unsurprising but sobering observation was included in the Preface to a report issued on September 14 by the Institute of Medicine (IOM), “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.” The IOM is an affiliate of the National Academy of Science and the report was prepared by a nonpartisan committee that included physicians, nurses, insurers, lawyers, and gerontologists. The goal of the report was to offer a road map to providing care at the end of life that is “person-centered, family-oriented, and evidence-based.” To that end, the report proposed sweeping reforms to end of life care, including the nature of care provided, how the government and insurers compensate for medical service, and the focus of medical education. It is a lengthy report, some 507 pages, that reflects the complexity of the issues and the care that went in to the study of them by the IOM committee. It is a document that deserves the attention of the medical community, patients and their families, political leaders, and the public at large.Read More »Blog No. 48. Dying in America: Yes, There Is a Better Way