[Reblog] How the discussion on dying has changed over 40 years: A conversation with Nancy Berlinger | Association of Health Care Journalists

How the discussion on dying has changed over 40 years: A conversation with Nancy Berlinger | Association of Health Care Journalists.

From the 18 February 2015 post

If you want a refresher on how far society has come on dealing with end-of-life care issues — and what issues are still to be resolved — then this retrospective article in the Feb 12 issue of the New England Journal of Medicine from experts at The Hastings Center is a great place to begin. It reviews the history of the end-of-life care movement in the U.S., takes a look at the integration of palliative care into health care delivery, discusses the still controversial “death with dignity” laws and ethical issues like removal of feeding and hydration tubes.

I recently spoke with co-author Nancy Berlinger, Ph.D., a research scholar at Hastings, about how the conversation on death and dying has changed over four decades.

Q: Why did you and your colleagues develop this retrospective for publication in a medical journal?

NB: It stemmed from a recent revision of The Hastings Center Guidelines [for Decisions on Life-Sustaining Treatment and Care Near the End of Life].

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We see lots of ads from hospitals advertising their standards of excellence and their programs. None of them ever advertise their end of life care.

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it’s clear that financial incentives are very misaligned with what people need, what they want, what would be medically appropriate. This is a very complex issue – it can’t be undone by a patient, or by an individual doctor or nurse. This has to be the focus of very high-level attention.

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Q: What should journalists be focusing on?

NB: Even if they don’t cover the deep medical end of things, they can still ask questions in the context of health and wellness, such as:

• How much power does a sick person have?
• How much power does a really stressed out family have?
• How much power does a doctor, seeing X number of patients, really have?
• And, what still do we want to try to help these people to do? To understand we’re all connected in these efforts.

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