Some call it a death panel. Some call it end-of-life counseling. Let’s just call it humane.
Oncologists Call for End-of-Life Counseling
Despite hysteria over so-called death panels, The American Society of Clinical Oncology (ASCO) is calling on physicians, medical schools, insurers, and others to help patients understand and make decisions about end-of-life care.
The ASCO encourages physicians to initiate candid discussions about the full range of palliative care and treatment options soon after patients’ diagnosis with advanced cancer (defined as incurable disease).
“While improving survival is the oncologist’s primary goal, helping individuals live their final days in comfort and dignity is one of the most important responsibilities of our profession,” said ASCO President George W. Sledge, Jr., MD. “Patients have a right to make informed choices about their care. Oncologists must lead the way in discussing the full range of curative and palliative therapies to ensure that patients’ choices are honored.”
The ASCO released a guide to help patients initiate conversations about their prognosis, treatment, and palliative care options with their physicians, and later this year will issue clinical guidance to help oncologists incorporate palliative therapy into oncology practice.
Palliative Care Improves Quality-of-Life for Patients and Caregivers
“Studies show that palliative therapies not only improve patient quality of life, but can even extend life,” said Dr. Sledge. “Yet for many with advanced cancer, conversations about palliative and hospice options do not occur until the patients’ final weeks or days of life, if they happen at all. This not only hurts patients, but their caregivers as well. ASCO’s new patient booklet and upcoming clinical guidance will help patients and physicians broach these topics early in the course of care.”
A randomized trial sponsored by The ASCO Cancer Foundation found that patients with advanced lung cancer who received both chemotherapy and palliative care immediately after their diagnosis lived almost three months longer than those who received chemotherapy alone. Another study published in the Journal of Clinical Oncology showed that caregivers of terminally ill patients who receive palliative therapy suffer less emotional stress. ICU and hospital deaths were associated with more psychiatric illness among bereaved caregivers compared with home hospice deaths.
It’s Not a Death Panel: What You Don’t Know Can Hurt You
Most public or private insurance plans provide little or no compensation for palliative care options, but ASCO points to the demonstrated value of physician/patient discussions regarding end-of-life care.
Is there a need for honest talk between doctors and their patients regarding terminal illness? Of course. Who would argue otherwise? When faced with terminal illness, would you choose a hospital, hospice, or home? How would you want pain treated? Would you want information on clinical trials? Who will speak for you if you can no longer communicate your wishes?
These are important decisions that should not be left to chance. The “death panel” label that succeeded in getting incentives for end-of-life planning cut from the Affordable Care Act did us all a great disservice.
It doesn’t have to be cancer. When you get to end-of-life issues, what you don’t know… and what you don’t plan for… can hurt you. Kudos to the ASCO for telling it like it is and putting patients’ rights first.
Photo Author: Rhoda Baer, Source: National Cancer Institute (NCI)
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