End-of-life care

Interesting reading, if you are interested in the topic, that is. A long article about re-thinking end-of-life treatment by Atul Gawande in the August 2 issue of The New Yorker. Gawande is a surgeon at Brigham and Women's Hospital in Boston and an associate professor at Harvard Medical School and the Harvard School of Public Health. He has written several best-selling books. Here is a statistic to ponder: According to Gawande, 25% of all Medicare spending is for the 5% of patients who are in their final year of life, and most of that money goes for care in their last couple of months which is of little apparent benefit.

This article was closely followed by the publication of a study in the August 19 edition of The New England Journal of Medicine. Also included is a related news article and some editorials generated by the study.

1. Gawande A. Letting go. The New Yorker 2010 Aug 2; p. 36-49.
http://www.newyorker.com/reporting/2010/08/02/100802fa_fact_gawande

2. Temel JS, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733-42.
http://www.nejm.org/doi/pdf/10.1056/NEJMoa1000678

3. Kelley AS, Meier DE. Palliative care: a shifting paradigm [editorial]. N Engl J Med 2010;363:781-2.
http://www.nejm.org/doi/pdf/10.1056/NEJMe1004139

4. McNeil DG Jr. Palliative care extends life, study finds. The New York Times 2010 Aug 18.
http://www.nytimes.com/2010/08/19/health/19care.html?ref=donald_g_jr_mcneil

5. The Oregonian Editorial Board. Rx: a dose of old-fashioned comfort [editorial]. The Oregonian 2010 Aug 19.
http://www.oregonlive.com/opinion/index.ssf/2010/08/rx_a_dose_of_old-fashioned_com.html