AAHPM submitted the following letter to US News & World Report in response to Dr. Bernadine Healy’s “On Health” column from the recent February 2010 Special Issue – “Aging Well” – which included some misleading comments about hospice and palliative medicine. We encourage AAHPM members to post their thoughts at the end of the article in the Reader Comments section.
Letter to the Editor
US News & World Report
February 12, 2010
Bernadine Healy is correct when she says that patients need to be informed about their health care, including end-of-life care (On Health, February 2010 – Special Issue: Aging Well). As a doctor who specializes in hospice and palliative medicine, I have always urged patients to have living wills and to discuss their wishes for end-of-life care with their doctors and family members.
But some information Dr. Healy presents about palliative medicine is simply incorrect, and suggests that expanding the availability of palliative medicine will limit options for people with serious illness. Exactly the opposite is true.
Palliative medicine is a board-certified medical specialty that focuses on relieving suffering and providing support and care coordination for patients with serious illnesses, regardless of age or prognosis, or whether curative treatments are being given. Many of our patients recover from their illnesses and credit palliative medicine with making grueling curative treatments bearable.
Studies show that palliative medicine decreases hospital admissions, and Dr. Healy fears this goal of health care reform will result in premature death for patients with chronic and incurable illnesses. Palliative medicine keeps patients out of hospitals by relieving their symptoms and coordinating their out-patient care, which often reduces the need for hospitalization. It’s better for the patient and the family. And, yes, it saves the system money.
Dr. Healy refers to “so-called terminal sedation” and seems to suggest that this is one way that hospice care – a specific type of palliative care – might be used to hasten death, and cut costs. I believe she is referring to “palliative sedation.” Palliative sedation is used – rarely – to bring relief to patients already near the end of life whose pain and suffering are overwhelming and otherwise uncontrollable. When it is necessary, and a patient chooses it, palliative sedation can enable us to fulfill our promise to help our patients face death with some comfort and control.
My colleagues and I chose to practice palliative medicine to ease pain and suffering, and give patients more control over their care. The health care reform debate has brought attention to our specialty – not always accurately. We want people – especially those who may need the care we provide – to have the facts. They can find them at www.PalliativeDoctors.org.
Gail Austin Cooney, MD
American Academy of Hospice and Palliative Medicine