Hospice Patients Alliance: Consumer Advocates

Medical Textbooks reported to lack
information on end-of-life care!

A February 9, 2000 article in the Journal of the American Medical Association reports that medical textbooks do not teach doctors enough about end-of-life care. Medical textbooks on oncology/hematology, treatment of infectious diseases/AIDS, and surgery were especially lacking in information on end-of-life care. The article concluded that: "Specialty textbooks with information about particular diseases often did not contain helpful information on caring for patients dying from those diseases." This explains why many physicians need help when it comes to properly treating patients with terminal illnesses. If physicians seek the advice of others more qualified, or if they get further training, then the problem may be overcome, but if the medical textbooks are generally indicative of what physicians learn (and that's a safe assumption to make), then physicians by and large may lack the basic information on how to care for your loved one!

Textbooks on family medicine, geriatrics and psychiatry had the most helpful content on end-of-life care, according to the study. Is your physician a specialist in hospice care, family medicine or geriatrics? If not, your loved one may not get the best care possible. Especially astonishing is the lack of information on caring for the dying in oncology or AIDS/infectious disease textbooks! This means that doctors who routinely treat cancer or AIDS are probably not adequately trained in caring for those dying of the diseases they are treating...and the majority of hospice patients are cancer patients and AIDS patients! Hospice nurses routinely report "difficulty" getting adequate orders for pain medications to effectively treat pain, even from oncologists. We would think that oncologists would be the most prepared and better trained to handle the symptoms of those dying from cancer, but according to this article, not so!

For those of you who wish to refer to the article itself and its research sources, you can find the Journal of the American Medical Association on-line at: http://jama.ama-assn.org/ Look for Volume 289 No. 6, February 9, 2000. Researchers who reviewed the medical textbooks included: Michael Rabow, M.D., (asst. prof. of medicine at Univ. of California at San Francisco); Grace E. Hardie, PhD, RN; Joan M. Fair, PhD, NP; and Stephen J. McPhee, M.D.

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