End-of-life care: How does your state measure up? A few months ago, I read an article in USA Today, which revealed that dying patients are still not getting relief from their pain. A coalition of health-care groups, called Last Acts, has released a very discouraging study involving all 50 states: Nearly half of the 1.6 million Americans living in nursing homes suffer from untreated pain. They said that life was being extended but it amounted to little more than an extension of pain and suffering. The report, which is the first comprehensive look at end-of-life care, ranked each state's ability to provide eight key elements of palliative care. Palliative care relieves the patient's pain and other physical symptoms while supporting the patient and his family emotionally and spiritually, and while respecting their cultural traditions. Most states got a "report card" littered with C's, D's and F's. Despite the growing need for end-of-life care, many doctors don't receive formal training in this field. Just 39 percent of the physicians caring for dying patients had been trained in issues that often come up as death approaches. If the situation is hopeless, then the "power of positive thinking" should be laid aside. The doctor should advise that all tubes and respiratory aids be removed, unless some of them contribute to the comfort of the patient. You, and only you, should decide how you should be cared for if you become seriously ill. Write it down. File it with your doctor. Discuss it with your family. This document will communicate your wishes even if you are unable to do so. You can find more information on the Web (try searching under "Advance Directives") or talk with your attorney. Keeping an eye on junk medicine,
William Campbell Douglass II, MD | 
