Talking It Out: Helping Our Patients Live Better While Dying

Although dying is an inevitable part of the life cycle, there has been extensive political debate over end-of-life care. Participating in end-of-life care conversations can be emotionally challenging for every-one involved. Messages about serious or terminal illnesses can be very hard for patients and their families to hear, and physicians frequently struggle with the burden of delivering these messages. Still, evidence shows that conversations about end-of-life care op-tions between physicians and patients can improve the quality of life of dying patients and help to relieve the emotional burden on surviving loved ones. Legislation to support these discussions by consistently reimburs-ing physicians for their time spent performing this service has been blocked on multiple occasions. More research on how to improve end-of-life care will enable health care providers to optimize treat-ment of their patients. Overcoming political divides to support end-of-life care conversations is needed to promote care that is consistent with patients ’ values and needs and is a key step in encouraging better quality of life for dying patients. Ann Intern Med. 2011;154:830-832. www.annals.or