Abstract
In January 1997, at Medicine Grand Rounds, Dr Joanne Lynn discussed the approach to caring for and counseling a woman nearing the end of life.<sup>1</sup>Mrs J, an enthusiastic and gracious woman, had chronic congestive heart failure, and she understood that death could occur soon. Dr Lynn explained that patients and families face many issues at this crucial point in life, and she outlined strategies for how health care providers could best serve the needs of dying patients, while relating to their search for meaning and personal growth. She emphasized quality of care and offered opportunities for improving the care system for patients at the end of life. Following an exacerbation of her illness, Mrs J was admitted to the palliative care unit at the Beth Israel Deaconess Medical Center, and died a few days prior to the conference. We asked the patient's daughter and primary care physician to
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