An evaluation of the end-of-life care content in leading neurology textbooks.

Abstract

Guidelines by the American Academy of Neurology state that neurologists have a duty to provide adequate palliative care,1,2⇓ but a recent survey suggests that there is a sizable gap between established guidelines and the end-of-life care beliefs and practices of many neurologists.3 Deficiencies in physician training, including inadequate textbook content, likely contribute to this problem. Previous research suggests that the end-of-life content in most medical textbooks is limited, but neurology textbooks in particular have not been assessed.4,5⇓ We evaluated the end-of-life care content in three top-selling neurology textbooks. From 1998 to 1999 we reviewed the most recent editions of 50 top-selling textbooks6 (three in neurology and 47 in 11 other medical disciplines). Details of textbook selection, rating procedures, and data analysis are available elsewhere.5 In each neurology textbook, we reviewed four textbook chapters that pertained to common neurologic causes of death (AD, cerebrovascular accident, vegetative state, and brain death) and one cancer (neuroblastoma). In …