The Project on Death in America: History, Impact, and Continuing Relevance (TH332)

Abstract

•Foster a critical understanding of the history and contribution of the Project on Death in America (PDIA).•Identify lessons and sources of inspiration from the PDIA that might be applied elsewhere.•Consider how the PDIA legacy might make an impact in the current global context of palliative care. From 1994 to 2003, the Project on Death in America (PDIA) played a prominent part in end-of-life-care innovations in the United States. The PDIA produced a wide range of novel activities that explored the meanings of death in American culture and highlighted experiences of care at the end of life. It led to extensive service development and practice innovations. It contributed to the evidence base for palliative care and the emergence of a new field of specialization. It addressed the needs of underserved communities at the end of life and barriers to improved care as well as legal and ethical challenges. The PDIA generated strategies for “transforming” the culture of end-of-life care by empowering individuals and communities promoting organizational change, encouraging research and educational activities, and supporting public debate together with the consideration of ethical issues. The project occurred at a time of major philanthropic interest in end-of-life issues, so its impact is difficult to disentangle from that of other funders and initiatives. But it undoubtedly made a significant and enduring contribution to the improvement of end-of-life care in the United States. What can we learn from that impact? What is the enduring legacy of the PDIA? Are there lessons from the PDIA that can continue to inform the development of the palliative care field, not only in the United States but also further afield? Is the PDIA approach still a relevant resource for responding to the growing palliative care needs of countries around the world?