Hospice Physicians Research Articles

Educational objectives for medical training in the care of the terminally ill.

Palliative medicine is developing as a distinct clinical discipline worldwide. The U.S. literature describes goals for education in palliative medicine, yet this literature lacks validated educational objectives. To develop and validate appropriate educational objectives for medical training in the care of the terminally ill, 200 randomly selected members of the Academy of Hospice Physicians were asked in 1992 to evaluate 39 educational objectives by an item-objective congruence procedure. Each objective was rated as -1 (inappropriate), 0 (unsure), or 1 (appropriate). Of the 200 members surveyed, 127 (64%) responded. Of the 39 objectives, 34 were considered valid, with a mean score of > or = .8. The index of content validity was .87. The objectives not considered valid all dealt with nonmedical issues related to hospice or palliative care. This study validated 34 educational objectives for medical training in the care of the terminally ill. Training programs using these objectives, amended for specific audiences, should be included in the various levels of U.S. medical education.

Hospice are we a dumping ground?

The enclosed article addresses a common attitude of many hospice organizations regarding the enrollment of patients still on life support systems. Many hospices refuse to take a patient unless all life sustaining apparatus has been removed prior to admission. I am attempting to create an appropriate ethical and humane attitude which will influence all hospices to willingly accept patients in the above situation, relying on a hospice physician to remove life supports.

International Hospice Institute; Academy of Hospice Physicians A vision for hospice

International Hospice Institute; Academy of Hospice Physicians A vision for hospice

Concepts of grief and loss for the hospice physician

Concepts of grief and loss for the hospice physician

What is the role of the hospice physician?

What is the role of the hospice physician?

How Shall the Aged Die?

Journal Article How Shall the Aged Die? Get access Ethics on Call: A Medical Ethicist Shows How to Take Charge of Life-and-Death Choices, by Nancy Dubler, with David Nimmons. Harmony Books, New York, 1992, 403 pp., $20.00 (cloth).Euthanasia Is Not the Answer: A Hospice Physician's View, by David Cundiff. Humana Press, Totowa, NJ, 1992, 190 pp., $17.95 (cloth).A Good Death: Taking More Control at the End of Your Life, by T. Patrick Hill and David Shirley. Addison-Wesley, Reading, MA, 1992, 160 pp., $11.95 (paper).Hospice Care, by Bert Hagship and Joel Leon. Sage Publications, Newbury Park, CA, 1992, 235 pp., $28.00 (cloth), $14.00 (paper).The Right to Die: Policy Innovation & Its Consequences, by Henry R. Glick. Columbia University Press, New York, 1992, 238 pp., $32.50 (cloth).Suicide and the Older Adult, edited by Antoon A. Leenaars, Ronald Maris, John L. Mclntosh, & Joseph Richman. The Guilford Press, New York, 1992, 160 pp., no price listed (cloth).When Others Must Choose: Deciding for Patients Without Capacity, New York State Task Force on Life and the Law, New York, 1992, 288 pp., $9.00 (paper). Stephen G. Post Stephen G. Post Search for other works by this author on: Oxford Academic PubMed Google Scholar The Gerontologist, Volume 33, Issue 3, June 1993, Pages 427–429, https://doi.org/10.1093/geront/33.3.427 Published: 01 June 1993

Euthanasia Is Not the Answer: A Hospice Physician's View

In the summer of 1992,I read, among other books about euthanasia, Derek Humphrey's controversialFinal Exit. It is an unapologetic and somewhat bizarrely forthright how-to book on ending one's life. Humphrey, a news reporter, states simply that his goal was to actually give dying people printed guidance on how to end their lives if their suffering was unbearable! Just as divorce has increased dramatically among the elderly, so has suicide. Suicidal wishes would be acted upon much more frequently if individuals had the physical capacity, awareness, and access to end their lives. Recent publicity has focused on an American practitioner and author, Dr Jack Kevorkian (The Goodness of a Planned Death), whose invention of a death machine to end the life of an Alzheimer's patient has received considerable support and far less condemnation from the public. ... 'where cure is not possible, care is still needed'... The medical community has not,

What is the role of the hospice physician?

What is the role of the hospice physician?

International Hospice Institute; Academy of Hospice Physicians--a vision for hospice.

International Hospice Institute; Academy of Hospice Physicians--a vision for hospice.

Ethics and hospice physicians

Advocates of compassionate care for the dying should contribute to the formulation of ethical policies for dealing with the dying. Having identified the relevant ethical principles and controversies there is a need for continued dialogue as society makes new demands on the medical profession. At a time when the concept of what is moral or immoral is under review, as societal mores change, the needs of the dying also change. The medical profession must be flexible in responding, within the constraints of maintaining the integrity of the profession.

What is the role of the hospice physician?

What is the role of the hospice physician?

Hospice physician's current literature review

Hospice physician's current literature review

Hospice at the crossroads: the physician director.

The Medicare regulations for hospice haveallowedthe development of two types of programs. The physician-supervised model, in which the hospice provides a physician to oversee a general program with no requirement of his direct involvement with patient care. The second model is physician-directed, where the care of the patient is assumed by the hospice physician. This report reviews the implications of each model with an examination of their benefits and disadvantages. It is our feeling that the physiciandirected modelof hospice care has so many advantagesto this movement that it should be favored.

Perspectives on the Pain of the Hospice Patient

Behind the physical disfigurement and emotional ravages of advanced malignancy, it is the pain of cancer that is most dreaded. Severe biological pain is experienced by fewer than half of patients dying from cancer. Hospice physicians have the expertise to control the pain of those cancer patients who do experience it. The cancer patient may experience other forms of pain that can be equally devastating: pain of isolation, pain of abandonment, and pain of loss of role. It is important for the occupational therapist working in a hospice setting to understand all aspects of pain management, and the occupational therapy treatment strategies which can improve the quality of life and perception of pain for the hospice patient. Through presentation of case studies, the authors illustrate applications of occupational therapy assessments and interventions in respect to two hospice patients. The occupational therapy treatment strategies effected an improvement in the quality of life for these patients and consequently their perception of pain of loss of role. Occupational therapists, as part of the hospice team, play an important part in giving patients an opportunity to live out their lives in as dignified and purposeful a manner as their disease permits.

Accuracy of predictions of survival in later stages of cancer.

Though 83% of 168 cancer patients admitted for "terminal care" died within 12 weeks of admission predictions of the probable length of survival showed little relation to the actual length of survival. A total of 83% of all "errors" were in an "optimistic" direction, the patient being expected to survive longer than he actually did.No significant differences were found between the accuracy of predictions made at referral by general practitioners, by doctors at other hospitals, by hospice physicians on the day of admission, or by ward sisters and senior nurses at the same time. A week after admission predicted and actual survival correlated more closely but predictions were still optimistic.It is concluded that predictions of the length of time which a cancer patient who is at the end of active treatment can be expected to survive should be made and interpreted with the greatest caution.