The National Institute of Nursing Research recently hosted a briefing on the Institute of Medicine report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.
NINR director Dr. Patricia Grady noted that end-of-life care is “a topic of great interest across the NIH and across the Department of Health and Human Services and it is reflected by the attendees at today’s meeting.”
IOM committee co-chair and former U.S. comptroller general David M. Walker introduced the consensus report findings and themes. He was joined by co-chair Dr. Philip Pizzo of Stanford University School of Medicine, who highlighted the committee’s reasoning for each recommendation. In regard to honoring individual preferences and decisions, Pizzo said, “We were very clear in our work that while we were attentive to cost, we were putting quality first.” He stressed the importance of understanding “what people want…so that they could have the best quality of life and the best quality of death.”
|Attending the IOM briefing were (from l) Dr. Philip Pizzo, IOM committee co-chair; Dr. Patricia Grady, NINR director; David Walker, IOM committee co-chair; and IOM committee members Dr. Pamela Hinds, Judith R. Peres and Dr. James Tulsky.
The briefing also included remarks from IOM committee members Dr. James Tulsky, chief of Duke Palliative Care and professor of medicine and nursing at Duke University; Judith R. Peres, an independent consultant; Dr. Pamela Hinds of Children’s National Medical Center; and Dr. Adrienne Stith Butler, the IOM study director.
Tulsky spoke on the importance of quality communication between clinicians and patients. “We’re not trying to drive people to a particular kind of care, we’re trying to drive them to the type of care that they want, need and deserve,” he said.
When discussing the social work aspects of palliative care, Peres noted that “we need to know the role of the interdisciplinary team, the role of the family caregiver and…meeting people’s spiritual needs at the end of life.” From a policy standpoint, she emphasized “the role of the integration of medical and social services” as “a critical component to getting people what they need near the end of life.”
Hinds observed, “This is our opportunity to prevent complications for families, when end-of-life care is not the best that can be offered in America. Americans die in many different locations. How can we bring the best of care to all of those locations?” Meanwhile, Butler was adamant about disseminating the report and sharing the committee’s findings with other scientists and health care providers.
After a Q&A session, Pizzo remarked that the questions were “profound and they require clarity from many different disciplines.” He also noted “it’s not typical to prioritize death over life in funding, and yet, if we don’t do that, we are doing a disservice to every single person in this room and every single person on the planet.”