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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In his article,¹ Dr Weissman discusses how to address end-of-life issues, an important and changing subject. The article included an interview with the medical oncologist who has cared for a cancer patient over the past 2 years. During these years, the physician was able to establish a trusting relationship with the patient and probably with her family.

With the evolution of inpatient care, hospitalists frequently substitute for primary care physicians in the hospital for patients with a noncancer diagnosis, for whom the demarcation of disease progression may be less clear than for patients with a cancer diagnosis. Not only is it harder to recognize when these end-of-life conversations should occur, but the important relationships needed to have a thoughtful and trusted discussion may not have been developed. Although specialists involved with the patient could have that relationship, the specialist may view only a small part of . . . [Full Text of this Article]

David B. Edwards, MD
david.edwards@bannerhealth.com
Banner Desert Medical Center
Mesa, Ariz

RELATED ARTICLE

Decision Making at a Time of Crisis Near the End of Life
David E. Weissman
JAMA. 2004;292(14):1738-1743.
ABSTRACT | FULL TEXT