This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Joanne Lynn, MD, MA, MS
for the SUPPORT Investigators; The George Washington University Medical Center Washington, DC

JAMA. 1996;276(15):1217.

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

To the Editor.

—Dr Emanuel's¹ characterization of the methods and findings of SUPPORT (The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments) might mislead the reader as to the relevance of SUPPORT for understanding costs at the end of life.^2-5 To date, SUPPORT publications on costs have been descriptive of overall costs not related to advance directives or to the end of life. The SUPPORT manuscripts that address the association of advance directives and costs are either in preparation or under review, and it would be premature to comment on these now.

Emanuel describes the SUPPORT intervention as "indirect and flawed." The intervention included providing multiple prognostic estimates and reports of patient and family interviews to the physicians and medical records, and providing a specially trained and dedicated nurse to encourage improved information and communication among patient, family, physicians, and care team.³ The approach was polite, . . . [Full Text PDF of this Article]

Footnotes
Edited by Margaret A. Winker, MD, Senior Editor, and Phil B. Fontanarosa, MD, Senior Editor.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?