Finding Our Way—Perspectives on Care at the Close of Life
- Stephen J. McPhee, MD;
- Michael W. Rabow, MD;
- Steven Z. Pantilat, MD;
- Amy J. Markowitz, JD;
- Margaret A. Winker, MD
- Author Affiliations: University of California, San Francisco (Drs McPhee, Rabow, and Pantilat and Ms Markowitz). Dr Winker is Deputy Editor, JAMA.
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- palliative care
- terminal care
Hope does not lie in a way out, but in a way through.—Robert Frost
Dying is inevitable; there is no escape, no way out. Despite an ideal vision of the end of life in which people die peacefully and comfortably at home, surrounded by supportive family and friends, many individuals die in hospitals, and many are in pain and alone.1 Increasingly, clinicians are recognizing the difficulties that arise when caring for dying patients.2 Perceiving death as a personal defeat or professional failure despite its being a natural event,3-4 clinicians caring for patients at the close of life may feel lost in a foreign land without a map. Clinicians sometimes fear that recognizing the imminence of death may remove a patient's hope. They also may have little confidence in their ability to manage severe pain, dyspnea, and other terminal symptoms. The intense emotions that patients …
