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Refining questions for the dying

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David Casarett, M.D., the director of palliative care at Penn Medicine, discusses  in this New York Times blog entry his lessons from the Veterans Administration and elsewhere on how to provide end-of-life care.

He writes that providers often do not ask dying patients and their families the right questions.

Patients, for instance,  understandably might not care how good a hospital’s parking is.

Dr. Casarett writes that “{I]f we’re not asking the right questions, we won’t know how well we’re doing. We won’t know whether we’re giving patients and families enough information about an illness and its likely trajectory and prognosis. We won’t know whether we’ve done enough to help them preserve their sense of dignity and control. We won’t know whether we’re helping them to use the time they have left in the best way possible. And if we don’t know how well we’re doing, we can’t improve.”

“We could include questions about emotional and spiritual support, control over decisions, adequacy of information and respect for dignity. Those sorts of questions are arguably important for all of us, but they’re particularly relevant to those who are facing advanced, incurable illnesses.”

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