The 1997 report from the Institute of Medicine, Approaching Death: Improving Care at the End of Life, found widespread dissatisfaction with end of life care and many gaps in our scientific knowledge of this phase of life. In response, the National Institute of Nursing Research (NINR) sponsored a workshop on the symptoms of terminal illness, and NINR was later designated the lead Institute within NIH for end o f life research.
One of the critical topics in end o life explored by the NINR follows below:
Documenting end of life wishes:
Among a group of patients with terminal cancer, less than half had an advance directive, although Whites were more likely to have one than Blacks. Between patients, and their caregivers, there was almost a 50% disagreement on the desire for life-sustaining measures in patients without advance directives. A later study found that Blacks were more likely than Whites to prefer hospitalization and life-sustaining measures when in a near-death condtion; Blacks were also more likely than Whites to use spirituality to cope with their illness.
Phipps,
Albert Einstein Healthcare Network,
2003, 2005
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