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 National Institute of Health (NIH) for end-of-life research.
Below, is one of the critical issues identified by the NINR which occurs at the end of life:
Inconsistent Communication in discussing end-of-life Issues
May family members of recently deceased terminal patients felt that doctors avoided discussions of prognosis with them until death was imminent, sometimes forcing them to make a quick decision related to life support measures. Nurses were seen as more available and more willing to share information. Most family members indicated they wanted doctors and nurses to offer hope, but also to be truthful and help them prepare for the worst.
Kaufman, University of California, San Francisco, 2005
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