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:
Missed opportunities in end-of-life meetings:
When a patient is dying in an intensive care unit (ICU), clinicians may meet with the family to explore the decision to withhold or withdraw life sustaining treatment. However, an analysis of communication during these meetings found that clinicians often "missed opportunities" to address the concerns of family members, including:
(1) Failure to listen;
(2) Falure to acknowledge emotions, and
(3) Failure to explain ethical considerations or palliative/supportive care.
Curtis,
University of Washington,
2004
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