Analysis

Editorial Extols Palliative Care as a Way to Help Patients and Families

Many Americans face important palliative health care decisions.iStock

Palliative care can reduce pain and anxiety for patients and their families.

On Jan. 19, the Journal of the American Medical Association published an important editorial by Dr. Atul Gawande, a Boston surgeon and author of the best-selling book Being Mortal: Medicine and What Matters in the End. Gawande corrects the misperception that palliative care—management of a patient’s physical, psychological, emotional, and spiritual needs—and advance care planning amount to “giving up” near the end of life. He writes that palliative care is instead “dedicated to assisting seriously ill people with setting and achieving goals aside from just survival, which may include control of symptoms, attending to life projects, connecting with loved ones, or other vital objectives.”

If we are to improve care for seriously ill people and those near the end of life, we need to consider shifting our focus from treating disease to offering palliative care, for those who may choose this option, to reduce pain and anxiety for patients and their families. As Gawande notes, most people want medicine to allow “as good a life as possible all the way to the very end.” Palliative services—sometimes referred to as comfort care—can be the best way to ensure that individuals receive the type of care they want in order to live, and die, as they choose.

Pew’s improving end-of-life care project is committed to advancing policies that will help people make informed decisions. Along with experts, clinicians, and policymakers, we are working to learn about innovative models of care, increase access to advanced care plans, establish metrics that track the success and quality of end-of-life treatment, and help health care consumers understand their choices. We are encouraging the federal government to research the benefits of palliative care to foster quality treatment centered on patients’ needs and desires. When it comes to end-of-life care, as Gawande writes, “the vital goal almost all people want from medicine is not having a good death but having as good a life as possible all the way to the very end.”

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