scholarly journals How Often Is End-of-Life Care in the United States Inconsistent with Patients' Goals of Care?

2017 ◽  
Vol 20 (12) ◽  
pp. 1400-1404 ◽  
Author(s):  
Nita Khandelwal ◽  
J. Randall Curtis ◽  
Vicki A. Freedman ◽  
Judith D. Kasper ◽  
Pedro Gozalo ◽  
...  
Keyword(s):  
United States ◽  
End Of Life ◽  
End Of Life Care ◽  
The United States ◽  
Life Care ◽  
Goals Of Care

End-of-Life Care behind Bars

2002 ◽  
Vol 10 (3) ◽  
pp. 233-241 ◽  
Author(s):  
Phyllis B. Taylor
Keyword(s):  
United States ◽  
End Of Life ◽  
End Of Life Care ◽  
The United States ◽  
Chronic Illnesses ◽  
Direct Result ◽  
Life Care ◽  
Prison Health ◽  
The Many ◽  
Changing Demographics

More people than ever before are being incarcerated in the United States. Many inmates are infected with HIV and hepatitis C. Sentences are increasing in length. Prison health care is now having to cope with the many chronic illnesses associated with an ill and aging population. The growth of end-of-life care programs in corrections in the United States is a direct result of the changing demographics of inmates. This article examines the need for end-of-life care behind bars and discusses selected hospice programs.

End-of-Life Care in the Netherlands and the United States: A Comparison of Values, Justifications, and Practices

1997 ◽  
Vol 6 (2) ◽  
pp. 189-204 ◽  
Author(s):  
Timothy E. Quill ◽  
Gerrit Kimsma
Keyword(s):  
United States ◽  
The Netherlands ◽  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
Ethical Climate ◽  
The United States ◽  
Policy Implications ◽  
Life Care ◽  
Physician Assisted Suicide

Voluntary active euthanasia (VAE) and physician-assisted suicide (PAS) remain technically illegal in the Netherlands, but the practices are openly tolerated provided that physicians adhere to carefully constructed guidelines. Harsh criticism of the Dutch practice by authors in the United States and Great Britain has made achieving a balanced understanding of its clinical, moral, and policy implications very difficult. Similar practice patterns probably exist in the United States, but they are conducted in secret because of a more uncertain legal and ethical climate. In this manuscript, we plan to compare end-of-life care in the United States and the Netherlands with regard to underlying values, justifications, and practices. We will explore the risks and benefits of each system for a real patient who was faced with a common end-of-life clinical dilemma, and close with challenges for public policies in both countries.

The Status of End-of-Life Care in the United States

JAMA ◽  
2018 ◽  
Vol 320 (3) ◽  
pp. 239 ◽  
Author(s):  
Ezekiel J. Emanuel
Keyword(s):  
United States ◽  
End Of Life ◽  
End Of Life Care ◽  
The United States ◽  
Life Care ◽  
The Status

scholarly journals End-of-Life Care among US Adults with ESKD Who Were Waitlisted or Received a Kidney Transplant, 2005–2014

2020 ◽  
Vol 31 (10) ◽  
pp. 2424-2433
Author(s):  
Catherine R. Butler ◽  
Peter P. Reese ◽  
James D. Perkins ◽  
Yoshio N. Hall ◽  
J. Randall Curtis ◽  
...  
Keyword(s):  
United States ◽  
End Of Life ◽  
Kidney Transplant ◽  
End Of Life Care ◽  
Reference Group ◽  
Deceased Donor ◽  
The United States ◽  
Life Care ◽  
Advance Care ◽  
Functioning Kidney

BackgroundThe care of patients in the United States who have ESKD is often shaped by their hopes and prognostic expectations related to kidney transplant. Little is known about how patients’ engagement in the transplant process might relate to patterns of end-of-life care.MethodsWe compared six measures of intensity of end-of-life care among adults in the United States with ESKD who died between 2005 and 2014 after experiencing differing exposure to the kidney transplant process.ResultsOf 567,832 decedents with ESKD, 27,633 (5%) had a functioning kidney transplant at the time of death, 14,653 (3%) had a failed transplant, 16,490 (3%) had been removed from the deceased donor waitlist, 17,010 (3%) were inactive on the waitlist, 11,529 (2%) were active on the waitlist, and 480,517 (85%) had never been waitlisted for or received a transplant (reference group). In adjusted analyses, compared with the reference group, patients exposed to the transplant process were significantly more likely to have been admitted to an intensive care unit and to have received an intensive procedure in the last 30 days of life; they were also significantly more likely to have died in the hospital. Those who died on the transplant waitlist were also less likely than those in the reference group to have been enrolled in hospice and to have discontinued dialysis before death.ConclusionsPatients who had engaged in the kidney transplant process received more intensive patterns of end-of-life care than other patients with ESKD. These findings support the relevance of advance care planning, even for this relatively healthy segment of the ESKD population.

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