When You Deserve Trustworthy Assurance the Most

Article submitted by Laurence Durante, M.D., MPH; Medical Director, St. Joseph Hospice and Palliative Care; ABHPM - Board Certified; AAHPM - Fellow.
Edited from the AMA statement on end-of-life care.
For more information, he can be reached at 504-734-0140.

Providing care at the end of a patient's life is a privilege and a sacred trust between patient and their end-of-life professionals. Patients seek peace and dignity in the last phase of life and should expect the following elements of care from physicians, health care institutions, and the community:

The opportunity to discuss and plan for end-of-life care. This should include: the opportunity to discuss treatment preferences with the physician, the chance for discussion with others, the chance to make a formal "living will" and proxy designation, and help with filing these documents.

Trustworthy assurances that physical and mental suffering will be carefully attended to and comfort measures intently secured.

Trustworthy assurance that preferences for withholding or withdrawing life-sustaining intervention will be honored. Patients' preferences regarding withholding or withdrawing intervention should be honored in accordance with the legally and ethically established rights of patients.

Trustworthy assurance that there will be no abandonment by the physician. If a physician must transfer the patient in order to provide quality care, that physician should make every reasonable effort to continue to visit the patient with regularity.

Trustworthy assurance that dignity will be a priority. Patients should be treated in a dignified and respected manner at all times.

Trustworthy assurance that burden to family and others will be minimized. Patients should be able to expect sufficient medical resources and community support, such as palliative care, hospice or home care, so that the burden of illness need not overwhelm caring relationships.

Attention to the personal goals of the dying person. Patients should be able to trust that their personal goals will have reasonable priority.

Trustworthy assurance that care providers will assist the bereaved through early stages of mourning and adjustment. Patient and their loved ones should be able to trust that some support continues after bereavement.