Comments on: Diane Meier and language and policy-making

By: Patrick Clary, MD

Patrick Clary, MD — Mon, 08 Mar 2010 01:48:10 +0000

What we are being asked for by Dr. M. is essentially denial: denial that care for the dying is central to our mission in this case. Most of the patients I see in palliative care consultations are dead within weeks. My referrals to hospice generally turn out to have brief stays, and, frankly, are dreaded by hospice RNs, though they appreciate the clarity of my documentation, particularly around the goals of care.

There are “slow deaths” among those, but I think the more appropriate label would be “slow, expensive deaths.” The public revulsion at “Death Panels” and “Death Taxes” requires more than a turning away from reality; it requires education, not “re-branding.” I am proud of what I do to care for the dying and advocate that we continue to call a spade by its proper name.

By: dmcgrew

dmcgrew — Sun, 07 Mar 2010 02:13:21 +0000

Great point by Clay. I can see the merit to both sides. Let us not forget that there is more than one legitimate perspective as we move forward in our education of the public and politicians. No matter how flat the pancake is, it still has two sides.

By: clay anderson

clay anderson — Sat, 06 Mar 2010 03:44:16 +0000

i agree that language is important, and that to an extent, language has been an albatross impeding the progress of pallaitive care. but is it really that we are misusing the language, or that society, the media, the health care professions are misunderstanding our language? in truth, most of what is done in palliative care, and especially in hospice, truly is end of life care and care for the dying. for this, we should be proud. indeed palliative care is more than that of course, and thank goodness for that. but it is A LOT more than symptom management and goals of care discussion in people with advanced chronic illness. to surgically resect the compassionate and expert care of the dying from our language is to minimize and belittle the majority, truthfully, of what we all do. we do need to broaden our language and be precise about our language, but i would argue we should not eliminate the very important, authentic, and truthful aspect of caring for those who we can help live well til they die and then die well. we as a community that is half hospice providers need to talk more about this language issue.