Doctors delay talking about end-of-life care

A study published this month finds doctors delay talking about end-of-life care, which often proves very costly. The Los Angeles Times reports: "Most doctors don't talk about end-of-life issues with their cancer patients when those patients are feeling well, a new survey has found." Physicians also tended to delay these conversations "until treatments have been exhausted. Those delays mean patients might not be able to make truly informed choices early in their treatment. The study, published online Jan. 11 in the journal Cancer, surveyed 4,188 physicians about how they would talk to a hypothetical cancer patient with four to six months to live. A majority of respondents (65%) said they would discuss prognosis, but only a minority said they would discuss do-not-resuscitate status (44%), hospice (26%) or preferred site of death (21%) at that time. Rather, they would wait until symptoms were present or until there were no more treatments to offer" (Adams, 1/25).

In a separate piece, The Los Angeles Times reports on palliative care and the high costs of end-of-life treatment: "Every year, billions of dollars are spent in the United States to treat terminally ill patients during their final year of life. ... The Centers for Medicare and Medicaid Services estimate that 5% of the beneficiaries who die each year take up 30% of the $446-billion annual Medicare budget. About 80% of that money is spent during the final month, on mechanical ventilators, resuscitation and other aggressive life-sustaining care." The article reports that patients who plan in advance for end-of-life treatment have lower costs and often have higher quality of life in the final days (Zamosky, 1/22).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.