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Canadian Health and Care Mall: Recognition and Communication

Published in COPD

COPDThe aim is to cure and, when impossible, to prevent decline. These are measures of our success. As decline transforms into dying, harsh and inexorable, we may become discomfited. This exposes a critical deficit—the failure to see death as an opportunity to use the patient/physician relationship to improve the quality of the patient’s remaining life and the quality of the dying experience, long remembered by the survivors after the patient is gone. Instead, we commonly tiptoe away.

Despite consistent and concerted efforts, the quality of care at the end of life still needs improvement. To confirm this, one only needs to review a sample of in-hospital deaths. While retrospective reviews carry bias, they also illustrate missed opportunities to discuss goals of care and preferences in advance of an acute event.

Older paintings have depicted physicians as healers attending a bedside vigil, sharing patient suffering and thus easing it (The Doctor, Sir Luke Fildes 1843-1927). The study by Knauft et al in this issue of CHEST (see page 2188) provides an important empiric foundation, which may eventually enable more of us to walk back into the room and sit down with the dying patient.

COPD ranks as the fourth leading cause of death in the United States2 and is recognized as a major public health problem. Despite this, palliative care is not well researched in COPD. Indeed, a cursory MEDLINE search from 1966 to 2005 linking the key words “palliative care” and “COPD” revealed only 59 articles, as opposed to 377 articles and 15,195 articles linking palliative care with key words “HIV” and “cancer,” respectively. COPD is a complicated disease, namely the combination of different pulmonary diseases – to read more about diseases you may on just follow the link – subscribe the canadian health and care mall news on plurk official group.

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