Paternalism in discussing resuscitation status has given way to an approach in which patients may be asked to choose from a bewildering array of medical options, but physicians-in-training are rarely taught how to lead such conversations confidently and effectively.

Though life expectancy inexorably decreases with advancing age, we tend to avoid discussing overall prognosis with elderly patients who have no dominant terminal illness. But we may thereby undercut patients' ability to make informed choices about their future.

New York's new Palliative Care Information Act mandates that physicians provide terminally ill patients with information and counseling regarding palliative care and end-of-life options. But it seems unlikely to lead to the best end-of-life medical practices.

The card, with its picture of a bouquet of flowers, was on my desk when I arrived at the hospital on Monday morning. I opened it, assuming it was a thank-you note from an interviewee for our residency program. But the handwriting was that of an elderly ...

The Medicare Payment Advisory Commission has recommended substantial changes designed to improve the accuracy of Medicare payments to hospices, increase hospice organizations' accountability, and ensure greater involvement by physicians in end-of-life ...

More Americans are choosing hospice for end-of-life care, but ironically, hospice patients increasingly are forced to give up effective palliative treatments along with aggressive medical intervention. Drs. Alexi Wright and Ingrid Katz discuss open-access ...

Dr. Gail Gazelle writes that hospice care is now considered part of mainstream medicine, as evidenced by growing patient enrollment and Medicare expenditures. But despite its increased use, many aspects of hospice care are still misunderstood by both ...

I recently helped my father to die. He was an engineer, independent, always on the go and in charge. He began to deteriorate rapidly from an ill-defined dementing illness, and his confusion and intermittent agitation did not respond to the standard ...

Researcher Linda Ganzini, M.D., says she was “stunned” after tallying the questionnaire results reported in this issue of the Journal (pages 359–365): Among the hospice nurses in Oregon who were surveyed, nearly twice as many had cared for patients who ...