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Perspective

Letting Go of the Rope — Aggressive Treatment, Hospice Care, and Open Access

List of authors.
  • Alexi A. Wright, M.D.,
  • and Ingrid T. Katz, M.D., M.H.S.

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. For Joanne Doolin, a 64-year-old mother of three who spent her last 2 years of life fighting colon cancer that eventually made it impossible to eat, enrollment in hospice care involved a difficult trade-off: with only a few weeks left to live and her daughter's wedding approaching, Doolin was forced to choose between entering hospice care and continuing to receive total parenteral nutritional support.Unfortunately, treatment options are often limited by the economic constraints . . .

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Funding and Disclosures

An interview with Dr. Timothy Quill, director of the Center for Palliative Care and Clinical Ethics at the University of Rochester, can be heard at www.nejm.org.

Author Affiliations

Dr. Wright is a fellow in hematology–oncology at the Dana–Farber Cancer Institute, and Dr. Katz is a fellow in infectious disease at the Beth Israel Deaconess Medical Center — both in Boston.

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