Friday, August 20, 2010

Palliative Care Study Deserves Fanfare

John Carney
Vice President for Aging and End of Life
Center for Practical Bioethics

The title of the study is certainly innocuous, “Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer.” But the results are profound. It’s the endorsement, the confirmation, even vindication that palliative care professionals have been waiting for – for a long, long time.

This week’s New England Journal of Medicine (August 19, 2010) featured the news, along with high profile coverage in both the Wall Street Journal and the New York Times. Not bad press for a study of 150 or so patients with lung cancer.

So why the fanfare? Three reasons:

First, the study passed muster with the medical establishment. It was a randomized study – the holy grail required to get the scientific community’s attention, and laying claim that the results weren’t subject to chance.

Two, the “study also showed that early outpatient palliative care for patients with advanced cancer can alter the use of health care services, including care at the end of life. Other studies of outpatient palliative care have failed either to investigate these outcomes or to show an effect on the use of resources”.

And three – drumroll, please: Patients lived longer when they received palliative care as part of their course of treatment. From the get go, they got palliative care - and they did better, died later and died better.

So, we can now join the rest of the world and begin to face the proven fact that it’s better to take care of the whole person instead of just throwing an arsenal of munitions at a disease, hoping for the best.

Who’d have thunk that science could actually come to our aid in actually proving that the science of medicine and the art of care could actually have been one and the same all along?

And that Americans who believe that “more is better” in healthcare aren’t wrong after all, at least when the “more” relates to things that matter to the patient’s quality of life.

I like this study, not only because it’s scientifically rigorous, but it makes sense, saves money and helps us see how we can help very sick people live longer.



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