Factors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers

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Abstract
Dying patients confront complex and unique challenges that threaten their physical, emotional, and spiritual integrity. The Study to Understand Prognosis and Preferences for Outcomes and Risks of Treatments (SUPPORT) documented that many patients die prolonged and painful deaths, receiving unwanted, expensive, and invasive care.1 Patients' emotional suffering at the end of life can be profound, yet physicians are too frequently ill equipped to address this suffering.2,3 In response, medical societies, health care organizations, and the public have identified improved end-of-life care as a high national priority. The American Medical Association and the Institute of Medicine have outlined goals for improved care of the dying, and The Robert Wood Johnson Foundation has devoted millions of dollars to public education on this issue through the Last Acts initiative.4-6