More Americans are choosing hospice for end-of-life care, butironically, hospice patients increasingly are forced to giveup effective palliative treatments along with aggressive medicalintervention. For Joanne Doolin, a 64-year-old mother of threewho spent her last 2 years of life fighting colon cancer thateventually made it impossible to eat, enrollment in hospicecare involved a difficult trade-off: with only a few weeks leftto live and her daughter's wedding approaching, Doolin was forcedto choose between entering hospice care and continuing to receivetotal parenteral nutritional support.
Unfortunately, treatment options are often limited by the economicconstraints . . . [Full Text of this Article]
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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.
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.
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