Journal of palliative medicine
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Gay men and lesbians have special interests in documenting their preferences regarding advance care planning and end-of-life care. A 64-item survey instrument was developed to ascertain the preferences of this community regarding approaches to end-of-life care, viewpoints on physician-assisted suicide (PAS) and euthanasia, and practices regarding advance care planning. The survey was completed by 575 participants recruited through community-based health care and social service organizations serving the lesbian and gay community, primarily in the New York metropolitan area. ⋯ Although respondents completed advance directives at a higher rate than adults generally, the legal importance for gay men and lesbians to execute directives should encourage health care providers and community organizations to assume a larger educational role on advance care planning. Results confirm other reports on the need to address provider communication skills. It is speculated that the HIV epidemic was a major influence behind these results because of the overwhelming personal impact of the epidemic on most gay men and lesbians during the past two decades.
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Within the academic medical center providing interdisciplinary, experiential, longitudinal, and mentored learning experiences for students regarding hospice/end-of-life care is a considerable challenge. This article describes an innovative course for medical, nursing, and social work students taught as a partnership among the departments of family medicine, medical history/ethics and three community hospice programs. ⋯ Achieving these goals is challenging for students (especially medical students) and faculty but highly rewarding. The development, implementation and evolution over the past 3 years of this hospice volunteer training course are discussed.
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Biography Historical Article
Religion, medicine, and community in the early origins of St. Christopher's Hospice.
Commentators on the history and development of hospice and palliative care can appear inclined toward a revisionist viewpoint that sees something "lost" in recent years from the original concept. The thesis concerning the "secularization of hospice" is one such example. It is suggested that the quality of these debates can be improved by serious scholarly attention to earlier events and circumstances, drawing on contemporary source materials, rather than retrospective viewpoints. ⋯ It shows how Cicely Saunders and her associates created an Aim and Basis for the hospice that sought to reconcile questions about its religious orientation; its relationship to medicine; and its status as a community. We see how tensions between these were resolved, resulting in a model that would be applicable in other contexts. Without this pragmatic turn, it is unlikely that the hospice movement would have spread so quickly and so far in the 1970s and 1980s.