Friday, March 12, 1999

Doctors, nurses
aim to improve
end-of-life care

Better service to patients may
help forestall suicide requests

By Helen Altonn


Hawaii's doctors have joined a national effort to improve care for dying patients.

"We recognize all over the country there are problems in hospitals," says Dr. Len Howard, a past president of Hawaii Medical Association who has long been involved in ethics issues.

"People have living wills. Doctors don't pay any attention to them. Patients are having a lot of pain. Doctors are afraid to give much medicine, afraid the Drug Enforcement Agency will come down on them."

Those and other issues will be tackled by the HMA in a series of statewide seminars to train island physicians and nurses on care of the dying, Howard said.

The two-year project, starting tomorrow in Honolulu, is part of the American Medical Association's Education for Physicians on End-of-Life Care program.

Howard said the program was developed in response to problems that have led people to request physician-assisted suicide.

Howard said the End-of-Life Care program aims to have physicians pass on what they learn. "The goal ultimately is to present the program to every licensed practicing physician in the state."

The HMA also is including nurses, Howard said. "They are so integral in treatment of end-of-life situations, they need to get the same exposure to the information that physicians do."

The information will cover such topics as the legal aspects of advanced directives and the status of a living will, Howard said.

"Can it be ignored? Should it be ignored? What are your obligations to a patient who has a living will?"

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