Los Angeles Times Health Section Looks at Issues Surrounding End-of-Life Care

The Health section of today's Los Angeles Times examines issues surrounding end-of-life care in separate articles, focusing on "Preparation," "Pain," "Culture" and "Quality of Life." The following briefly describes the articles:

• Pain: "Last Days Needn't Be Spent In Agony": With surveys indicating that Americans have "an acute fear of dying in pain," the Times reports that although medical advances in the last decade have led to "safe treatments" to control pain, many "obstacles" prevent relief for patients. Such barriers include a lack of medical training, the "stigma" associated with narcotics and "roadblocks" from insurers and the government. For example, many doctors are apt to "under-prescribe" narcotics to avoid scrutiny from medical boards and the Drug Enforcement Administration (Marsa, Los Angeles Times, 8/20).
  
• Preparation: "Putting Your Wishes In Writing": As medical treatments have become more "sophisticated" and people are living longer, the Times reports that it is "crucial" for patients to determine how they want to live their last days. By completing and having "advance directives," a collection of legal binding documents, patients can ensure someone they trust will make the "important decisions" about their care. The Times reports that anyone over 18 years of age should have a living will, durable power of attorney for health care and a do not resuscitate order (Hamilton, Los Angeles Times, 8/20).
  
• Culture: "When a 'Good Death' Isn't for Everyone": Although a "majority" of Americans want to manage their end-of-life care, some come from cultures and backgrounds that have different customs regarding end-of-life care and life-support technology. "Forcing" family members to make treatment decisions sometimes "backfires" among many recent and first generation immigrants who "resent" the idea that they want to make "life and death" decisions. In response, U.S. doctors are becoming more aware of different cultures to work with family members (Carey, Los Angeles Times, 8/20).
  
• Quality of Life: "Her Happiness During Her Final Days Was Innate, Not Prescribed": Describing his wife's battle with a fatal brain tumor, John Rossman writes, "Judgment of quality of life cannot be made by any objective measurement. Life quality is something that only the person living the life can evaluate" (Rossman, Los Angeles Times, 8/20).