MEDICAL TEXTBOOKS: Lack End-of-Life Care Topics
Leading medical textbooks contain little to no helpful information on end-of-life care for patients, according to a new study published in today's Journal of the American Medical Association. Researchers at the University of California-San Francisco evaluated 50 top medical textbooks on 13 key end-of-life topics including management of pain; management of symptoms other than pain; psychological issues like depression; social issues such as family, gender and race; spiritual issues; and ethics, laws and policies and found that the books lacked content on more than half of the topics. In addition, researchers found minimal content on one-fifth of the topics and helpful information in less than one-fourth of the topics. Social, spiritual, ethical and family issues as well as physician responsibility after a patient's death were the least covered issues. Researchers found that surgery textbooks contained the least end-of-life information, followed by infectious diseases and AIDS texts and oncology and hematology texts. Books devoted to family medicine and primary care, geriatrics and psychiatry contained the highest percentage of "helpful" end-of-life information. The study's lead author, Dr. Michael Rabow, said, "I'm afraid the textbooks we researched received a failing grade. That is troubling because if end-of-life material is not in the books, there's a good chance medical students won't learn it and physicians won't do it." However, he did note some recent attempts to change textbook content, particularly in nursing, pediatrics and psychiatry texts. Moreover, some publishers have commissioned updates of textbooks to include new chapters dedicated to end-of-life care (JAMA release, 2/8).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.