Improving care for dying people has moved onto the national stage with a prestigious institute announcing it will try to refocus medical care to match the kind of end-of-life experience patients and their families most value.

The Washington, D.C.-based Institute of Medicine announced last week it is drawing together experts to review federal policy, financing and hospital practices.

Recommendations of the private, nonprofit arm of the National Academy of Sciences often make their way into U.S. laws and federal agency policies.

The panel's mission comes after this newspaper's yearlong Cost of Dying series explored the financial and emotional drain on patients and taxpayers in a health care system that tends to isolate the dying amid high-cost, high-tech treatments.

The series -- posted at www.mercurynews.com/cost-of-dying -- concluded with a story that prescribed ways to make end-of-life care more affordable and humane and led to community meetings throughout the Bay Area.

"I am very excited. The time is right. People are finally paying attention," said Kate O'Malley of the California HealthCare Foundation where she works on improving end-of-life-care.

Increasingly, media reports reveal that patients, families and physicians across the nation are troubled by the high-tech battle against death that often compounds suffering rather than eases it.


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"During the last century and more, death has evolved from a common family event centered in the home to a medical event occurring in a distant medical facility overseen by trained experts and administrators," the Institute of Medicine reported in announcing the new study.

"Coordinated, expert, compassionate care for people dying from chronic diseases continues to challenge the American health care system."

One major goal is to include families caring for the seriously ill. The panel's findings, to be released in spring 2014, will be well publicized in a way, the institute said, that considers "the fears and anxieties surrounding aging and death" and also the nation's cultural diversity.

The National Academy of Sciences is also hosting the first National Summit on Advanced Illness on Jan. 29 and 30 to spark a movement to break barriers to good end-of-life care.

Sixteen years ago, the institute issued a landmark report, "Approaching Death: Improving Care at the End of Life." In 2003, its "Describing Death in America: What We Need to Know" report outlined the need for better understanding of the effectiveness of end-of life-care.

But much has changed since -- such as technological advances, demographic and cultural shifts, improvements in comforting care and growing concern over costs.

"I welcome this committee," said Dr. Steve Pantilat, director of UC San Francisco's Palliative Care Program. "A great deal has happened since the last report to improve end-of-life care -- yet challenges remain."

He said he looked forward to the work bringing less stressful care to dying people.

Provisional members of the panel include Dr. Phillip Pizzo, former dean of Stanford University School of Medicine, bioethicist Dr. Bernard Lo of UC San Francisco, and other national experts from Brown University, the University of Pennsylvania, Duke University and elsewhere.

The first meetings of the Committee on Transforming End-of-Life Care will be Feb. 20 and 21 in Washington, D.C.

Contact Lisa M. Krieger at 650-492-4098.

Resources, details
The Institute of Medicine's Committee on Transforming End-of-Life Care will hold its first meetings Feb. 20 and 21 at the National Academy of Sciences building, 2101 Constitution Ave. N.W., Washington, D.C.
Interested parties may submit materials to EOL@nas.edu. Submitted comments, including names and identifying information, will be public.
Information is available at www.iom.edu/Activities/Aging/TransformingEndOfLife.aspx.
This newspaper's Cost of Dying series is posted at www.mercurynews.com/cost-of-dying.