form, 108, 119-121, 198-203

from informed patients, 68

intensive care history and, 68

issues to be raised with patients, 66

nursing home patients, 100

socioeconomic characteristics of patients and, 70

Advocacy, 255, 337-338

African Americans. See Blacks

Age

attitudes about, 48-49

and cause of death, 2, 34

and chronic illness, 14

and death rates, 34-35, 248, 260-261

and disability, 43-44

and financing of health care, 156, 158

life expectancy at birth, 35-36

and outcome measures of care, 139

population patterns, 3, 36-37

and rationing of care, 154, 181-182, 262

and site of death, 39, 40, 41

and symptoms of death, 43-44, 248

Agency for Health Care Policy and Research (AHCPR), 12, 132, 151, 257, 269, 270

Agency for HIV/AIDS, 321

AIDS patients, 17, 76, 77, 78, 128, 131, 155, 168 n.10, 195, 240, 256, 356

Alaskan Natives, 37

Alliance for Aging Research, 327-328

Alzheimer's Association, 321

Alzheimer's disease, 52, 53, 93, 99, 148, 158, 168 n.10

American Academy of Family Physicians, 322

American Academy of Hospice and Palliative Medicine, 20, 226, 328-329

American Academy of Hospice Physicians (AAHP), 164 n.9

American Academy of Neurology, 323

American Academy of Pediatrics, 321

American Alliance of Cancer Pain Initiatives, 322

American Association of Health Plans, 323

American Association of Homes and Services for the Aging, 323

American Association of Retired Persons (AARP), 44-45, 324

American Bar Association Commission on Legal Problems of the Elderly , 324

American Board of Hospice and Palliative Medicine (ABHP), 223, 324 , 328-329

American Board of Internal Medicine (ABIM), 20, 208, 210, 217, 222 , 223, 226-227, 322, 329-330

American Board of Medical Specialties, 330

American Cancer Society, 321

American College of Physicians, 73-74, 329

American Geriatrics Society, 139, 140-141, 204 n.10, 322, 337, 390

American Hospice Foundation, 324

American Hospital Association, 323

American Indians, 37, 70 n.2

American Medical Association (AMA), 19, 20, 193, 197, 208, 232, 322 , 330-331

American Medical Directors Association, 151, 324

American Nurses Association, 204 n.10, 322

American Pain Society, 126, 127, 323

American Psychiatric Association, 191, 204 n.10

Americans for Better Care of the Dying, 327

Amyotrophic lateral sclerosis (ALS), 52, 342

Anesthesiology, 209, 217

Angina pectoris, 150, 220

Anorexia-cachexia syndrome, 76, 241.

See also Cachexia-anorexia-asthenia syndrome

Anxiety, 78, 237, 243, 250.

See also Fear of dying

APACHE system, 358-362

Aplastic anemia, 92-93

Appropriateness of care.

See also Clinical practice guidelines

advance directives and, 176-177

case histories, 90-95

determinants of, 118, 134

guidelines, 333-334

uncertainties and disagreements about, 21-22

Arizona, 113

Artificial nutrition and hydration, 134

Asians and Pacific Islanders, 37, 375-376

Ascites, 77

Assessment. See Patient assessment

Assisted suicide

advance directives and, 176

attitudes about, 45, 251

committee position, 13, 270-271

defined, 203

depression and, 75

and end-of-life care initiatives, 16, 19, 32, 176, 259-260, 270-271, 388

Front Matter (R1-R18)

Summary (1-13)

1 Introduction (14-32)

2 A Profile of Death and Dying in America (33-49)

3 Caring at the End of Life (50-86)

4 The Health Care System and The Dying Patient (87-121)

5 Accountability and Quality in End-Of-Life-Care (122-153)

6 Financial and Economic Issues in End-Of-Life Care (154-187)

7 Legal Issues (188-206)

8 Educating Clinicians and Other Professionals (207-234)

9 Directions for Research to Improve Care at the End of Life (235-258)

10 Conclusions and Recommendations (259-271)

References (272-312)

Appendix A (313-320)

Appendix B (321-326)

Appendix C (327-357)

Appendix D (358-362)

Appendix E (363-382)

Appendix F (383-399)

Appendix G (400-404)

Appendix H (405-406)

Appendix I (407-412)

Appendix J (413-418)

Index (419-437)