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Clinical Crossroads: An 88-Year-Old Woman Facing the End of Life

J. R. Williams, MD; Barry M. Kinzbrunner, MD; Domingo Gomez, MD
JAMA. 1997;278(12):978. doi:10.1001/jama.1997.03550120038020.
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To the Editor.  —We agree with Dr Lynn1 that we can do better in caring for the chronically and terminally ill. In fact, the hospice industry already is.The practice of hospice care and Lynn's concept of "Medi-caring" are on common ground. Hospice has been effectively and comprehensively treating ill patients for 2 decades. Many of the more than 30 000 patients who are admitted to our program each year are patients who do not have cancer. Our interdisciplinary teams care annually for more than 3600 patients with end-stage heart disease, 3200 patients with Alzheimer disease and other dementias, and 1600 patients with chronic obstructive pulmonary disease and other respiratory diseases.Hospice is the most effective, most accessible alternative for these patients. We agree that more education about endof-life care is needed for physicians and caregivers, and we also agree that we should focus health care resources on such education. We


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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