How did changing the definition change the field of palliative care research?
Dr. Rowland: In expanding the definition, the IOM recommended more attention be given to the emotional, spiritual and practical needs of patients and their families. Nobody with cancer does it alone and does it well. It takes a medical team to treat you medically and a secondary team of family and friends to help you get through it. We’re treating cancer as a chronic illness now, and that’s a whole new philosophy. It ensures that palliation does not get “orphaned” at the end of life. Can doctors palliate and treat an illness at the same time? Ms. Denicoff: Yes, it should never be an either/or choice. The challenge is that doctors are trained to diagnose and cure illness and patients naturally focus on living and not dying. There’s real avoidance of the ‘elephant in the room’ because culturally we Americans don’t like to discuss death. Things began to improve when the definition of palliative care took on a broader meaning and it was no longer an either/or choice. We began to appreciate
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