Defining Quality Cancer Care at the End of Life

Panel members discuss end of life care in the context of healthcare reform

Speaking on an Avalere Health audio conference today, National Coalition for Cancer Survivorship Acting President & CEO Ellen Stovall emphasized the need to provide patient-centered, quality care at the end of life that enables people to live and die well in accordance with their wishes. Stovall was a speaker along with Sir Michael Rawlins, chairman of the National Institute of Health & Clinical Excellence (NICE), in the discussion, titled "Directives in Dispute / End-of-Life Counseling and the Politics of Health Reform," which focused on the current role of public policy in end-of-life counseling and the impact of these services on patients and physicians.

"Research findings affirm that when people have a serious illness like cancer, they want to discuss the risks and benefit of various treatments; they want to express their wishes and their fears," Stovall said. "But there are many biases and other barriers that stand in the way of those discussions taking place." 

The topic of end-of-life care came under fire with a recommendation in the healthcare reform bill that encourages patients and physicians to engage in end-of-life consultations. In addition to the language contained in the bill, Stovall pointed to evidence from research that shows that physicians are hesitant to deliver bad news and patients don't necessarily want to hear it, leading to a "don't ask, don't tell," culture in many medical settings. This formula results in what Stovall calls a "formula for failure," and needs to be corrected.

In August, NCCS emphasized its support of the use of advance care planning as a best practice for quality care, which was highlighted on today's audio conference. NCCS considers advance care planning a vehicle to better position patients to be in control of their care as their treatment needs evolve and change throughout the span of their survivorship.

Stovall's call to action on improving end-of-life care was announced in a pledge she made of NCCS to "work with any organizations who support our vision that all people diagnosed with cancer will receive the highest level of evidence-based care and that they will be treated with dignity and respect for their preferences."

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