Ideas and Opinions3 February 2015
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    Since the early 1980s, the delivery of care near the end of life in the United States has changed dramatically—and improved—often without much notice. The rights of persons to refuse all types of medical interventions are well-established and no longer litigated. Pain is now the fifth vital sign. Specialized palliative care consultative services are available in most U.S. hospitals (1). Increasing numbers of persons in the United States die while receiving hospice care, including 60% of those who have died of cancer (2). And new initiatives are increasingly prompting clinicians and patients to engage in advance care planning, such as ...

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