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Biomedical subjects

Diane E Meier

Publications and source records attributed to Diane E Meier.

6 recordsLinked to original sources
PubMed2002

Assessing differences in care needs and service utilization in geriatric palliative care patients.

Little is known of the palliative care needs and experiences of older adults. This study explored whether these needs differed from those of younger patients. We performed a retrospective data analysis of 1184 palliative care consultations in a major teaching hospital. There were statistically significant differences across age groups in patient demographic and clinical characteristics, advance care planning, and service utilization. Patients over age 80 had a reduced prevalence of cancer, a higher prevalence of dementia and incapacity, more frequent decisions to withhold or withdraw life-sustaining treatments, and fewer interventions for symptom management. The palliative care needs of older adults appear to be substantially different from those of younger patients. Dementia and incapacity profoundly influence decision-making, requiring more time and communication with patients and families.

Aged↗
PubMed2002

Assessing the outcome of a palliative care educational initiative.

PURPOSE: In 1997, a biweekly, 18-month Palliative Care Seminar Series was started at Mount Sinai School of Medicine as a way to explore participants' beliefs about palliative care and to instill the knowledge, skills, and attitudes needed to improve care at the end of life. The goal of this study was to examine the effects of Mount Sinai's Palliative Care Seminar Series on faculty development and personal growth. METHODS: Twenty of 42 respondents were interviewed immediately after completing the Seminar Series. Subjects identified themselves as physicians (n = 16) or nurses (n = 4). The same open-ended questions and follow-up probes were asked of each interviewee and transcripts were coded for confidentiality. The questions were developed to examine the impact of the Seminar Series on practitioners' knowledge of and attitude toward end-of-life care. Content analysis of the coded transcripts was performed by a group consisting of one physician, one medical student, and two social scientists. RESULTS: Content analysis of interview transcripts revealed five common themes: subjects perceived a gain in palliative care knowledge and skills; they believed themselves to be more confident in the practice of palliative care; they believed themselves to be more confident that what they were doing is appropriate; and they felt less isolated in their beliefs as a result of regular interactions with supportive peers. CONCLUSIONS: Five common themes arose from the transcripts of both physicians and nurses: participants perceived a gain in palliative care "practice" skills, participants perceived a gain in palliative care "process" skills, participants believed themselves to be more confident that palliative care was appropriate care for dying patients, participants believed themselves to be more confident in their ability to practice and teach palliative care, and participants felt less isolated in their beliefs through regular interactions with supportive peers.

Attitude of Health Personnel↗
PubMed1992

Physician-assisted dying: theory and reality.

...[T]here appears to be a conflation of physician-assisted suicide (the doctor makes the means of suicide available by, for example, writing a prescription for barbiturates) with active euthanasia (the doctor actively intervenes to kill the patient). I believe that these two entities are quite distinct in terms of several factors: they require very different roles for the physician, they involve distinct and disparate power relationships between physician and patient, and they would likely have a substantially different impact on the ethos of the medical profession. Thus, I would argue that it may be reasonable to support easing constraints on physician-assisted suicide while retaining them for active euthanasia, and that the distinction between the two entities should be addressed, particularly in discussions of legalization.

Capital Punishment↗