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The Promise of Palliative Care—and the Possibility of a Physician-Assisted Death as a Last Resort

Timothy E. Quill MD, FACP, FAAHPM

Georgia and Thomas Gosnell Distinguished Professor in Palliative Care, Professor of Medicine, Psychiatry and Medical Humanities, University of Rochester School of Medicine

Thursday, October 5

Palliative care is a relatively new field of medicine wherein efforts are made to keep patients as comfortable as possible with as much information and choices as possible. During this time, they are receiving the best possible medical treatment of their underlying disease.

Patients receiving palliative care alongside disease-directed treatment tend to live longer than those who do not. They also tend to make a more timely transition to hospice when medical treatments stop working. Hospice is a system of care to provide palliative care to patients who accept they are dying as well as to their families. Hospice is highly effective at making the end of life as meaningful and as comfortable as possible.

Although hospice is effective and acceptable to patients the vast majority of the time, there are a very small but important number of patients whose suffering becomes unacceptable despite our best efforts. And some of those patients ask for our assistance dying sooner rather than later. Although the controversial practice of physician-assisted death has gotten the most public attention (and is now legal for about one-sixth of the country), there are lesser known last resort options that are currently available across the country. This is true even in places, such as New York, that legally prohibit physician-assisted death.

In this session we will review the promise and potential of palliative care and hospice, and also outline the legal options currently available for the small number of patients for whom end-of-life suffering becomes unacceptable despite our best efforts.

Timothy E. Quill, MD, is the Thomas and Georgia Gosnell Distinguished Professor in Palliative Care at the University of Rochester Medical Center (URMC) where he is also Professor of Medicine, Psychiatry, Medical Humanities and Nursing. He was the Founding Director of the URMC Palliative Care Division and a Past President of the American Academy of Hospice and Palliative Medicine.

Dr. Quill has published and lectured widely about various aspects of the doctor-patient relationship, with special focus on end-of-life decision-making, including delivering bad news, non-abandonment, discussing palliative care earlier, and exploring last-resort options. He is the author of several books on end-of life care and over 150 articles published in major medical journals. Dr. Quill was the lead physician plaintiff in the New York State legal case challenging the law prohibiting physician-assisted death that was heard in 1997 by the U.S. Supreme Court (Quill v. Vacco).

Dr. Quill received his undergraduate degree from Amherst College (1971), and his MD from the University of Rochester (1976). He completed his Internal Medicine Residency in 1979 and a Fellowship in Medicine/Psychiatry Liaison in 1981, both from the University of Rochester School of Medicine and Dentistry. He is a Fellow in the American Academy of Hospice and Palliative Medicine, a Fellow in the American College of Physicians, and an ABMS-certified palliative care consultant.

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