August 2001 MedBytes: End-of-Life Care

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This month, MedBytes looks at Internet sites that provide training, tools, and clinical resources for physicians and other health care professionals who treat individuals at the end of their lives; support and educational materials for those who are dying and their families; and advocacy and grass-roots information for persons interested in improving the quality of end-of-life care in the United States.

EPEC
Education for Physicians on End-of-life Care (EPEC) at www.epec.net offers a comprehensive curriculum "designed to educate all physicians on the essential clinical competencies required to provide quality end-of-life care." Developed by the American Medical Association, supported by The Robert Wood Johnson Foundation, and sponsored by Northwestern University Medical School, the EPEC curriculum of four 30-minute plenary modules and twelve 45-minute workshop modules "provides physicians with the basic knowledge and skills needed to appropriately care for dying patients." The training qualifies for up to 10 hours of AMA PRA Category 1 credit.

Promoting Excellence in End-of-Life Care
At promotingexcellence.org, the Promoting Excellence in End-of-Life Care site provides materials for health care professionals seeking innovative ways to improve the care of the dying. It includes information on numerous special populations and situations, from urban African-American patients to individuals with Alzheimer's disease and other dementias to handling death in maximum-security prisons. The site director is Ira Byock, MD, who spoke at the TMA 1998 Fall Conference.

Beth Israel Medical Center
Sponsored by the Beth Israel Medical Center's Department of Pain Medicine and Palliative Care, www.stoppain.org provides educational materials -- including online audio conferences -- for professionals in pain management at all stages of a patient's life. The section on palliative care includes patient education tips, background on hospice care, suggestions for the management of pain and other symptoms, and guidance on ethical and legal issues.

The Growth House
The Growth House: Guide To Death, Dying, Grief, Bereavement, and End Of Life Resources at www.growthhouse.org includes information for health care professionals, patients and their families, and the general public. One Texas palliative care specialist says the professional forum on this site is an "incredible" way to share information with others in the field. Other areas on the site include extensive information on AIDS, as well as such specialized topics as estate planning, infant death, and suicide.

Supportive Care of the Dying
Created by a coalition of Catholic health care systems during Oregon's public debate over physician-assisted suicide, Supportive Care of the Dying (www.careofdying.org) offers scientific assessment and improvement tools for hospitals and other organizations that want to measure how well they are meeting the needs of dying patients, their families, caregivers, and health care professionals. Visitors can sign up for monthly e-mail delivery of the Supportive Voices newsletter or browse articles from past issues organized by topic.

Americans for Better Care of the Dying
At www.abcd-caring.org, the Americans for Better Care of the Dying Web site is dedicated to systems change and provides clinicians several action guides to help them "make the end of life a worthy part of living, a time of confidence, reflection, and meaning whenever it can be."

Last Acts
Last Acts (www.lastacts.org) is a "call-to-action campaign to improve care at the end of life." The Web site offers an e-mail discussion group and a weekly e-mail newsletter, news stories on end-of-life care policy issues, a media center, and extensive resources for visitors who want to join the Last Acts advocacy efforts or research the movement and its goals.

Texas Medical Association
The new cancer pain control page on the TMA Web site offers extensive links to physician education materials, government reports, guidelines for cancer pain management, and sites of interest to patients and their families.

Among the most widely accessed sections of the TMA Web site is a series of guidelines, discussions, and downloadable forms on medical power of attorney, the directive to physicians, and do-not-resuscitate orders. All can be accessed under "Medical Ethics."

MedBytes is a quick look at new, or newly discovered, Web sites of interest to Texas physicians. The column also highlights features of the TMA Web site at www.texmed.org. If you know of some cool medical sites or have questions about how to use the TMA Web site, email Erin Prather. Publication of information about Web sites in this column is not to be considered an endorsement or approval by the Texas Medical Association of the sites or sponsors, or of any products or services involved.

August 2001 Texas Medicine Contents
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