Half the patients able to communicate in the last three days of life said they were in severe pain. Phase two developed these interventions based on the kinds of information that doctors said they needed regarding patients' medical status and wishes for treatment. The tools that experts thought would work didn't. Reports of pain increased. The costs of care did not change.
Physicians are taught to save lives, that death is a failure.
Patients and families have come to expect miracles in every case. No one wants to give up too soon. We need to create measures to assess quality of care while dying, and change financial incentives to promote better care while dying. Suffering while dying must become a bad outcome in the health care system. Everyone has a vision for living.