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Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
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J Committee Biographies

CHRISTINE K. CASSEL, M.D., F.A.C.P., is chairman of the Department of Geriatrics and Adult Development of Mount Sinai Medical Center and professor of geriatrics and medicine. She joined Mount Sinai in 1995 after 10 years as chief of general internal medicine at the University of Chicago, where she was also professor of medicine and public policy studies, chief of the Section of General Internal Medicine, director of the Center on Aging, Health and Society, director of the Center for Health Policy Research, and George M. Eisenberg Professor in Geriatrics. Dr. Cassel received an undergraduate degree in humanities at the University of Chicago and her M.D. at the University of Massachusetts in 1976 and took her training in Internal Medicine at Children's Hospital of San Francisco and at the University of California, San Francisco.

Among Dr. Cassel's numerous publications are three textbooks, Geriatric Medicine: Principles and Practice (first published by Springer-Verlag in 1984, now in its third edition), Ethical Dimensions in the Health Professions, also in its third edition, and Nuclear Weapons and Nuclear War: A Source Book for Health Professionals. Dr. Cassel, a member of the Institute of Medicine, is immediate past president of the American College of Physicians.

ROBERT A. BURT, J.D., is Alexander M. Bickel Professor of Law at Yale University. He has been a member of the Institute of Medicine since 1976, having served on the Council of the Institute from 1990–1993 and most recently as a member of the IOM Committee on Xenograft Transplan-

Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
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tation: Ethical Issues and Public Policy. He is a member of the Advisory Board of the Project on Death in America, the Open Society Institute, and chair of the Board of Trustees of the Judge David L. Bazelon Center for Mental Health Law. Mr. Burt earned a B.A. from Princeton University, a B.A. in Jurisprudence at Oxford University, as a Fulbright Scholar, and a J.D. from Yale.

MARGARET L. CAMPBELL, R.N., M.S.N., C.S., has managed the palliative care practice at Detroit Receiving Hospital since 1988. From 1974 to 1988, she served in a number of critical care nursing positions including staff nurse, educator, and clinical nurse specialist. Ms. Campbell serves on the Board of Directors of the Medical Ethics Resource Network of Michigan and is a member of the Human Rights/Ethics Committee of the Michigan Nurses Association. She is a faculty member of the Wayne State University College of Nursing. Ms. Campbell lectures, studies, and publishes on end-of-life care and related issues. She has a diploma in nursing from the Henry Ford Hospital School of Nursing and bachelor's and master's degrees from Wayne State University.

ROBERT KLIEGMAN, M.D., is professor and chair of the Department of Pediatrics at the Medical College of Wisconsin and pediatrician in chief at Children's Hospital of Wisconsin. Dr. Kliegman completed his residency training in general pediatrics at Babies' Hospital in New York, New York. He completed neonatology and metabolism fellowships at Case Western Reserve University in Rainbow Babies and Children's Hospital. Dr. Kliegman's interests include neonatal bioethics and prevention of infant mortality and low birth weight. Dr. Kliegman has focused attention on the problems of low-income and medically underserved children. He has been a child advocate working with the American Academy of Pediatrics, municipal, state, and federal governments (Baby Doe, Health Reform), and The George Washington University Health Policy Institute-Packard Foundation Roundtable.

MATTHEW LOSCALZO, M.S.W., is a research associate at the Johns Hopkins University School of Medicine and the director of oncology social work at the Johns Hopkins Oncology Center. He is also the co-director for cancer pain research at the Johns Hopkins Oncology Center. Prior to his appointment at Johns Hopkins in 1993, Mr. Loscalzo provided psychobehavioral and social work services to patients and families as part of the Pain Service and Supportive Care Team at Memorial Sloan-Kettering Cancer Center. At this position, he was a founding member of one of the first supportive care teams in the United States. He has published widely on cancer pain, psychobehavioral interventions, and palliative care. His many

Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
×

national and international presentations reflect his ongoing interest in cancer pain, palliative care, patient and family advocacy, problem-solving therapies, and psychobehavioral interventions. He is the past president of the Association of Oncology Social Work. Mr. Loscalzo received his master's degree at the New York University School of Social Work.

JOANNE LYNN, M.D., M.A., M.S., is a professor of health care sciences and medicine and the director of the Center to Improve Care of the Dying, a multidisciplinary center committed to research, education, and advocacy to improve the care of seriously ill persons at The George Washington University Medical Center. As a geriatrician, Dr. Lynn has served in a variety of clinical positions, including 17 years as medical director for a nursing home and a hospice. A nationally known expert on end-of-life issues, she was assistant director of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and the principal writer of the commission's book, Deciding to Forego Life-Sustaining Treatment . Dr. Lynn was also co-director of the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments, a 10-year multicenter study examining the process of care for over 10,000 seriously ill or elderly hospitalized patients. Dr. Lynn has served on many boards including the Board of Directors of Concern for Dying, the American Bar Association's Commission on Legal Problems of the Elderly, and the Hastings Center Task Force which wrote Guidelines for the Termination of Treatment and the Care of the Dying. Dr. Lynn was elected to membership in the Institute of Medicine in 1996.

NEIL MacDONALD, C.M., M.D., F.R.C.P.(C), F.R.C.P.(Edin), earned his undergraduate degree at the University of Toronto and his medical degree at McGill University, completing postgraduate studies at the Royal Victoria Hospital and Memorial Sloan-Kettering Cancer Center. Dr. MacDonald was director of Edmonton's Cross Cancer Institute (1971–1987) and director of the Division of Oncology for the University of Alberta (1975–1987). He has acted as chief medical oncology examiner for the Royal College of Physicians and Surgeons and has been an active participant in the American Society of Clinical Oncology, the Canadian Oncology Society, and the Canadian Cancer Society. He was named professor of Palliative Medicine and received one of the first Canadian chairs in the field in 1987. He is the editor of the Canadian Palliative Care Curriculum for undergraduate medical education, co-editor of the Oxford Textbook of Palliative Medicine, and past president of the newly formed Canadian Society for Palliative Care Physicians. In 1990–1991, Dr. MacDonald worked as a medical officer at the World Health Organization Cancer Palliative Care Unit in Geneva assisting the unit with development of palliative care

Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
×

policies and educational programs. He is currently director of the Cancer Ethics Program within the Center for Bioethics of the Clinical Research Institute of Montreal. He is also a professor within the Department of Oncology, McGill University Palliative Care Division with clinical responsibilities at the Royal Victoria Hospital in Montreal, Canada.

WILLARD G. MANNING, JR., Ph.D., is director of graduate studies, Doctoral Program in Health Services Research, Policy, and Administration at the University of Minnesota. He is also a professor at the Institute for Health Services Research, School of Public Health at the University of Minnesota. From 1988 to 1991, Dr. Manning was a professor in the Department of Health Services Management and Policy, School of Public Health, and Department of Economics of the University of Michigan. He earned his M.A. and Ph.D. degrees at Stanford University. Throughout his career, Dr. Manning's teaching areas have included microeconomics, health economics for public health students, applied economics, industrial organization, and econometrics. He was elected to Institute of Medicine membership in 1995.

DONALD L. PATRICK, Ph.D., M.S.P.H., is professor and director of the Social and Behavioral Sciences Program in the School of Public Health at the University of Washington. He trained in psychology at Northwestern University and received his Ph.D. degree in sociomedical sciences and M.P.H. degree from Columbia University. He has published widely on outcomes measurement, having worked on the assessment of health status and quality of life throughout his career, including applications to chronic illness and disability, health promotion, evaluation research, poverty and underserved populations, and the design and evaluation of advance directives. Dr. Patrick teaches graduate courses and conducts research on costs and outcomes in health and medicine. He is now working on assessment of the quality of dying. He was the inaugural president of the International Society for Quality of Life Research. He is a member of the Institute of Medicine and a Fellow of the Association of Health Services Research.

RICHARD PAYNE, M.D., is professor of neurology and chief of the Pain and Symptom Management Section at the University of Texas, Department of Neuro-Oncology, M.D. Anderson Cancer Center, in Houston, Texas. The Pain and Symptom Management Section is a multidisciplinary program involving over 40 health care professionals. He is also a clinical associate professor in the Department of Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston. A graduate of Yale University and Harvard Medical School, Dr. Payne completed postgraduate training in internal medicine at the Peter Bent Brigham Hospital in Boston and in

Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
×

neurology at the New York Hospital-Cornell University Medical College. In addition, he completed a fellowship in neuro-oncology and pain management at Memorial Sloan-Kettering Cancer Center in New York. He served on the Agency for Health Care Policy and Research panel that developed guidelines for acute pain management, and later co-chaired the expert panel that developed clinical practice guidelines for the management of cancer pain. Dr. Payne has authored or co-authored over 100 peer-reviewed papers, invited reviews, book chapters, and abstracts. He has co-edited one book with Dr. Kathleen M. Foley. Currently, Dr. Payne serves on the editorial board of the Pain Forum (the official journal of the American Pain Society) and the Journal of Pain and Symptom Management.

GEORGE E. THIBAULT, M.D., graduated summa cum laude from Georgetown University in 1965 and magna cum laude from Harvard Medical School in 1969. He completed his internship and residency in medicine and fellowship in cardiology at Massachusetts General Hospital (MGH). He also trained in cardiology at the National Heart and Lung Institute in Bethesda and at Guys Hospital in London and served as Chief Resident in Medicine, the Medical Practices Evaluation Unit, and as director of the Medical ICU/CCU at the MGH. In 1978, he became the director of the Training Program in Internal Medicine and assistant chief (and subsequently associate chief) of the Department of Medicine, MGH. In 1988, he became chief of the medical services at Brockton/West Roxbury VA Medical Center and vice chairman of medicine at Brigham and Women's Hospital (BWH). Since July of 1995, Dr. Thibault has been the chief medical officer at the BWH and Professor of Medicine at Harvard Medical School. His research has focused on the evaluation of practices and outcomes of medical intensive care units and variations in the use of cardiac technologies. He has also served on numerous committees of national organizations, including the Institute of Medicine, the Department of Veteran Affairs, the National Institutes of Health, and the American College of Physicians. He has been a visiting scholar at both the Institute of Medicine and Harvard's Kennedy School of Government and a visiting professor of medicine at many medical schools in the United States and abroad.

THERESA H. VARNER, M.S.W., M.A., is the director of the Public Policy Institute at the American Association of Retired Persons (AARP). The Institute is AARP's focal point for public policy research and analysis on health, long-term care, economic security, and consumer issues. Before assuming her current position in 1991, she served for several years as the senior coordinator of the Health Policy Team in the Public Policy Institute. She came to AARP from the Alabama Department of Mental Health where she directed the state's largest hospital-based, pre-release program. Ms.

Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
×

Varner has presented at numerous national conferences and symposia on a variety of health care reform topics. Her publications have focused on health care coverage, consumer information needs, and long-term care. She also oversaw the development of AARP's draft proposal for health care reform, Health Care America. Between 1993 and 1995, she served as a consumer representative on the Institute of Medicine's Committee on the Future of Dental Education. She holds two master's degrees from the University of Alabama, one in social work and one in English literature.

Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
×
Page 413
Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
×
Page 414
Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
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Page 415
Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
×
Page 416
Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
×
Page 417
Suggested Citation:"Appendix J." Institute of Medicine. 1997. Approaching Death: Improving Care at the End of Life. Washington, DC: The National Academies Press. doi: 10.17226/5801.
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Page 418
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When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening.

Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care.

This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life:

  • Determining diagnosis and prognosis and communicating these to patient and family.
  • Establishing clinical and personal goals.
  • Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances.

Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

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