I read with interest the piece by Wilson et al regarding their examination of end-of-life care patterns in hospitalized patients on their vascular surgery practice in Oregon. I applaud the authors for examining their practices and recognizing that the patients rarely entered the hospital with an advanced directive and rarely were afforded the benefit of palliative care consultation. Hopefully, they will use this information to address their practices prospectively to enhance the care provided to critically ill patients who die in the hospital. I hope that the national movement for the use of a Physician Orders for Life-Sustaining Treatment form helps to address the problem of patients receiving treatment that is not aligned with what they want because they have not discussed or documented their treatment preferences or because these documents are not available when needed.

Read More