title: Missed opportunities in providing palliative care for the urban poor: a case discussion.
abstract: BACKGROUND
  We report the case of a woman with chronic, unexplained symptoms admitted to a large urban hospital, whose clinical status declined rapidly without a definite underlying diagnosis, and who died 2 days after palliative extubation.
  
  
  CONCLUSIONS
  This case illustrates some of the challenges that patients, families, caregivers, and medical teams face in cases of serious life-limiting illness in the disenfranchised poor. Proposed solutions to these challenges include introduction to palliative care earlier in the course of illness and improved access to palliative care in medical safety-net settings.
authors.affiliation: Palliative Care Service, Department of Family Medicine, University of Washington School of Medicine, Seattle, Washington 98195, USA. benderma@uw.edu
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Bender
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Clarke
authors.forename: Rose M
authors.initials: RM
authors.lastname: Guilbe
authors.forename: Peter A
authors.initials: PA
authors.lastname: Selwyn
mesh_terms: D017809:Fatal Outcome; D005260:Female; D006297:Health Services Accessibility; D006786:Hospitals, Urban; D006801:Humans; D008507:Medically Underserved Area; D008875:Middle Aged; D010166:Palliative Care; D010348:Patient Care Team; D013727:Terminal Care