title: Social, Economic, and Political Issues Affecting End-of-Life Care.
abstract: For many decades, Americans showed a preference for delaying death through a technological imperative that often created challenges for nurses in caring for dying patients and their families. Because of their vast knowledge of health and healing, and their proximity to patients' bedsides, nurses are often well positioned to advocate for healthcare reform and legislation to improve end-of-life care. This article provides an overview of the social, economic, and political factors that are shaping end-of-life care in the United States. First, historical perspectives on end-of-life care are presented to enhance understanding of why some clinicians and patients seem to resist change to current practices. Second, end of care issues related to advanced technology utilization, societal expectations of care, clinical practices, financial incentives, palliative care services, and policy reforms are discussed. Finally, future recommendations are provided to encourage nurses and other healthcare providers to improve care for individuals facing end-of-life care decisions.
authors.affiliation: PhD student, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida jsopcheck@comcast.net.
authors.forename: Janet
authors.initials: J
authors.lastname: Sopcheck
mesh_terms: D001293:Attitude to Death; D003657:Decision Making; D005544:Forecasting; D018166:Health Care Reform; D006291:Health Policy; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D024802:Nurse's Role; D011057:Politics; D013727:Terminal Care / Q000191:economics* / Q000266:history / Q000523:psychology* / Q000639:trends*
keywords: end-of-life care; historical events; nursing's caring; palliative and hospice services; practice reforms; technological imperative