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American Journal of Hospice and Palliative Medicine®
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Beyond Polarization, Public Preferences Suggest Policy Opportunities to Address Aging, Dying, and Family Caregiving

Ira R. Byock, MD

Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, IByock{at}aol.com, Department of Community and Family Medicine, Dartmouth Medical School, Hanover New Hampshire

Yvonne J. Corbeil

Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, Department of Community and Family Medicine, Dartmouth Medical School, Hanover New Hampshire

Martha E. Goodrich, MS

Department of Community and Family Medicine, Dartmouth Medical School, Hanover New Hampshire

Despite well-documented deficiencies and widespread suffering experienced by millions of elderly or ill Americans and their families, politicians rarely address end-of-life issues. Citizen Forums in New Hampshire surveyed 463 people regarding aging, serious illness, and caregiving. More than 80% indicated it was very or extremely important to have their dignity respected, preferences honored, pain controlled, and to not leave family with debt. Less than half strongly endorsed being kept alive as long as possible, prayed with or for, or having assisted-suicide available. Over 80% strongly endorsed palliative care requirements clinical licensure and reimbursement, expansion of family caregiver leave, respite care, and bereavement support. By avoiding actions which elicit strong divergence of opinion and focusing on actions on which consensus exists, public officials and candidates can respond to problems and improve care and experience for frail elders, dying Americans, and their families.

Key Words: family caregiving • palliative • aging • dying • policy • end of life • public opinion

This version was published on June 1, 2009

American Journal of Hospice and Palliative Medicine®, Vol. 26, No. 3, 200-208 (2009)
DOI: 10.1177/1049909108328700
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