New IOM Committee on Transforming End-of-Life Care

During the last century and more, death has evolved from a common family event centered in the home to a medical event occurring in a distant medical facility overseen by trained experts and administrators. Coordinated, expert, compassionate care for people dying from chronic diseases continues to challenge the American health care system. The development of hospice was an early innovative response to these challenges, and a broader focus on palliative care to reduce pain and suffering during serious illness has emerged as another important response.



The IOM will conduct a consensus study that will produce a technical report on the current state of end-of-life care with respect to delivery of medical care and social support; patient-family-provider communication of values and preferences; advance care planning; health care financing and reimbursement; and education of health professionals, patients and their loved ones. The study will also explore approaches to advance the field. Specifically, the committee will:

• Review progress since the landmark 1997 IOM report Approaching Death: Improving Care at the End of Life, assess challenges and opportunities, and evaluate strategies to integrate end-of-life care into a person-centered, team-based framework. Demographic and cultural changes will be considered as will advances in technology that affect the provision of care in different settings, most notably in the home. Families are increasingly recognized as a vital component of the healthcare team, and the financial and other ramifications for families and society will be considered;


• Develop recommendations for changes in policy, financing and clinical care that will align care with individual values and preferences and promote high-quality, cost-effective care at the end of life; and


• Develop a dissemination and communication strategy to promote public engagement and understanding. This strategy will need to consider the fears and anxieties surrounding aging and death and cultural diversity in values and preferences.