While rewards for editors are sometimes intangible, with their efforts to preserve the purity of thought from author to paper painstaking yet often invisible, it's undoubtedly gratifying to witness the transformation of an idea from drawing board to journal page, especially when the result is thought-provoking material that readers will apply in their daily lives and practices. Such is the case with the “End-of-Life Care” series that debuts in this issue and represents the fruition of an idea sparked to life during AFP's annual editors' meeting last summer.
The brainchild of Caroline Wellbery, M.D., assistant deputy editor of AFP, this special series was considered by AFP's board of editors during their once-a-year gathering to review editorial policies and plan editorial content. Sensitive to a growing awareness among physicians of the need to increase their effectiveness in end-of-life care, Dr. Wellbery brought the idea of a mini-series on this topic to the table. The panel agreed: although as inevitable as taxes, death and dying represent an area of care in which physicians may lack adequate training.
After exploring approaches that would be most helpful in providing family physicians with appropriate knowledge to deal with end-of-life issues, the editorial board opted for a multifaceted approach that would recognize the interdisciplinary nature of effective end-of-life care. Dr. Wellbery, who became coordinator of the series, says that the “End-of-Life Care” collection will contain a mix of editorials, “Curbside Consultation” pieces and key articles that will help physicians synthesize key issues in end-of-life care.
Dr. Wellbery has a personal interest in end-of-life care issues, particularly the way art, literature and the humanities can come together with the science of medicine to enhance the care of a dying patient. In a society whose cultural anxiety about death too often leads to avoidance of important issues rather than effective spiritual and medicinal means of caring for the dying, Dr. Wellbery sees the need for academics, artists, health care professionals and others to join together in developing a compassionate, multidisciplinary approach to relieving the suffering of dying and bereavement. Dr. Wellbery considers coordinating the series for AFP as one small opportunity to encourage communications on end-of-life issues.
She has chosen to begin the series with the article “Managing Pain in the Dying Patient” by Philip S. Whitecar, M.D., Patrick Jonas, M.D., and Mark E. Clasen, M.D., Ph.D. (page 755). A companion editorial, entitled “Family Physicians Should Be Experts in Palliative Care,” by Robert B. Gwinn, D.O., appears on page 633. Other article topics will include breaking bad news, managing common symptoms, making adjustments in pain medications, withdrawing and withholding care, and managing grief and depression.
We hope you will watch for these articles, “Curbside Consultation” pieces and editorials in the “End-of-Life Care” series, which will appear in selected issues during the upcoming year.