Palliative Care and the Health Care Crisis in the United States: A Candid Conversation with Dr. Diane Meier

This paper is a synthesis of the 2012 Lourie Lecture, framed as a series of questions and responses, and supported by images used in the lecture. I’m going to focus on the growth of this new field called palliative care and will make the connection that the crisis afflicting healthcare in the United States cannot be addressed without widespread scaling and implementation of palliative care across the system. My subject is not end-of-life care, but rather care during serious illness. A serious illness is something a person can live with for many years, such as emphysema, or end-stage renal disease on dialysis, or dementia. Of course, serious illnesses are also progressive and eventually lead to end-of-life, but I want to address care for a much broader patient population, not those who are clearly dying and who will qualify for hospice services.