AMSA's Death and Dying Interest Group

This Interest Group arose in response to medical students' concern that medical school leaves us inadequately prepared to communicate with terminally ill patients, as well as being poorly equipped emotionally to deal with matters of death and dying. This is important to us on a personal level as we face dying patients almost daily on the wards. On a professional level, we address important issues such as aid in dying and palliative care. In response to these needs, we as an interest group provide guidance, support and resources for students who wish to supplement their medical education in the area of death and dying. As co-coordinators, we act as facilitators for this learning, but the Interest Group needs your active participation to be successful!

GET INVOLVED

Death and Dying Listserve

We hope to make this listserve a forum for active discussion of issues and a way for students at different medical schools to work together on projects. We will jump-start the discussions by posting a question each month to generate conversations around issues of interest. We hope that you guys will not only participate in the discussions, but will also post questions or topics for your colleagues from around the country. Listserve Guidelines

Again, we encourage you to sign up for our listserve and e-mail us if you have any suggestions!

RESOURCES

END-OF-LIFE EDUCATION

AMSA Foundation EOL Fellowship
Introduces selected students to end-of-life care issues and develop curricula for their medical schools. With program sites in Chicago and Miami/Ft. Lauderdale, the program combines an orientation to end of life care with weekly seminars and field placements at local hospices, nursing homes and inpatient hospice units.

Physician-Assisted Suicide: For and Against

End-of-Life Care Curriculum Guide
Addresses many important issues in dealing with terminally ill patients, with topics ranging from delivering a terminal diagnosis to addressing spiritual perspectives on end-of-life.

• The Past Life of My Cadaver
• Gross Anatomy
• Medical Students and the Grieving Process: A Personal Perspective
• Spirituality and End-of-Life Care
• How to Deliver a Terminal Diagnosis to Patients: A Helpful Approach
• The Lab
• Turning To The Past To Face The End: Caught in Cultural Limbo
• Advance Directives: Personalizing Your End-of-Life Care Decisions
• He Only Takes the Best: A Diary of Terminal Illness

PROJECT GUIDES

A 7 Step Plan for Starting a Death and Dying Interest Group at Your School

Playing God: The Dilemma of the Dying Patient (PDF 17KB)
This project takes a controversial case, selected from a local health care facility and utilizes members of the health care team involved in the case as presenters. Suggests methods for audience examination of the issues involved.

A Program to Honor the Cadavers used During Anatomy
A planning guide for students and the cadaver's families as a way to honor the tremendous gift bestowed upon medical students yearly through local donation programs.

Cancer Outreach Relief Effort (CORE)
Matching pediatric patients with medical students

A Dinner Sponsored by Hospice and AMSA

Forming Partnerships with your Local Hospice

Forming a Journal Club at your School

Projects-in-a-Box developed by 2008 AMSA EOL Fellows

• AMSA End-of-Life Project at Pikeville College of Osteopathic Medicine, Angela Dawn Thacker, Pikeville College of Osteopathic Medicine
• End of Life Education at Touro University, Kenneth Leong, Touro University, College of Osteopathic Medicine
• End of Life Care: An Introduction for Osteopathic Medical Students, Colleen Fitzgerald, Touro University, College of Osteopathic Medicine
• Expanding Education about End of Life Care, Katherine Burton-Wang, Case Western Reserve University, School of Medicine
• UCI SOM Palliative Medicine Elective, Lawrence Kim, University of California—Irvine, School of Medicine
• The Good Death: Doctor and Patient at the End of Life, Katherine Sankey, University of Michigan Medical School

Projects-in-a-Box developed by 2007 AMSA EOL Fellows

• Hospice and the Budding Physician, Jennie Hart, University of Maryland School of Medicine
• AMSA EOL Fellowship in a Box, Mark Sylvester, Miller School of Medicine, University of Miami
• Expanding End of Life Care Education at the University of New England, College of Osteopathic Medicine, Kimberly Salaycik, University of New England, College of Osteopathic Medicine
• Death (comma) Thou Shalt Die, Megan Banis, Northeastern Ohio Universities College of Medicine
• AMSA Curricular Project, Rachel Bardowell, Miller School of Medicine, University of Miami

Projects-in-a-Box developed by 2006 AMSA EOL Fellows

• EOL@ECU: Improving Education Pertaining to Issues Concerning the End of Life, Benjamin Dieter, East Carolina Univ Brody SOM
• Implementing Change in End of Life Education, Karen Bauer, Univ of Chicago-Pritzer SOM
• End of Life Care: The Past and Future for Chicago Medical School, Lee Anne Jasper, Chicago Medical School
• EOL Educational Changes @ University of Wisconsin-Madison, Maryam Hamidi, Univ of Wisconsin-Madison
• End of Life Curricular Changes at Rush--Exciting Times Ahead! Michelle Tortorello, Rush Univ Medical College
• EOL and OUCOM Curriculum Changes, Prasad John Thottam, Ohio Univ College of Medicine
• My Gift Back, Richard Dunne, SUNY Downstate College of Medicine
• Improvements on the End of Life Care Curriculum at the University of Michigan Medical School, William Cedarquist, Univ of Michigan Medical School

Projects-in-a-Box developed by 2005 AMSA EOL Fellows

• Increasing Student Awareness and Exposure to End of Life Care, Katie Macfarlane, Univ of New England College of Osteopathic Medicine
• Expanding End of Life Care Education at the University of Wisconsin Medical School, Jackie Redmer, Univ of Michigan SOM
• Lunch and Learns, Discussions Groups, and Symposiums on EOL Care, Aditi Sethi, Medical College of Georgia
• AMSA End of Life Fellowship: How Can I Implement This at My School? Tasha Zaman, Midwestern Univ-Arizona College of Osteopathic Medicine
• End of Life Curriculum at MSU-CHM, Lisa McElroy, Michigan State Univ CHM
• Supplemental Lecture Topics in End of Life Care, Lauren M. Wasson, Ohio Univ College of Osteopathic Medicine
• End of Life Care at CCOM, Laura Studnicka, Midwestern University, Chicago College of Osteopathic Medicine
• Expanding EOL Care with Lunch, Lectures, and Connections, Kristen Barry, Rush Medical College
• Coordinating a Seminar on End of Life Care for Area Medical Students, Kira Skavinski, New York College of Medicine

• End of Life Care Curriculum Implementation at UNE, Daniel Gibbons, Univ of New England College of Osteopathic Medicine
• Expanding Electives in EOL Care, Katie Messner, Midwestern Univ-Chicago College of Osteopathic Medicine
• An Online Pallative and End of Life Care Course for Medical Students, Ilene Lewis, Univ of California SOM
• End of Life Project at University of Michigan, Jason Cheng, Univ of Michigan SOM
• End of Life Education at George Washington School of Medicine, Adriana Rossi, George Washington Univ SOM
• EOL Interest Group: Ohhh, the possibilities…, Vanessa Goodlin, Univ of Maryland-Baltimore
• Death and Dying Awareness Week, Aviva Hopkins, Univ of Miami SOM
• Integration of EOL Care into Georgetown's Curriculum, Ilona Lorincz & Lisa DelSignore, Georgetown Univ SOM

Projects-in-a-Box developed by 2004 AMSA EOL Fellows

• Interdisciplinary Series for EOL Education, Cidney Hulett, Tulane Univ SOM
• Bringing End-of-Life Care Issues to Medical Students, Cory Brown, George Washington Univ SOM
• Recommendations for Integrating EOL into Medical School Curriculum, Emily J. Gilmore, Univ of New Mexico SOM
• Luncheon Seminars on EOL Care and Suggestions for Integration of EOL into the Curriculum, Hena Arora, Rush Univ
• Introducing Clinical EOL Experiences to Medical Students, Janelle Pflieger, Chicago College of Osteopathic Medicine
• Expanding Education in EOL Care through Experiential, Interactive and Didactic Methods, Juan Geldres, Wayne State Univ SOM
• EOL Week at Medical School, Matt Ambrose, Univ of Michigan Medical School
• Integrating EOL Topics into Pre-clinical Courses, Nicolas R. Cahanding, Chicago College of Osteopathic Medicine
• Curricular and Extracurricular Activities for EOL Education, Paula Yellon, Univ of Maryland
• Luncheon Seminars on EOL, Rebecca Butler, Texas Tech Univ
• Death and Dying Interest Group, Susanne Carpenter, Texas A&M College of Medicine
• End of Life Lunchtime Symposia for M1 & M2, Daniel McFarland, New York College of Osteopathic Medicine

Projects-in-a-Box developed by 2003 AMSA EOL Fellows

• Luncheon Seminars, Erin Wright
  Luncheon Seminars Sign In Sheet, Erin Wright
• EOL Lecture and Establishing a Death and Dying Interest Group, Heather Goffinet
  EOL Lecture and Establishing a Death and Dying Interest Group, Heather Goffinet
• Improving and Integrating EOL Education into the Curriculum, Andy Huchingson
• Extracurricular EOL Offerings, Angie Chmielewski
• Discussion Groups on EOL Films and Literature, Ashley Nichols
• Forming a Death and Dying Interest Group, Donna Kim
• Experiential EOL Learning Module, Richard Lin
  Experiential EOL Learning Module, Richard Lin
• Project Know Thyself: Interpersonal Journey to Learn about Death and Bereavement, Hamayan Nawaz
• Integrating Hospice and Palliative Care into Medical School, Jim Richter
• Death and Dying Elective for M1, Mabel Obeng
• Exposure to Hospice and Palliative Care Before and During 3rd Year, Melanie Johnson
• Exercises to Introduce Student to Concepts of Death and Dying, Munish Bakshi

POWERPOINT LUNCH LECTURES AND PRESENTATIONS
Compliments of Horizon Hospice, AMSA Foundation's academic partner for the End of Life (EOL) Fellowship Program in Chicago, IL

• Grief and Bereavement, Karen Horinek, LCPC
• Ethics and Law in Palliative Medicine, Kathy Neely, MD
• Pediatric Hospice, Kimberly Battle-Miller, MD
• What is a Good Death? Role of Health Care Workers, Michael Marschke, MD
• Gaps in EOL Care, Michael Marschke, MD
• Bedside Assessment at EOL, Michael Marschke, MD
• Communication Workshop, Michael Marschke, MD
• Common Physical Symptoms: Weakness, Falls, and Skin Problems, Michael Marchke, MD
• Volunteer Training, Noel Gilligan, MPS, ACPE and Nick Cahanding
• Pain: Assessment and Management, Michael Marschke, MD
• Nutrition and Hydration at EOL, Lisa Shives, MD
• Developing EOL Curricula, Michael Marschke, MD
• Spirituality and Medicine, Michael Marschke, MD
• Socioeconomic Concerns at EOL, Maryellen McGreevey
• Who's Caring for the Caregiver, Maryellen McGreevey
• GI and Pulmonary Problems, Michael Marschke, MD
• Complementary and Alternative Medicine, Michael Marschke, MD and the CAM Team
• Common Physical Symptoms: Depression, Anxiety, Delirium, Michael Marschke, MD
• Care in the Final Hours, Michael Preodor, MD
• Palliative Care Across Cultures, Lori Hedges
• Case Studies in EOL Care
• Philosophy of Death and Dying, Michael Marschke, MD

Compliments of VITAS Innovative Healthcare Corporation, AMSA Foundation's academic partner and funder for the End of Life (EOL) Fellowship Program in Miami, FL

• Good Death and Introduction to Palliative Care—Dr. Joel S. Policzer and Dr. Barry M. Kinzbrunner
• End of Life Care Delivery Systems—Dr. Policzer
• Breaking Bad News—Dr. Policzer
• The Interdisciplinary Team—Dr. Paul Rozynes
• Hospice Criteria—Dr. Rozynes
• Patient Assessment—Dr. Policzer
• Wound Care: Best Practice Guideline—Dr. Larry McDermott
• Pressure Ulcers and Wounds—Dr. Monica Warhaftig
• Nonpain Symptoms—Dr. Warhaftig
• Pain Management—Dr. Rozynes
• Depression, Anxiety, and Delerium—Dr. Jeffrey Behrens
• Introduction to Medical Ethics—Dr. Kinzbrunner
• Spiritual and Ethical Issues—Dr. Kinzbrunner
• Nutrition and Hydration—Dr. Kinzbrunner
• Physician Assisted Suicide and Total Sedation—Dr. Policzer
• Spiritual Issues at the End of Life—Chaplain Misti Johnson
• Bereavement Care—Chaplain Mitch Husar
• Caring for the Caregiver—Dr. Rozynes
• Pediatric Hospice Care—Dr. Lynn Meister
• Caribbean Culture and Attitudes Toward Hospice—Elaine Goddard
• End of Life Care for Patients of Hindu Faith—N. Pathak
• Dying and Death: An African Context—Rasheed Oshooya, MPH
• Buddhism: Introduction and Concepts—Sara Roby

READING LIST

• Becker, Ernest. The Denial of Death. Free Press: New York. 1973.
• Burnell, George. Final Choices: To Live or To Die in an Age of Medical Technology. Galen Press: Tucson, AZ.
• Byock, I. Dying Well: Peace and Possibilities at the End of Life. Riverhead Books. 1998.
• Carlson, Lisa. Caring for Your Own Dead, 2nd ed. Galen Press: Tucson, AZ.
• Cassell, Eric. The Nature of Suffering and the Goals of Medicine. Galen Press:Tucson AZ.
• Death To Dust: What Happens To Dead Bodies? Second Edition, Galen Press, Ltd. Tucson, AZ, 2001, 821 pgs
• Dunn, Hank. Hard Choices For Loving People: CPR, Artificial Feeding, Comfort Measures Only and the Elderly Patient. A&A Publisher's Inc.: Herndon, VA. 1994.
• Doyle, D, Hanks GWC, Cherny,NI, Kenneth, C. Oxford Textbook of Palliative Medicine. Oxford Press; 3rd edition. November 2003.
• Ethnic Variations in Dying, Death, and Grief: Diversity in Universality. Eds. Donald P. Irish, Kathleen F. Lundquiat, Vivian Jenkins Nelsen. Galen Press: Tucson AZ.
• The Gravest Words: Notifying Survivors About Sudden Unexpected Deaths (Educational Video) Galen Press, Ltd., Tucson, AZ, 2000
• Grave Words: Notifying Survivors About Unexpected Deaths Galen Press, Ltd., Tucson, AZ, 1999. 342 pgs
• Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying. Hastings Center. 1987.
• Hendin, Herbert. Seduced By death: Doctors, Patients, and the Dutch Cure. W.W. Norton and Company: New York. 1997.
  - Also by Herbert Hendin: Suicide in Scandinavia, Black Suicide, Suicide in America
• Humphry, Derek. Final Exit. Dell Trade Paperback: New York. 1991.
• Iserson, Kenneth. Death to Dust: What Happens to Dead Bodies? Galen Press: Tucson, AZ.
  - Also by Kenneth Iserson: After-Death Planning Guide
• Jamison, Stephen. Final Acts of Love: Families, Friends, and Assisted Dying. Putnam Publishing: New York. 1996.
  - Also by Stephen Jamison: Assisting a Patient to Die: A Guide for Physicians.
• Karnes, B. Gone from My Sight: the Dying Experience, Barbara Karnes Books Inc: Kansas. 10th ed.
• Kinast, Robert. When A Person Dies. Crossroad: New York. 1984.
• Kramer, Kenneth. The Sacred Art of Dying. Paulist Press: Mahwah, N.J. 1988.
• Kubler-Ross, Elisabeth. On Death and Dying. MacMillan Publishing Company: New York. 1969.
  - Also by Elisabeth Kubler-Ross: Questions and Answers on Death and Dying, To Live Until We Say Good-bye, Living With Death and Dying, Remember the Secret, Death: The Final Stage of Growth, On Children and Death, Working It Through, AIDS: The Ultimate Challenge
• Leash, R. Moroni. Death Notification: A Practical Guide to the Process. Galen Press: Tucson, AZ.
• Levine, Stephen. Meetings At the Edge. Anchor Press: New York. 1984.
• Moore, Thomas. Care of the Soul. Harper: New York. 1992.
• Morgan, Earnest. Dealing Creatively with Death: A Manual of Death Education & Simple Burial, 13th ed. Galen Press: Tucson AZ.
• Nouwen, Henri. The Wounded Healer. Image Books: New York. 1972.
• Nulan, Sherwin. How We Die: Reflections on Life's Final Chapter. Galen Press: Tucson, AZ.
• Pocket Protocols: Notifying Survivors About Sudden Unexpected Deaths Galen Press, Ltd., Tucson, AZ, 1999. 65 pgs
• Pohl, AE. Beyond Grief: To Acceptance and Peace. Eagle Publications Co: FL. April 2002.
• Ram, Dass. The Only Dance There Is.
• Redemption of the Shattered, a Teenager's Healing Journey Through Sandtray Therapy - Book Review
• Shavelson, Lonny. A Chosen Death: The Dying Confront Assisted Suicide. Simon & Schuster: New York. 1995.
• Society for the Right to Die. The Physician and the Hopelessly Ill Patient. Society for the Right to Die: New York. 1985.
• Storey, P, Knight CE, Pocket Guide to Hospice/Palliative Medicine American Academy of Hospice and Palliative Care: IL. 2003.
• Teaching Slide Sets: Notifying Survivors About Sudden Unexpected Deaths Galen Press, Ltd., Tucson, AZ, 2000
• Thurston, Jeffrey. Death of Compassion: How Managed Care and Bureaucracy Are Strangling the Heart of Medicine. WRS Publishing: Waco, Texas. 1995.
• Tolstoy, Leo. The Death of Ivan Illich. Bantam: New York. 1981.
• Westberg, Granger. Good Grief. Fortress Press: Philadelphia. 1962.

ARTICLES BY DR. IRA BYOCK:
Author and president of the American Academy of Hospice and Palliative Medicine. Note, AMSA has been permitted to offer these articles but Dr. Byock retains all copyrights of his material. Please cite these references if you use this material.

• Consciously Walking the Fine Line: Thoughts on a Hospice Response to Assisted Suicide and Euthanasia J of Pal Care 9:3 pp 25-28 Autumn 1993
• A Letter to The National Academy of Sciences Institute of Medicine Committee on Care at the End of Life May 20, 1996, Academy of Hospice Physicians
• Notes of a Hospice Physician, The Western Journal of Medicine, Vol 164, No. 4, pp 367-8, April 1996
• Patient Refusal of Nutrition and Hydration: Walking the Ever-Finer Line The American Journal of Hospice and Palliative Care, March/April 1995 pp 8-13
• The Nature of Suffering and the Nature of Opportunity at the End of Life Clinics in Geriatric Medicine, Vol. 12: 2, pp 237-251 May 1996
• When suffering persists.... Journal of Palliative Care Vol.10, No.2, pp 8-13, 1994