Wednesday, December 06, 2006

PSU/Law & PSU/Med Symposium on "Quality of Life"

Penn State - Dickinson School of Law, and Penn State College of Medicine together recently announced their jointly-sponsored "2007 Regional Symposium on Health Care and Quality of Life" to be held on Friday, March 2, 2007, at the Capital Union Building, on the Penn State-Harrisburg Campus. The planned symposium is described on a dedicated website found here.

According to that website, "The symposium will examine issues related to health care and quality of life currently being addressed among regional colleges/universities and other agencies."

It is intended for "all interested parties, such as faculty, students, public officials, and business leaders."
The potential topics could include: Health care and quality of life; cultural competency; health care policy and delivery; health education; legal and financial aspects; long-term care; quality of life and end of life issues; wellness; and health care for protected groups.

Why is such a symposium significant?
For at least two reasons, I think.

1) the general topic --
Health Care and Quality of Life. -- and some particular aspects of it: Long-term care and end-of-life issues.

Wikipedia presents the topic "
Quality of Life" here, and immediately distinguishes the medical aspects from other general characteristics:

Debate on quality of life is millennia-old, with Aristotle giving it much thought in his Nicomachean Ethics and eventually settling on the notion of eudaimonia, a Greek term, often translated as happiness, as central. The neologism liveability (or livability), from the adjective liv(e)able, is an abstract noun now often applied to the built environment or a town or city, meaning its overall contribution to the quality of life of inhabitants.

Understanding quality of life is today particularly important in health care, where monetary measures do not readily apply. Decisions on what research or treatments to invest the most in are closely related to their effect of a patient's quality of life. * * *

There is a growing field of research concerned with developing, evaluating and applying quality of life measures within health related research (e.g. within randomised controlled trials). Many of these focus on the measurement of health related quality of life (HRQoL), rather than a more global conceptualisation of quality of life. They also focus on measuring HRQoL from the perspective of the patient and thus take the form of self completed questionnaires. The International Society for Quality of Life was founded in response to this research and is a useful source of information on this topic.
"Quality of Life" issues arise frequently in situations of chronic disability or illness, and in end-of-life stages. The Center for Gerontology and Health Care Research, of the Brown Medical School (affiliated with Brown University), is a nationally-prominent research center that studies the diverse health and social service needs of elderly and other persons with chronic illnesses.

That Center has developed new "instruments" for measuring "
Quality of Life", presented on its project website entitled "Time: Toolkit of Instruments to Measure End-of-Life Care", found online here.
A fundamental barrier in the quality of care at the end of life is the lack of measurement tools. These measurement tools should identify opportunities for improving medical care, examining the impact of interventions or demonstration programs, and holding institutions accountable for their quality of care.

The Toolkit takes steps toward crossing this measurement barrier by creating patient-focused, family-centered survey instruments that address the needs and concerns of patients and their families, as defined by them.

With funding from the Nathan Cummings Foundation and the Robert Wood Johnson Foundation, we have assembled an authoritative bibilography of instruments to measure the quality of care and quality of life for dying patients and their families. Based on these reviews, we have created the Toolkit instruments, which are available on this site at no charge.
Understanding the "Toolkit" is challenging, in its presentation of issues, procedures, and measurements involved in "quality of life" assessments. Within the Tookit, I found these topics to be most universal:
  • Physical Comfort
    • Why is it important to focus on pain?
    • What do the experts say about pain management?
    • What are the basics you need to know?
    • Interpreting your score
    • What are the next steps to improve the quality of care?
  • Communication and Shared Decision Making
    • Why is it important to focus on emotional comfort?
    • What do the experts say?
    • What are the basics you need to know?
    • Interpreting your score
    • What are the next steps to improve the quality of care?
The Toolkit site offers helpful resource links here. These matters address the "nitty-gritty" elements of personal health care decision making, which are the very matters & settings that new Act 169 of 2006 was crafted to address practically. It will take effect in Pennsylvania on January 29, 2007.

2) the collaboration between a law school and a medical school on this topic.

In Pennsylvania, as nationwide, the professional working relationships between lawyers and doctors have been strained over issues of medical malpractice, individual rights to health care, & medical insurance coverage, as evidenced by this Associated Press article,
"Malpractice debate takes ugly turn", dated June 16, 2004, which appeared on the PhillyBurbs website.

The recent cooperation of the Pennsylvania Bar Association and the Pennsylvania Medical Society (among many other interested groups) in the preparation & presentation of Senate Bill 628 (now Act 169 of 2006) offers a different model for an inter-professional working relationship that yields benefits to both.

The common effort of a law school with a medical school to convene a discussion on the complex subject of "Quality of Life" --involving significant medical & legal principles -- is noteworthy and heartening.

* * *
Update: 02/27/07:

The planned schedule of events for the Symposium is available online here.