Ezekiel J. Emanuel, MD, PhD; Diane L. Fairclough, DPH; Julia Slutsman, BA; Linda L. Emanuel, MD, PhD
Acknowledgments: The authors thank Drs. DeWitt Baldwin, Marion Danis, Lee Goldman, and Russell Phillips for critical review of the manuscript. They also thank Erica Omundsen for research assistance and Alma Kuby and the National Opinion Research Council for conducting the patient and caregiver interviews.
Grant Support: In part by grants from the Commonwealth Fund and the Nathan Cummings Foundation.
Requests for Single Reprints: Ezekiel J. Emanuel, MD, PhD, Department of Clinical Bioethics, Warren G. Magnuson Clinical Center, National Institutes of Health, Building 10, Room 1C118, Bethesda, MD 20892-1156.
Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, firstname.lastname@example.org.
Current Author Addresses: Dr. E.J. Emanuel: Department of Clinical Bioethics, Warren G. Magnuson Clinical Center, National Institutes of Health, Building 10, Room 1C118, Bethesda, MD 20892-1156.
Dr. Fairclough: Center for Research Methodology and Biometrics, AMC Cancer Research Center, 1600 Pierce Street, Denver, CO 80214.
Ms. Slutsman: Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, 615 North Wolfe Street, Baltimore, MD 21205.
Dr. L.L. Emanuel: Institute of Ethics, American Medical Association, 515 North State Street, Chicago, IL 60610.
Author Contributions: Conception and design: E.J. Emanuel, D.L. Fairclough, L.L. Emanuel.
Analysis and interpretation of the data: E.J. Emanuel, D.L. Fairclough, L.L. Emanuel.
Drafting of the article: E.J. Emanuel, D.L. Fairclough, J. Slutsman, L.L. Emanuel.
Critical revision of the article for important intellectual content: E.J. Emanuel, D.L. Fairclough, L.L. Emanuel.
Final approval of the article: E.J. Emanuel, D.L. Fairclough, J. Slutsman, L.L. Emanuel.
Statistical expertise: D.L. Fairclough.
Obtaining of funding: E.J. Emanuel, L.L. Emanuel.
Administrative, technical, or logistic support: J. Slutsman.
Collection and assembly of data: E.J. Emanuel, J. Slutsman.
Emanuel E., Fairclough D., Slutsman J., Emanuel L.; Understanding Economic and Other Burdens of Terminal Illness: The Experience of Patients and Their Caregivers. Ann Intern Med. 2000;132:451-459. doi: 10.7326/0003-4819-132-6-200003210-00005
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Published: Ann Intern Med. 2000;132(6):451-459.
Serious illness has an adverse effect on patients, family, and friends. Previous studies have demonstrated that caregivers of patients with cancer and dementia have increased health problems and psychosocial stress (1-7). For example, studies have reported that up to one third of spouses of patients with terminal cancer have depressive symptoms (8, 9). Families of terminally ill patients also experience adverse economic effects. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT) reported that families of seriously ill patients experienced substantial economic losses. In 20% of families, a family member had to stop working; 31% of families lost most of their savings (7).
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