Lessons from End-of-Life Care in Oregon

To the Editor: Tolle and Teno (March 16 issue) 1 address the glaring deficiencies in the delivery of end-of-life care in the United States. The considerable benefits that the Physician Orders for Life-Sustaining Treatment (POLST) Program in Oregon provided its patients and health care system were encouraging, but these findings must be viewed with skepticism since Oregon is predominantly white (87.6% of the population) and historically whites have been more accepting of end-of-life care than nonwhites. 2 – 4 The authors address this concern by comparing Oregon with Washington, a neighboring state that has “comparable demographic features,” but Washington has twice as many . . .