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AMA goal: Improve care for terminally ill

The American Medical Association on Friday announced an ambitious project to teach every doctor in America how to provide better care for the terminally ill.

The project, jointly financed by the AMA and the Robert Wood Johnson Foundation, is the first major initiative of the new Institute for Ethics at the American Medical Association.

The institute, with an annual budget of $1-million, will conduct research and establish ethical guidelines for doctors. Another of its projects will be to create ethical "report cards" for managed care organizations.

AMA leaders Friday discussed the institute and the new end-of-life care program during the AMA's conference on ethics and American medicine. The two-day meeting in Philadelphia is examining the history of the organization's 150-year-old ethics code, as well as daunting ethical issues, such as managed care, genetic testing, assisted suicide and cloning. The meeting has drawn more than 300 bioethicists, historians, doctors and students.

Linda Emanuel, a former Harvard Medical School ethicist who will head the Institute for Ethics, said she hopes her office can help physicians deal with a "tumultuous era" by focusing on physicians' core values.

The goal of the two-year end-of-life project is to teach every practicing doctor how to give more compassionate, competent care to the dying.

The AMA plans to have meetings throughout the country not only to help doctors talk about death, but also to treat the pain, fatigue, breathing problems and depression that often accompany terminal illness.

Arthur Caplan, director of the University of Pennsylvania's Center for Bioethics, said he is pleased by the AMA's emphasis on ethics. The profession, he said, is in an "absolute state of crisis" because of the ethical challenges of managed care and other changes.