Photo by Al Seib, Los Angeles Times.By Eryn Brown, Los Angeles Times

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On Thursday, a coalition of Los Angeles-area healthcare providers — caring for millions of Angelenos among them — will endorse some groundbreaking guidelines designed to help patients … take more control over their final months, weeks and days. The hospitals will urge their doctors and nurses to help patients specify their hopes for the end of life through advance-care planning, and understand how to seek palliative care if a patient wants it.

The participants include Cedars-Sinai, HealthCare Partners Medical Group and Affiliated Physicians, Kaiser Permanente Southern California, Keck Medical Center of USC, Los Angeles County-USC Medical Center, MemorialCare Health System, Olive View-UCLA Medical Center, Providence Little Company of Mary Medical Center Torrance, Providence TrinityCare Hospice and the UCLA Health System.

The guidelines call on doctors to explain clearly to patients when a medical treatment under consideration — including interventions such as feeding tubes, intubation or dialysis — “may deprive the person of life closure (the ability to say ‘forgive me,’ ‘I love you’ or ‘goodbye’) or preclude a peaceful death.”

“We see a lot of harm at the end of life,” said endocrinologist Glenn Braunstein, vice president of clinical innovation at Cedars-Sinai and a leader of the guideline effort. “We said, ‘We have to fix this.'”

Kate O’Malley, a researcher who studies end-of-life care at the California HealthCare Foundation in Oakland, said the broad-based effort was unlike any she had seen before in the state.

“To see these health systems own this is extremely exciting to me,” she said, calling end-of-life talks “one of the most important things in healthcare that never happens.”

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