The advent of the new millennium is an appropriate juncture at which to look at the recent changes in health care delivery regarding end of life decision making. The concerted efforts made toward enabling patients and families—not only physicians—to enact their health care wishes, may well dub this year the Ethical Revolution. Affirming patients’ rights in the heretofore sacred sanctum of “doctor knows best” has been a significant milestone. The same door has also opened the way for HMO’s to indelibly add the language of “bottom line” to our routine visits to the doctor or the exigency of entering a hospital.

This issue of Ethics Network News offers an encapsulated snapshot of the important chapter that the New York City Long-Term Care Ethics Network has written in history in the making by providing a forum of education to professionals in the field of long-term care. Through our many avenues of seminars, publications and speakers, NYCLTCEN has been available to guide facilities through the evolution and revolution of this process, mostly by providing caregivers with the language with which to communicate and improve quality of service by raising consciousness.

In these pages Pat Krasnausky explores the effects of cultural change in the long-term care setting. Focusing on autonomy she indicates that decision making for elders begins with them and not for them. A telling sign of our times is recognizing that not every elderly resident’s mores necessarily follow the Judeo-Christian code. A new spirituality has emerged—breaking the stained glass ceiling—that may not be reflected in religious tradition. The sociological phenomenon of dying alone is poignantly treated in, Who is the Author? as well as a look at the level of our preparation for dying.

When remembering the past century, many will cite the technological strides of e-mail, cell phones and other advanced communication tools. Ironically, we have only begun to elicit the minutest sound bytes of the innermost wishes of our residents and patients.

The next millennium is laden with great expectation and potential. Together we can develop the lexicon to communicate and validate our stories as we have chosen to write them. We invite you, professionals in shaping our future delivery of health care services, to take an active role in the educational revolution that define a future that best meets the needs of those entrusted to our care.

Posted on December 29, 2000.

Looking Forward: From the Editor's Corner was published in the Winter edition of the Ethics Network News and is available on-line at: http://www.angelfire.
com/on/NYCLTCethicsnetwork/dec_jan00-01edcorn.html

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