Background

Death is the one universal constant. However, until recently, there was little attention paid to how people die, the issues dying individuals and their loved ones face, and the government's role in the dying process. Wide-spread attention to dying and death began occurring only after the United States Supreme Court issued its decision in its first "right-to-die" case in 1990 (Cruzan v. Director, Missouri Department of Health). Since then, the press, courts, legislatures, and professional medical and mental health organizations have devoted time and energy to examining end-of-life issues (e.g., withholding and withdrawing treatment, advance directives).

Psychosocial issues are a primary determinant of quality of life and of end-of-life decision-making. In fact they appear to be more important than physical pain and suffering (e.g., Breitbart et al., 2000). In addition, physical pain and suffering can be exacerbated by the presence of clinical depression and, conversely, they can be ameliorated by the alleviation of depression and other psychological conditions (Block, 2000). Thus, mental health professionals have important roles to play as people go through the dying process (Smith, 2001). Yet, although research provides clear links between psychosocial factors and end-of-life decisions, virtually all of the legislative, monetary, and research attention has been paid to medical aspects of the dying experience and how to reduce physical suffering.

Even the American Psychological Association has only recently begun giving systematic attention to the pressing social issue of the end of life. However, APA has started to commit significant time, resources, and attention to the end of life. The APA Working Group on Assisted Suicide and End-of-Life Decisions was convened in 1998 and submitted its final Report to the Board of Directors in May (2000; http://www.apa.org/pi/aseolf.html). Further, APA has just convened a three-year Ad Hoc Committee on End-of-Life Issues, the task of which will be to provide direction to the APA's efforts in this arena; however, the group has not been given any funds to implement large-scale efforts such as the current proposal. It should be noted that many of the recommendations set forth by the Working Group involved bringing together researchers, practitioners, educators, and policy-minded professionals to develop state of the science and best practices as well as to educate psychologists and the public (see pages 68-69 of the January, 2001 Monitor for an overview of the Working Group's activities and the Report; Smith, 2001).

Format of the Conference

This conference, sponsored by the Society for the Psychological Study of Social Issues, focused attention on the need to address psychosocial issues in research, education, policy, and practice by considering both our extant knowledge and how we can build upon it to improve care. We brought together a diverse group of theorists, researchers, practitioners, and policy-minded professionals to work on improving how people deal with this universal human experience. The conference included international and domestic perspectives and considered cultural issues throughout the presentations. Conference participants will articulate research, practice, and training agendas that will be communicated to federal funders and policy makers, and will therefore be on the cutting-edge of moving the field forward. Further, the conference's interactive sessions provided a unique opportunity for dialogue between researchers, practitioners, educators, and policy-minded individuals -- both domestic and international -- for the purpose of sharing ideas and articulating a cohesive vision for the future. In addition, the conference provided an opportunity for mental health professionals to attend more focused workshops about end-of-life issues.

Intended Audience

In order to appeal to a diverse audience, the conference included international and graduate student perspectives and considered cultural issues throughout the conference. To the degree possible, the plenary speakers and panel members included discussion of how other countries have responded to the need to research and ameliorate psychosocial issues among people who are dying and their loved ones. There was also a special focus on how to incorporate end-of-life research and practice into training programs so that graduate students can get the experiences they need.

Goals and Objectives

(1) to provide attendees with an overview of both the current and cutting-edge research and practice associated with psychosocial issues near the end of life
summarize the state of end-of-life care and decision-making
summarize the role psychosocial issues play near the end of life
discuss ways of improving psychosocial care near the end of life
discuss the state of the science and future research needs

(2) to facilitate multidisciplinary discussion
encourage members of different disciplines to collaborate on a practice agenda
encourage members of different disciplines to collaborate on a research agenda
encourage researchers, practitioners, educators, and policy-minded individuals B both international and domestic B to dialogue

(3) to develop research, practice, and training agendas that will be communicated directly to federal funders and policy-makers
produce comprehensive research, practice, and training agendas that will be distributed on Capitol Hill and to federal agencies

(4) to provide cutting-edge continuing education with the goal of enhancing practice and research skills.
offer at least five continuing education workshops that will appeal to a variety of professionals