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Duke University Creates National Institute on Care at the End of Life

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Duke Health News 919-660-1306

DURHAM, N.C. - Duke University has received a founding gift
of $13.5 million arranged by hospice pioneer Hugh A. Westbrook
to establish the Duke Institute on Care at the End of Life to
improve research, education and practice across the nation for
those near death, Duke President Nannerl O. Keohane announced
Wednesday.

The new institute will be based in Duke's Divinity School
and will have an interdisciplinary focus with a national and
international scope. It is the first academic entity in the
country to bring together a broad spectrum of disciplines,
schools and professions to look at what has become a pressing
social issue: how best to care, as a community, for those in
the last stage of life.

Westbrook is chief executive officer of VITAS Healthcare
Corp. of Miami, a 1970 Duke Divinity School graduate and an
ordained United Methodist minister. He coordinated the gifts
from the Foundation for the End of Life Care, the DadeFund of
the Dade Community Foundation and VITAS, the nation's largest
hospice provider.

"We are grateful for the leadership of Hugh A. Westbrook and
VITAS Healthcare in helping Duke to meet a critically important
social challenge - providing humane and compassionate care for
those at the end of life," Keohane said. "This new institute is
an excellent example of the interdisciplinary strength of the
university, linking faculty from our Divinity School with
colleagues from across the campus and the nation whose research
and expertise can help address the complexities of both living
and dying well."

"Duke's commitment to developing the world's leading center
for the advancement and improvement of care to the terminally
ill and their families focuses on one of the most important
challenges that can be addressed in human society," Westbrook
said. "This generation and all future generations will be able
to live a better life knowing that progress is being made on
behalf of those we care for at life's end."

The new Duke institute will involve the full spectrum of
professionals who provide end-of-life care, including
physicians and nurses at Duke's medical center, theologians and
ethicists from its Divinity School, humanities scholars from
its arts and sciences departments, pastors and other caregivers
from across the nation, and social work faculty from the nearby
University of North Carolina at Chapel Hill.

In addition, the institute is in the process of establishing
a formal affiliation with researchers and scholars in the
Department of Palliative Care and Policy at King's College,
University of London, and St. Christopher's Hospice in London,
England. St. Christopher's is widely recognized as the site
where the modern-day hospice movement began.

The institute, moreover, will be a partner with one or more
historically black colleges in the United States to address
issues of particular relevance to the African-American
community.

"Issues surrounding end of life care are always significant
and increasingly urgent because of changing demographics,
economic pressures in contemporary health care, and
technological advances tending toward aggressive
interventions,"said Divinity School Dean L. Gregory Jones. "In
light of these concerns, we need stronger research and improved
practice that draws on religious, ethical and socially
responsible commitments.

"We are excited about the innovative significance of this
new institute," Jones added. "Churches and synagogues have long
been leaders in caring for people at the end of life, and
Duke's Divinity School is well positioned to provide leadership
in this area. To deal with complex issues involved in dying
well, we need interdisciplinary, inter-school and
inter-professional efforts. Hugh A. Westbrook's leadership and
founding gifts will enable us to embody our vision for focusing
on more effective and faithful care at the end of life."

In earning his master-of-divinity degree at Duke, Westbrook
specialized in ethics and pastoral care. For the next 10 years,
he served as a pastor in North Carolina and Florida and worked
as a hospital chaplain caring for terminally ill patients and
their families. In 1978, he co-founded with Esther Colliflower
the VITAS Healthcare Corp., which provides hospice care to more
than 32,000 patients and bereavement services to more than
90,000 people annually across the nation.

In 1979, Westbrook wrote and was instrumental in gaining
passage in Florida of the nation's first hospice-licensing law
and establishing a quality standard for care of terminally ill
patients in that state. He has also chaired the National
Hospice Education Project, a grassroots effort to promote
awareness of hospice care.

Activities of the new Duke institute will include academic
research and teaching; practical training for health-care
providers, pastors and other caregivers; and public information
and educational programs for a wider public.

Traditionally, Duke has moved to address broad societal
issues through multi-disciplinary research. Nearly 50 years
ago, the university broke new ground in geriatrics research,
establishing the nation's first interdisciplinary Center for
the Study of Aging and Human Development. In addition, Duke
sponsors the Center for Health Policy, Law and Management
through its Terry Sanford Institute of Public Policy. It also
conducts the Kenan Ethics Program for the study and teaching of
ethics, and has recently established the Center for Medical
Ethics and the Humanities in its medical center.

"We anticipate programming for the Institute on Care at the
End of Life will include research and education on issues such
as theological and medical ethics, cultural diversity and pain
management," said Dr. Keith G. Meador, institute director and a
psychiatrist on both the faculties of Duke's divinity and
medical schools. "We also are committed to engaging
public-policy issues, particularly as they relate to
underserved populations. Although the challenges are
significant, we believe an interdisciplinary effort is critical
to making substantive improvements in practices related to
caring for suffering and dying persons."

Meador said he expects the Duke Institute on Care at the End
of Life will provide national leadership in training clergy who
care for the dying, whether in parish or health-care settings.
He also expects the new institute to use hospices across the
country to give clinical training to clergy in end-of-life
care. In addition, he said, he foresees the new institute
serving as a national resource for community and health-care
professionals who desire to provide end-of-life care that is
attentive to spiritual concerns.

The institute will celebrate its founding with a symposium
and dinner on Thursday, March 2, at Duke. The symposium,
"Opening Doors: Access to Care at the End of Life," will
address the virtues and strength of character needed for
caretaking, quality-of-life issues for the dying, a
patient-and-family centered model of care, and ways to access
care for those approaching death.

Dr. J. Richard Williams, president of the Foundation for End
of Life Care and VITAS executive vice-president, said: "In the
21st century, the most important contributions to the
health-care industry will come from the work pioneered by those
involved in end-of-life care. Duke's new institute will make a
pivotal difference in this care."

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