Obstacles in the treatment of dying patients

Theory and practice in the management of the dying patient have moved forward in the past two decades. However, the author believes the benefits of this progress have not reached a large segment of the population of dying patients--those individuals who have a higher level of psychopathology or are from a lower socioeconomic group. Obstacles in the treatment of such patients are described and illustrated by case histories; the author makes specific recommendations related to the care of these more difficult cases.