The Cunniff-Dixon Foundation was created in 2005 in memory of Carley Cunniff and in recognition of Dr. Peter S. Dixon. Carley died in January of 2005 after a 3- year battle with breast cancer. Peter Dixon was her attending physician during her last year; he was the guiding light who enabled her to die a peaceful death at home with her family and loved ones.

During the subsequent year, I came to realize that the experience that Carley and I had had at the end of her life was one that occurs all too rarely. Too many patients are deprived of a peaceful end surrounded by loved ones. Physicians are trained to sustain life; and the wonderful development of so many medical procedures makes it even more difficult to recognize and acknowledge that time when life is no longer sustainable in a way that is consistent with a patient’s wishes. End-of-life care has become an even more challenging task, and it is fraught with meaningful implications for the future.

A great deal of progress has been made in this field in the last 10 years. The role of Hospice facilities has greatly expanded. The development of palliative care centers has made improved end-of-life care available to many more patients. The evolution of pain management techniques has mitigated the suffering of patients. Palliative care has become a medical sub-specialty, inspiring more medical students to concentrate on this important field. And, most of all, nurses and social workers have taken on end-of-life care with passion and devotion.

In Carley’s case—and in the case of most terminal patients—the role of the attending physician is the critical factor. Without the sensitive leadership of the physician to whom the patient and the patient’s family look for direction and hope, insecurity, fear, and despair can set in. Failure to acknowledge that fragile line between curative medicine and palliative care can result in needless intervention, unnecessary institutionalization, and in some cases, misery.

It is the view of this Foundation that much can still be done to enhance the physician’s knowledge of the intricacies of end-of-life care. In addition, much can be done to inspire physicians to truly want to deliver a higher level of care and attentiveness to patients and their families at the end of life. It is a complex topic, riddled with ethical, legal, and religious issues. Furthermore, there are few economic incentives to reward improved medical care at the end, and real devotion to a patient at the end can be time consuming.

The mission of this Foundation is to enrich the provider-patient relationship near the end of life. Our goal is to educate clinicians and inspire them to provide the kind of care near the end of life that we all wish for ourselves and our loved ones. We aim to accomplish this in several ways. The first is a series of CME conferences designed to educate and inspire physicians regarding the care of terminal patients. Our first conference was in November of 2007 and the most recent was in May 2009. These conferences are conducted without commercial sponsorship and on a not-for-profit basis. We strive to assemble faculty members who are highly regarded in their respective fields and recognized for their commitment to end-of-life care. The target audience consists of physicians who are motivated to refine their skills and inspire passion for the care they provide to patients who are terminally ill.

Second, the Foundation is committed to the annual award of several Cunniff-Dixon Prizes, which will go to exemplary nurses and physicians in recognition of clinical contributions and commitment to the cause of end-of-life medical care. Third, the Foundation is engaged in a joint project with The American College of Surgeons to develop a medical curriculum for the benefit of surgical residency programs across the United States.

In the scheme of things, The Cunniff-Dixon Foundation is a relatively modest undertaking. We do not have the financial resources of many other foundations. But our goals are lofty and meaningful, and we have passion about our endeavor. We believe that we can make a difference. If we can deliver a thoughtful message and useful guidance to hundreds of physicians each year, those doctors will carry the message forth, they will share it with their peers, and their patients will be better served. That will be a tremendous reward for us, and will inspire us to continue with our mission.