TEDxDesMoines
Timothy Ihrig: What we can do to die well
提摩西·伊理各: 尊嚴離世，安寧善終
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美國醫療界太重視病理學、手術及藥理學，即醫師能在病患身上「做」什麼治療，卻忽略了病患身為人的價值所應得的照護。安寧照護醫師提摩西·伊理各說明一種迥異的方法，不但能促進病人的整體生活品質，也讓病人尊嚴離世，安寧善終。
Timothy Ihrig - Palliative care physician
Timothy Ihrig advocates for an approach to healthcare that prioritizes a patient's personal values. Full bio
Timothy Ihrig advocates for an approach to healthcare that prioritizes a patient's personal values. Full bio
Double-click the English transcript below to play the video.
00:13
I am a palliative care physician
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我是安寧照護醫師，
00:14
and I would like to talk to you
today about health care.
today about health care.
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今天我想跟大家談談健康照護。
00:18
I'd like to talk to you
about the health and care
about the health and care
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我想跟大家談
我國最脆弱的一群人
他們的健康與照護，
他們的健康與照護，
00:22
of the most vulnerable
population in our country --
population in our country --
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00:25
those people dealing with the most
complex serious health issues.
complex serious health issues.
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這群人對抗著
最複雜最嚴重的健康問題。
最複雜最嚴重的健康問題。
00:32
I'd like to talk to you
about economics as well.
about economics as well.
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我也想跟你們談一談經濟。
00:35
And the intersection of these two
should scare the hell out of you --
should scare the hell out of you --
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這兩者交會之處應該會把大家嚇死，
00:39
it scares the hell out of me.
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至少我是怕死了。
00:42
I'd also like to talk to you
about palliative medicine:
about palliative medicine:
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我也想跟大家談談安寧療護：
00:45
a paradigm of care for this population,
grounded in what they value.
grounded in what they value.
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這是基於這群病患的價值觀
而產生的照護模式。
而產生的照護模式。
00:52
Patient-centric care based on their values
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以病人為中心，
根據他們的價值觀而做的照護，
根據他們的價值觀而做的照護，
00:55
that helps this population
live better and longer.
live better and longer.
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幫助這個族群活得更好更久。
01:00
It's a care model that tells the truth
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這個照護模式會對病人說實話，
01:03
and engages one-on-one
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並與他們進行一對一對談，
01:05
and meets people where they're at.
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並在患者所在之處碰面。
01:09
I'd like to start by telling the story
of my very first patient.
of my very first patient.
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我想以我第一個病人的故事
來做開場白。
來做開場白。
01:13
It was my first day as a physician,
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那是我當醫師的第一天，
01:15
with the long white coat ...
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穿著白袍，
01:17
I stumbled into the hospital
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我一走進醫院，
01:19
and right away there's a gentleman,
Harold, 68 years old,
Harold, 68 years old,
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就碰到一位先生，海樂，68 歲，
01:21
came to the emergency department.
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到急診室報到。
01:23
He had had headaches for about six weeks
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他頭痛了六個星期，
01:25
that got worse and worse
and worse and worse.
and worse and worse.
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病情愈來愈重，愈來愈難過。
01:28
Evaluation revealed he had cancer
that had spread to his brain.
that had spread to his brain.
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診斷發現他有癌症，
而且已經擴散到腦部。
而且已經擴散到腦部。
01:33
The attending physician directed me
to go share with Harold and his family
to go share with Harold and his family
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他的主治醫生指示我去跟海樂和家屬
01:39
the diagnosis, the prognosis
and options of care.
and options of care.
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談他的診斷結果、預後及照護方案。
01:44
Five hours into my new career,
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我的職業生涯才過了五個小時，
01:47
I did the only thing I knew how.
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我只能做我唯一會做的事。
01:49
I walked in,
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我走進去，
01:51
sat down,
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坐下，
01:53
took Harold's hand,
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握住海樂的手，
01:55
took his wife's hand
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握住他太太的手，
01:58
and just breathed.
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然後就一直呼吸。
02:00
He said, "It's not good
news is it, sonny?"
news is it, sonny?"
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他說：「不是什麼好消息，
對吧，小夥子？」
對吧，小夥子？」
02:03
I said, "No."
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我說：「不是。」
02:04
And so we talked
and we listened and we shared.
and we listened and we shared.
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然後我們開始談話、傾聽、分享。
02:08
And after a while I said,
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過一陣子之後我說：
02:10
"Harold, what is it
that has meaning to you?
that has meaning to you?
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「海樂，什麼對你最有意義？
02:13
What is it that you hold sacred?"
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你最看重的東西是什麼？」
02:15
And he said,
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他說：
02:16
"My family."
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「我的家人。」
02:18
I said, "What do you want to do?"
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我說：「那你想怎麼辦？」
02:20
He slapped me on the knee
and said, "I want to go fishing."
and said, "I want to go fishing."
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他拍拍我的膝蓋說：
「我想去釣魚。」
「我想去釣魚。」
02:23
I said, "That, I know how to do."
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我說：「這個簡單，
我知道該怎麼做。」
我知道該怎麼做。」
02:26
Harold went fishing the next day.
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海樂隔天就去釣魚了。
02:29
He died a week later.
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他在一星期後去世。
02:32
As I've gone through
my training in my career,
my training in my career,
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現在我已在職場受到不少訓練，
02:35
I think back to Harold.
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我就回想起海樂。
02:36
And I think that this is a conversation
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我在想像這樣的對話
02:40
that happens far too infrequently.
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太少發生了。
02:43
And it's a conversation
that had led us to crisis,
that had led us to crisis,
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這樣的對話帶領我們到危機之處，
02:48
to the biggest threat
to the American way of life today,
to the American way of life today,
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對今天的美式生活產生最大的威脅，
02:50
which is health care expenditures.
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就是醫療支出。
02:53
So what do we know?
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所以我們知道什麼？
02:55
We know that
this population, the most ill,
this population, the most ill,
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我們知道這個族群病得最重，
02:58
takes up 15 percent
of the gross domestic product --
of the gross domestic product --
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吃掉了 15% 的
國內生產毛額 (GDP)，
國內生產毛額 (GDP)，
03:00
nearly 2.3 trillion dollars.
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將近二兆三千億美金。
03:04
So the sickest 15 percent
take up 15 percent of the GDP.
take up 15 percent of the GDP.
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所以病得最重的 15%
吃掉 15% 的 GDP。
吃掉 15% 的 GDP。
03:07
If we extrapolate this out
over the next two decades
over the next two decades
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照這樣推斷未來二十年，
03:11
with the growth of baby boomers,
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隨著嬰兒潮逐漸老化，
03:14
at this rate it is 60 percent of the GDP.
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這個數字會是 60% 的 GDP。
03:20
Sixty percent of the gross
domestic product
domestic product
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美國 GDP 的 60%──
03:22
of the United States of America --
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到了這個地步，
已經不再是醫療的問題了，
已經不再是醫療的問題了，
03:24
it has very little to do
with health care at that point.
with health care at that point.
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03:27
It has to do with a gallon of milk,
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而是變成買牛奶、
03:29
with college tuition.
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大學學費的問題。
03:31
It has to do with
every thing that we value
every thing that we value
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這跟我們重視的一切
03:34
and every thing that we know presently.
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及我們目前知道的一切有關。
03:38
It has at stake the free-market
economy and capitalism
economy and capitalism
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這會賭上美國自由市場
及資本主義的成敗。
及資本主義的成敗。
03:42
of the United States of America.
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03:46
Let's forget all the statistics
for a minute, forget the numbers.
for a minute, forget the numbers.
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讓我們先擱下統計數字。
03:50
Let's talk about the value we get
for all these dollars we spend.
for all these dollars we spend.
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我們先來談一下花大錢得到什麼。
03:54
Well, the Dartmouth Atlas,
about six years ago,
about six years ago,
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達特茅斯醫療照護地圖集
在大約六年前
在大約六年前
03:57
looked at every dollar
spent by Medicare --
spent by Medicare --
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看了一下聯邦醫療保險
花掉的每一塊錢，
花掉的每一塊錢，
04:00
generally this population.
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大多是這個族群花掉的。
04:01
We found that those patients who have
the highest per capita expenditures
the highest per capita expenditures
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我們發現有最高
人均醫療費用的病人，
人均醫療費用的病人，
04:08
had the highest suffering,
pain, depression.
pain, depression.
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同時也是最受苦、
最痛、最憂鬱的病人。
最痛、最憂鬱的病人。
04:12
And, more often than not, they die sooner.
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而且屢見不鮮，他們也比較快死。
04:15
How can this be?
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怎麼會這樣呢？
04:17
We live in the United States,
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我們活在美國，
04:19
it has the greatest health care
system on the planet.
system on the planet.
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這裡有地球上最棒的醫療系統。
04:21
We spend 10 times more on these patients
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我們花在這些病人身上的錢，
04:24
than the second-leading
country in the world.
country in the world.
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比第二名的國家高出十倍。
04:27
That doesn't make sense.
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這沒有道理。
04:29
But what we know is,
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但是我們知道的是，
04:31
out of the top 50 countries on the planet
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全球前 50 個
04:34
with organized health care systems,
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有醫療保健系統計畫的國家，
04:37
we rank 37th.
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我們排名第 37 位。
04:42
Former Eastern Bloc countries
and sub-Saharan African countries
and sub-Saharan African countries
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中歐東歐等前東方集團國家
及下撒哈拉非洲國家
及下撒哈拉非洲國家
04:46
rank higher than us
as far as quality and value.
as far as quality and value.
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排名都比我們還高，
品質及價值也比我們好。
品質及價值也比我們好。
04:52
Something I experience
every day in my practice,
every day in my practice,
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每天我看診時都會經歷一件事，
04:55
and I'm sure, something many of you
on your own journeys have experienced:
on your own journeys have experienced:
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而且我敢保證，
在座很多人自己都經歷過：
在座很多人自己都經歷過：
04:59
more is not more.
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多不代表好。
05:04
Those individuals who had more tests,
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做愈多檢查，
05:06
more bells, more whistles,
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愈精密複雜的儀器，
05:07
more chemotherapy,
more surgery, more whatever --
more surgery, more whatever --
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愈多化療，愈多手術，不管是什麼，
05:09
the more that we do to someone,
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只要我們在病人身上做愈多，
05:13
it decreases the quality of their life.
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就愈降低他們的生活品質。
05:17
And it shortens it, most often.
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而且更常看到的是縮短壽命。
05:21
So what are we going to do about this?
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所以我們要怎麼辦？
05:23
What are we doing about this?
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我們要怎麼做？
05:25
And why is this so?
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而且為什麼會這樣？
05:27
The grim reality, ladies and gentlemen,
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嚴峻的現實是，各位先生女士，
05:29
is that we, the health care industry --
long white-coat physicians --
long white-coat physicians --
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我們，醫療業界的人
——穿著白袍的醫師——
——穿著白袍的醫師——
05:32
are stealing from you.
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從你們身上偷東西。
05:34
Stealing from you the opportunity
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從你們身上偷走
05:37
to choose how you want to live your lives
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選擇如何過活的機會，
05:40
in the context of whatever disease it is.
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不管你得的是什麼病。
05:42
We focus on disease
and pathology and surgery
and pathology and surgery
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我們專注在疾病、病理、手術
05:45
and pharmacology.
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及藥理。
05:49
We miss the human being.
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我們沒看到人。
05:53
How can we treat this
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我們要怎麼治療這個
05:54
without understanding this?
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卻不了解這個的存在？
05:59
We do things to this;
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我們為此做了許多；
06:02
we need to do things for this.
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現在我們必須為這個做點什麼。
06:08
The triple aim of healthcare:
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醫療有三重目標：
06:09
one, improve patient experience.
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一，改善患者經驗。
06:13
Two, improve the population health.
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二，改善此族群的健康。
06:17
Three, decrease per capita expenditure
across a continuum.
across a continuum.
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三，降低照護過程的人均醫療費用。
06:23
Our group, palliative care,
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我們的安寧照護團隊
06:25
in 2012, working with
the sickest of the sick --
the sickest of the sick --
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在 2012 年與病得最重的患者合作，
06:31
cancer,
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癌症、
06:32
heart disease, lung disease,
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心臟病、肺病、
06:34
renal disease,
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腎臟病、
06:35
dementia --
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失智等等，
06:37
how did we improve patient experience?
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我們如何改善病患經驗？
06:41
"I want to be at home, Doc."
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「醫生，我想待在家。」
06:42
"OK, we'll bring the care to you."
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「好，我們會去你家照護你。」
06:44
Quality of life, enhanced.
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生活品質提高。
06:47
Think about the human being.
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想想人。
06:49
Two: population health.
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第二點：族群健康。
06:51
How did we look
at this population differently,
at this population differently,
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我們怎麼用不同的觀點看這個族群，
06:53
and engage with them
at a different level, a deeper level,
at a different level, a deeper level,
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在不同的層面、
更深的層次與他們交流，
更深的層次與他們交流，
06:56
and connect to a broader sense
of the human condition than my own?
of the human condition than my own?
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如何將他們以人來看待，
而不是從本位來想？
而不是從本位來想？
07:01
How do we manage this group,
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我們怎麼管理這個族群，
07:04
so that of our outpatient population,
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讓我們 94% 的門診病人
07:06
94 percent, in 2012,
never had to go to the hospital?
never had to go to the hospital?
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在 2012 年都不用進醫院？
07:11
Not because they couldn't.
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不是因為他們不能去，
07:15
But they didn't have to.
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而是他們不需要去。
07:17
We brought the care to them.
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我們把醫療照護帶給他們。
07:19
We maintained their value, their quality.
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我們維持他們的價值，他們的品質。
07:25
Number three: per capita expenditures.
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第三：人均醫療費用。
07:28
For this population,
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對這個族群而言，
07:30
that today is 2.3 trillion dollars
and in 20 years is 60 percent of the GDP,
and in 20 years is 60 percent of the GDP,
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現在的花費是二兆三千億美元，
二十年後是 60% 的國內生產毛額，
二十年後是 60% 的國內生產毛額，
07:35
we reduced health care expenditures
by nearly 70 percent.
by nearly 70 percent.
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我們減低了幾乎
70% 的人均醫療費用。
70% 的人均醫療費用。
07:40
They got more of what they wanted
based on their values,
based on their values,
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他們本著自己的價值觀
得到更多自己想要的，
得到更多自己想要的，
07:44
lived better and are living longer,
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可以活得更好，現在活得更久，
07:47
for two-thirds less money.
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只要三分之一的花費。
07:54
While Harold's time was limited,
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雖然哈樂的時間不多，
07:57
palliative care's is not.
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安寧照護卻非如此。
08:00
Palliative care is a paradigm
from diagnosis through the end of life.
from diagnosis through the end of life.
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安寧照護模式要看顧
從診斷到臨終這整段時間。
從診斷到臨終這整段時間。
08:06
The hours,
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可能是幾小時、
08:08
weeks, months, years,
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幾週、幾個月、幾年、
08:11
across a continuum --
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連續整段時間，
08:13
with treatment, without treatment.
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有沒有治療都是。
08:15
Meet Christine.
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來看克里斯汀的例子。
08:17
Stage III cervical cancer,
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第三期子宮頸癌，
08:19
so, metastatic cancer
that started in her cervix,
that started in her cervix,
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轉移癌，從她的子宮開始，
08:22
spread throughout her body.
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擴散到整個身體。
08:24
She's in her 50s and she is living.
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她五十幾歲，還活得很好。
08:28
This is not about end of life,
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我們不是在講臨終，
08:30
this is about life.
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我們是在講生命。
08:33
This is not just about the elderly,
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我們不只在說老年人，
08:35
this is about people.
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我們在說人。
08:37
This is Richard.
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這位是理查。
08:39
End-stage lung disease.
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肺病末期。
08:42
"Richard, what is it
that you hold sacred?"
that you hold sacred?"
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「理查，你最重視什麼？」
08:45
"My kids, my wife and my Harley."
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「我的孩子，老婆和哈雷摩托車。」
08:49
(Laughter)
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（笑聲）
08:50
"Alright!
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「好！
08:52
I can't drive you around on it
because I can barely pedal a bicycle,
because I can barely pedal a bicycle,
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我不能騎它載著你到處跑，
因為我連腳踏車都不會騎，
因為我連腳踏車都不會騎，
08:55
but let's see what we can do."
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但是來看看能做什麼。」
08:58
Richard came to me,
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理查來找我，
09:00
and he was in rough shape.
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情況很糟。
09:04
He had this little voice telling him
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有個小小的聲音告訴他，
09:06
that maybe his time was weeks to months.
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大概只剩幾個星期或幾個月了。
09:09
And then we just talked.
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我們就只是聊聊。
09:10
And I listened and tried to hear --
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我聽著，也試圖去聽言外之意，
09:14
big difference.
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這兩者有很大的差別。
09:16
Use these in proportion to this.
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多聽少說。
09:20
I said, "Alright, let's take it
one day at a time,"
one day at a time,"
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我說：「好吧！過一天是一天。」
09:23
like we do in every
other chapter of our life.
other chapter of our life.
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就像生命中其它章節一樣。
09:26
And we have met Richard
where Richard's at day-to-day.
where Richard's at day-to-day.
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我們天天去理查住的地方。
09:31
And it's a phone call or two a week,
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一星期一通或兩通電話，
09:35
but he's thriving in the context
of end-stage lung disease.
of end-stage lung disease.
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以他肺病末期的狀況而言，
他過得很好。
他過得很好。
09:43
Now, palliative medicine is not
just for the elderly,
just for the elderly,
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現在，安寧照護不只照顧老年人，
09:45
it is not just for the middle-aged.
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也不只照顧中年人，
09:49
It is for everyone.
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我們照護每一個人。
09:51
Meet my friend Jonathan.
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來看看我的朋友強納生。
09:53
We have the honor and pleasure
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我們很榮幸
09:55
of Jonathan and his father
joining us here today.
joining us here today.
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請到強納生和他的父親來到現場。
09:57
Jonathan is in his 20s,
and I met him several years ago.
and I met him several years ago.
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強納生二十多歲，我幾年前遇到他。
10:00
He was dealing with
metastatic testicular cancer,
metastatic testicular cancer,
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他在與轉移性睪丸癌奮鬥，
10:04
spread to his brain.
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擴散到腦部。
10:06
He had a stroke,
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他有過中風，
10:08
he had brain surgery,
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他曾動過腦部手術，
10:09
radiation, chemotherapy.
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做過放療、化療。
10:13
Upon meeting him and his family,
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在跟他及家人會診時，
10:15
he was a couple of weeks away
from a bone marrow transplant,
from a bone marrow transplant,
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他才做完骨髓移植幾星期。
10:18
and in listening and engaging,
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他很仔細聽，
10:20
they said, "Help us
understand -- what is cancer?"
understand -- what is cancer?"
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他們說：「可不可以讓我們
了解一下什麼是癌症？」
了解一下什麼是癌症？」
10:27
How did we get this far
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我們怎麼撐到這一步，
10:30
without understanding
what we're dealing with?
what we're dealing with?
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一點都不了解我們到底在對抗什麼？
10:33
How did we get this far
without empowering somebody
without empowering somebody
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我們是怎麼走到這一步，
沒有教育任何人，
沒有教育任何人，
10:35
to know what it is they're dealing with,
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讓他們了解他們到底在對抗什麼，
10:37
and then taking the next step and engaging
in who they are as human beings
in who they are as human beings
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再帶他們走下一步，
讓他們以人類的身分參與，
讓他們以人類的身分參與，
10:41
to know if that is what we should do?
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明白我們到底該不該那樣做？
10:43
Lord knows we can do
any kind of thing to you.
any kind of thing to you.
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天知道我們會在你們身上做什麼。
10:49
But should we?
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但是我們應該做嗎？
10:53
And don't take my word for it.
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你可以不信我的話。
10:55
All the evidence that is related
to palliative care these days
to palliative care these days
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但所有跟現今安寧照護有關的證據
11:00
demonstrates with absolute certainty
people live better and live longer.
people live better and live longer.
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都很確定患者活得更好更久。
11:04
There was a seminal article
out of the New England Journal of Medicine
out of the New England Journal of Medicine
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2010 年，新英格蘭醫學雜誌
發表了一篇影響深遠的文章。
發表了一篇影響深遠的文章。
11:07
in 2010.
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11:09
A study done at Harvard
by friends of mine, colleagues.
by friends of mine, colleagues.
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我在哈佛的同事好友做了一個研究，
11:12
End-stage lung cancer:
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在講末期肺癌：
11:13
one group with palliative care,
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一組有安寧照護，
11:16
a similar group without.
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1682
另一組沒有。
11:19
The group with palliative care
reported less pain,
reported less pain,
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有安寧照護那組的報告說
他們比較不痛，
他們比較不痛，
11:23
less depression.
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不那麼沮喪。
11:25
They needed fewer hospitalizations.
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他們比較少住院。
11:28
And, ladies and gentlemen,
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而且各位，
11:30
they lived three to six months longer.
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他們能多活三到六個月。
11:35
If palliative care were a cancer drug,
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如果安寧照護是治療癌症的藥物，
11:39
every cancer doctor on the planet
would write a prescription for it.
would write a prescription for it.
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地球上每一位癌症醫師都應該
開這種藥給病人。
開這種藥給病人。
11:44
Why don't they?
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他們為什麼不開呢？
11:47
Again, because we goofy,
long white-coat physicians
long white-coat physicians
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3344
再說一次，因為我們這群
穿著白袍的傻瓜醫師
穿著白袍的傻瓜醫師
11:50
are trained and of the mantra
of dealing with this,
of dealing with this,
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只受過訓練處理這樣的問題，
11:56
not with this.
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不是這樣的問題。
12:02
This is a space that we will
all come to at some point.
all come to at some point.
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我們遲早都會碰到
（經濟與健康）交會之處，
（經濟與健康）交會之處，
12:07
But this conversation today
is not about dying,
is not about dying,
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但是今天的演講跟死亡無關，
12:10
it is about living.
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而是跟怎麼活著有關。
12:12
Living based on our values,
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基於我們的價值觀而活，
12:13
what we find sacred
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我們視為神聖的東西，
12:15
and how we want to write
the chapters of our lives,
the chapters of our lives,
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我們想怎麼寫自己生命的章節，
12:17
whether it's the last
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無論是最後一章，
12:19
or the last five.
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還是最後五章。
12:22
What we know,
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我們知道的，
12:24
what we have proven,
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我們已證明的，
12:26
is that this conversation
needs to happen today --
needs to happen today --
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就是這樣的對話今天就該發生，
12:29
not next week, not next year.
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不是下星期，也不是明天。
12:32
What is at stake is our lives today
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有危急的是我們今天的生活，
12:34
and the lives of us as we get older
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及我們老了之後的生活，
12:36
and the lives of our children
and our grandchildren.
and our grandchildren.
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還有我們的子子孫孫的生活。
12:40
Not just in that hospital room
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不僅是在醫院病房裡，
12:42
or on the couch at home,
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或是家裡的沙發。
12:44
but everywhere we go
and everything we see.
and everything we see.
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無論我們在哪裡看到什麼都一樣，
12:48
Palliative medicine is the answer
to engage with human beings,
to engage with human beings,
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安寧醫護就是答案，將病患視為人，
12:53
to change the journey
that we will all face,
that we will all face,
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改變我們都要面對的旅程，
12:58
and change it for the better.
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而且要變得更好。
13:02
To my colleagues,
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給我的同事，
13:04
to my patients,
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我的病患，
13:06
to my government,
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我的政府，
13:08
to all human beings,
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及所有人類，
13:10
I ask that we stand and we
shout and we demand
shout and we demand
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我要大家都站起來、呼喊、要求
13:14
the best care possible,
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最好的照護，
13:17
so that we can live better today
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讓我們今天能活得更好，
13:19
and ensure a better life tomorrow.
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並確保明天的生活更好。
13:21
We need to shift today
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我們今天就要改變，
13:24
so that we can live tomorrow.
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明天才能享受人生。
13:28
Thank you very much.
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謝謝各位！
13:30
(Applause)
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（掌聲）
ABOUT THE SPEAKER
Timothy Ihrig - Palliative care physicianTimothy Ihrig advocates for an approach to healthcare that prioritizes a patient's personal values.
Why you should listen
Dr. Timothy Ihrig, MD practices palliative medicine, caring for the most vulnerable and sickest people, and helps other providers improve the quality and value of the care they provide to this population. His work has shown how patient-centered care improves quality and length of life, and that it has significant economic benefits to patients, healthcare systems and the economy.
Ihrig is nationally recognized for his expertise in continuum population health and community-based palliative care. He holds appointments as content expert to the Accountable Care Learning Collaborative, an industry-leading healthcare innovation collaborative co-chaired by former Health and Human Services Secretary and Utah Governor Mike Leavitt and former Food and Drug Administration Commissioner Dr. Mark McClellan. Ihrig is a member of the Advisory Council of the Iowa Healthcare Collaborative, a think-tank for strategies in health care quality, safety and value for the state of Iowa. He also serves as an Iowa Alternate-Delegate to the American Medical Association.
Ihrig has been an expert source for palliative care development for the Brookings Institution, and he was the sole practicing physician assisting the Iowa General Assembly in raising minimum standard requirements for Iowa physicians with respect to end-of-life care and oversight of prescriptive narcotics. He also acted as an expert clinician in support of Iowa Physician Orders for Life-Sustaining Treatment bill. He holds appointments as Clinical Adjunct Professor in the Department of Medicine at the University of Iowa Carver School of Medicine and acts as Palliative Care clinical instructor. He is on the board of the Hospice and Palliative Care Association of Iowa, is the former chair of the Advocacy Committee and sits on the Palliative Care Advisory Committee.
Ihrig's other interests include sexuality at the end of life and global health. He served as the Medical Chair of the Health Services Committee for Empower Tanzania Incorporated, whose mission is the development of sustainable healthcare solutions in sub-Saharan Africa for individuals suffering with HIV/AIDS, cancer and other life-limited illnesses.
Timothy Ihrig | Speaker | TED.com