UNMET ACTIVITY OF DAILY LIVING NEEDS: ELDER MISTREATMENT AND ETHICS IN GERIATRIC RESEARCH

the direct care of patients. For example, I had no experience in the prescribing of high-dose opioids for pain and symptom management. I thought I had a good knowledge base of endof-life care during my geriatrics training. However, once I had the palliative care training, I recognized that I could have provided much better symptom management and psychosocial care of patients during my geriatrics training. Furthermore, I realized that I had referred my geriatric patients for hospice care very late and that the patients could have benefited from an earlier referral to the service. I feel strongly that this survey should not stand as evidence of competence of geriatricians in this important field. I strongly suspect that this is another example of the ignorance–arrogance paradox. I would think that a survey of physicians trained in both palliative medicine and geriatrics be performed to obtain a better sense of the adequacy of training in geriatrics in this important area.