Members of the medical and ethics communities are disappointed over the removal
The Senate Finance Committee has removed a provision in its healthcare reform proposal that would pay doctors who offer end-of-life counseling to patients. Now, ethicists say the decision will perpetuate dilemmas that plague medical care.
The Senate provision was designed to encourage doctors to make time to speak with their patients about end of life measures and living wills. Fears that this would create “death panels” and government interference prompted the Senators to scrap the idea. Father Joe Kukura founded the Catholic Healthcare Partnership of New Jersey. He says the intent of the provision would have helped families deal with situations in which patients can’t communicate their wishes.
Kukura: The more effort that can go into encouraging people to do such a thing, the better. Now, it doesn’t have to be by legislation.
Kukura says even now, people can act to have their wishes known. He says removing the provision creates confusion and fear at a time when patients should be proactive about their end-of-life concerns. Bioethicist Art Caplan says fears that the measure would wedge government into end-of-life care were unfounded.
Caplan: I’m not surprised it’s been pulled. It was becoming a third rail to getting health reform through, but I’m bitterly disappointed. I think it was a very good idea.
Caplan says people often don’t consider their end-of-life wishes when they’re healthy.
But that leads to medical battles, such as in the case of Terri Schiavo. Amy Goldberg, the trauma chief at Temple University, says the provision would have sent a message to patients to be proactive about having end-of-life discussions with their doctor.
Goldberg: I think you really do a disservice to patients and their families by not supporting, whether it’s monetarily or just in the media, that physicians should be automatically having these conversations with patients before they can’t speak for themselves.
The provision is still included in a healthcare reform proposal in the House.