End of Life Planning

Under a new policy, outlined in a Medicare regulation, the government will pay doctors who advise patients on options for end-of-life care which may include Advance Directives to forgo aggressive life-sustaining treatment. 

The only thing new is the paying of physicians.  Before Republicans oppose the regulation, they should survey the practices in religious based hospitals.  Anyone who is admitted on has a simple x-ray at any hospital with which I am familiar is harangued about creating an Advanced Directive or producing a Durable Power of Attorney which allows a family member to authorize the withholding of care.  The family of severely demented patients in skilled nursing facilities run by the Catholic Church are urged to approve a Do Not Resuscitate directive.  Critical care doctors and nurses are familiar with the laws which bind them to a meaningless protocol of care for terminal patients who do no have an Advanced Directive or a Durable Power of Attorney for Health Care assigned to a family member.  The care is may involve ventilation, circulatory support, nutritional support, and anti-biotics.  The later has the potential of augmenting resistant strains which may contaminate the unit.  All this is extremely wasteful.   

Catholic Hospitals are cited as representing a large group of voters.  The practices in Protestant and Jewish institutions are the same.  There really is very little controversy in this area.  There is a need to reduce the volume of futile therapy as much as possible.  As with any issue, expect “non-profit” groups to spring up in opposition.  It would be easy for Democrats to garner a group of physicians and nurses of all religious strips to support the regulation.