Talking about end-of-life care

A provision in the proposed health care reform legislation to reimburse physicians for discussions with patients about their wishes at the end of life has been misunderstood and even misinterpreted as government intervention to ration care to elderly patients near the end of life. The provision is gone now, but the provision has started conversations about end-of-life care in homes and doctors offices across the country. Conversations about what the kind of care patients want at the end of life should be ongoing, both with the patient's physician and the patient's family. But when a patient is near the end, often the person to have the difficult end-of-life conversation with the patient is a palliative care specialist. The New York Times had a compelling article today about palliative care doctors and how they approach their difficult job. I think the most important part of this article is the conversations that it is capable of generating, both online and in hospitals and physicians offices and homes across the country. The only way to assure that you or a loved one will reach the kind of end-of-life care you want at the end is to have ongoing, respectful and honest conversations.