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New State Law Tackles End-of-Life Discussions

Wednesday, February 09, 2011

A new state law that takes effect this week wades into a national controversy about the government’s role in end-of-life care.

New York doctors and nurse-practitioners are now required to offer patients who have less than six months to live information about their options.

President Obama and Democratic lawmakers have gone back and forth on whether Medicare should pay doctors to initiate consultations with the terminally ill about things like hospice care and aggressive-versus-palliative treatment.

These delicate conversations – for which some Republicans supported funding but others labeled “death panels” – in the end won’t be covered by Medicare. At least not for the time being.

 But last year in Albany, lawmakers passed a law related to this debate that takes effect this week.

 Carol Levine, from the United Hospital Fund, said New York's law addresses a long-running problem.

 “People don’t want to talk about it. Doctors don’t want to talk about it,” said Levine, who leads the UHF’s “Next Step in Care” campaign. “The result is that people don’t get the kind of care that they really want at the end of life.”

She said the new state law will force care-givers to offer information, but patients don’t have to discuss anything they don’t want to.

“They can still say, ‘I don’t care. I’ll take any last chance I can get,’ ” she said. “But it’s the discussion that brings these things into the open -- the realistic options for the prognosis, the realistic options for cure, what's going to be available for you, what your preferences are.”

Medical guidelines for end-of-life conversations have existed for years, but Levine hopes the new law will give them some teeth.

“Physicians now have to take seriously their obligations to offer to discuss end-of-life situations with their patients,” she said. “They shouldn't just say, 'Oh, we'll leave that until two weeks before the patients is dead.' In order to provide the best quality of care, they have to discuss things that are very difficult to discuss.”

The statute requires care-givers who are uncomfortable with this conversation to refer patients to other people for counseling.

It’s not clear how the state will make sure care-givers are offering these consultations, and what authorities will do, if they don’t.

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Comments [1]

karen vinton from amherst new york

Who can I talk to? Where can I find information of whether or not New York State has a RIGHT TO END YOUR LIFE law. I must find information on this although the internet is vague. My Dad is 87 yrs old and is in a losing fight battling PSP - Progressive Supranuclear Palsy. He dies inside more and more each day. Can not walk, read, watch TV, has bowl movement trouble or diarrhea in his bed. He is in every sense an aged man with thoughts - living inside a body which will not allow him to live. there is no way to comfort him in these years in this disease. He cries and beats his fights on his wheel chair every day. He doesn't want to live like this anymore. We still have him at home. my 86 yr old mother, his constant care taker is barely able to handle his care anymore, the disease is now over 14 years old! He should not have survived this long. Please help me find answers. We promised him he will NEVER go to a nursing home He clearly wants to die

Feb. 18 2012 03:55 PM

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