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Monday, November 2, 2009

End of Life Legislation - The Crux of the Matter

We have been hearing a lot about a particular component to the healthcare legislation being crafted and that is the End of Life Counseling that will be required for all patients. At one point, the Republicans deemed it a "Government Death Panel" which the Democratics quickly denounced as simply untrue and another political scare tactic. The reality is that End of Life Counseling between patients, their familys and their doctors has been a part of medical care for many years. In the 80's, Eastern Virginia Medical School was one of the first to have a program dealing extensively with end of life issues, dealing with the myriad of ethical and legal dilemmas that are associated with the topic. It was part of the curriculum and training of their students, future doctors, to have these types of conversations with their future patients. This curriculum became a model for other medical schools around the country. I don't know the percentage as a fact to quote, but I suspect that most medical schools have this type of program in place in the 21st century. In addition, most hospitals (and again, I do not have the statistics to say whether 75, 80 or 90 percent) have Ethic Committees where teams of doctors discuss individual cases and address the complex questions end of life issues bring to the table, their commitment to the patient being their number one priority.
And here is the concern: by legislating "end of life counseling", it is a slippery slope to government legislating other aspects of medical care. Many physicans believe there will be no turning back once we allow this foot in the door for direction by the government in this area. It is a point of no return in the fight for physicians to be directing the care of their patients. What we now consider to be a sacred and private relationship between physician and patient will be redefined. It will be you, the government, and your physician. For most private practioners, the doctors in your community, this is the number one issue causing them concern.

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