The Affairs Organizer Blog

“NPR’s Julie Rovner reports on the impact the memo could have on patients’ wishes for their end-of-life care.

JULIE ROVNER: This year, marks the 20th anniversary of the year Congress first passed the law requiring that Medicare patients be told of their right to exercise so-called Advanced Directives, those express what kind of care a patient does or does not want in the event they become unable to speak for themselves.

Federal law and the law in all 50 states require such directives to be followed, but that doesnt always happen, says Barbara Coombs Lee.

Ms. BARBARA COOMBS LEE (President, Compassion and Choices): There’s not only a continuing problem with providers not honoring Advanced Directives, there is an increasing problem with providers not honoring Advanced Directives.

ROVNER: Lee heads the consumer group Compassion and Choices. She’s pleased the administration is taking steps to require hospitals to honor Advanced Directives, thats because many of the people she deals with are suffering from terminal diseases.

Ms. LEE: Their worst nightmare would be to be in a prolonged, unconscious debilitated, vegetative state, like Terri Schiavo. And they want to take steps now to document in writing that they are not to be kept alive artificially.

ROVNER: But she says more and more states are passing laws like the one recently approved by the Idaho legislature. It allows a wide array of health care providers who disagree with a patient’s treatment choices, to simply decline to abide by them. And patients have no recourse, she says.

Ms. LEE: That trend is putting the balance of power about health care decision-making exactly where it does not belong, which is with providers and institutions…”

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