Death Panels...Nonsense!

I don’t like talking about death, especially my own, but when all the rumors about government death panels were flying, I was hoping that the National Hospice and Palliative Care Association would use the opportunity to discuss the wisdom of life/death planning. Perhaps they did and I missed it; if not, what I wanted to see was hospice nurses speaking loudly and clearly to dispel the ridiculous notion that, under the evolving health care plan, the government will decide who should live and who should die.

During the furor, I was surprised to see how many intelligent people are under the misconception about end-of-life care.

They think there is no middle ground between bringing out all the big guns of extraordinary care and doing nothing when dealing with life-threatening illnesses. I found myself explaining the philosophy of palliative care, which can include a lot of care, and that patients can change their minds as time progresses.

The other concept is the importance of telling your physician and family which medical measures you want and don’t want and when. Too many people seem to have the notion that if a patient decides to forego extreme measures, they’ll get no care at all – that they’ll be abandoned by their medical providers.

I also learned that people are outraged at what they perceive to be a new incentive for “expediting death” – a provision that provides for reimbursement to physicians for discussing end-of-life care with their patients. Nurses and doctors to whom I’ve spoken don’t understand why this is even in the legislation except perhaps to create a new billing code. Physicians and hospice nurses already have these discussions during office and hospital visits.

The booklet on end-of-life decisions created and published by the Veterans Administration was soundly criticized, too. I’ve seen it and I think it provides veterans and anyone else who might want to use it with a systematic, sensible and sensitive way of considering all the possibilities around end-of-life care.

Maybe the big picture here is that, as our country grows more diverse, nurses must be aware of all the cultural differences that exist when it comes to facing our mortality, including the belief that life should be sustained at any cost.

Disclaimer: The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of AMN Healthcare or its employees.