Ensuring people can determine their own end-of-life care is a rare healthcare ethics issue bringing some Democrats and Republicans together.
Sen. Chris Coons, D-Del., and Rep. Diane Black, R-Tenn., lawmakers on opposite ends of the abortion fight, are teaming up on a bill making it easier for people to plan how long they would like to receive care should they undergo a serious accident or life-threatening condition.
The legislation comes at a time when acceptance is growing for end-of-life planning, an issue some Republicans had used in the past to spark fears that care could be rationed or seniors might be discouraged from expensive but lifesaving treatments.
Last month, the Obama administration issued final rules on how Medicare will start reimbursing doctors for providing counseling to patients facing the ends of their lives. In such counseling, patients are assisted in thinking through standards for their quality of life and how long they would like life-sustaining treatment.
The Coons-Black bill, dubbed the Medicare Choices Empowerment and Protection Act, would offer Medicare patients a small, one-time financial payment if they provide clear legal guidance to their doctors and family members on how to proceed if they become incapacitated.
End-of-life directives can help save money on unnecessary medical care. But the lawmakers emphasized they’re backing the legislation with an eye toward the rights of patients.
“There might be cost-savings, but that’s not the reason to do this bill,” Coons said. “This is a bill that allows families to respect the interests of their loved ones.”
That’s why National Right to Life, a leading anti-abortion organization, and other patients’ rights groups are backing the bill. With paying patients to create end-of-life care plans, it would provide Medicare patients with a web page informing them that they have the opportunity to both reject and accept care according to their personal values.
Any bill that might push patients toward rejecting treatment likelly would have alienated conservative groups. Burke Balch, National Right to Life director of medical ethics, said that was a “great concern.”
“From our perspective, it is very important that these decisions be made based on patients’ own values and this not be seen as some great way to save money by persuading people that they really shouldn’t choose treatment because it’s going to be expensive,” Balch said.
The legislation, which hasn’t received a cost score from the Congressional Budget Office, is also backed by Sen. Bill Cassidy and Rep. Chris Collins, both Republicans, and Democratic Reps. Mike Thompson and Peter Welch.
