Legislators have begun to recognize the medical, humanitarian and economic value of helping terminally ill patients and their families navigate treatment options as they approach the end of life.
Last week, over the objections of New York State's medical society, Gov. David A. Paterson signed into law a bill — the New York Palliative Care Information Act — requiring physicians who treat patients with a terminal illness or condition to offer them or their representatives information about prognosis and options for end-of-life care, including aggressive pain management and hospice careas well as the possibilities for further life-sustaining treatment.
The Medical Society of the State of New York objected, saying that the new law would intrude "unnecessarily upon the physician-patient relationship" and mandate "a legislatively designed standard of care."
A similar provision in the original federal health care overhaul proposal, which would have reimbursed doctors for the time it takes to have such conversations, was withdrawn when it was erroneously labeled by conservatives as a "death panel" option.
Also last week, a study in The New England Journal of Medicine reported that among 151 patients with newly diagnosed metastatic lung cancer, those who received palliative care, which is care focused on symptoms, along with standard cancer therapy had a better quality of life, experienced less depression, were less likely to receive aggressive end-of-life care and lived nearly three months longer than those who received cancer treatment alone.
The New York law was sponsored by Assemblyman Richard N. Gottfried and Senator Thomas K. Duane, both Democrats of Manhattan, at the request of Compassion and Choices of New York, an organization that seeks to improve end-of-life comfort care and reduce the agony often associated with dying in this era of costly can-do medicine.
The organization said the law addresses "a major concern for terminally ill patients and their families, who often face the most important decision of their lives — how to live their final days — without being informed of their legal rights and medical options." The law obligates health care providers to volunteer information on a complete menu of care options — if patients want to know about the options.