End-of-Life Choice, Death with Dignity, Palliative Care and Counseling

Press Releases

CMS Praised for Proposal to Reimburse Docs for End-of-Life Conversations

End-of-Life Choice Group Says Congress Should Complement Proposal by Passing Law

Daniel Wilson
Daniel Wilson

(Washington, DC – July 8, 2015) Compassion & Choices praised the Centers for Medicare & Medicaid Services (CMS) for proposing to reimburse doctors for communicating with patients about whether and how they would want to be kept alive if they become too sick to speak for themselves. The proposal follows the American Medical Association’s recommendation to make advance care planning services a separately payable service under Medicare.

Only one out of four Americans (26%) have completed an advance directive to ensure their end-of-life healthcare wishes are carried out if they are unable to speak for themselves, according to a study published in the January 2014 edition of The American Journal of Preventive Medicine.

Nearly one out of four older Americans say that either they or a family member have experienced excessive or unwanted medical treatment. This CMS proposal is a positive step – but by no means a panacea – toward ensuring patients receive only the end-of-life care they want – no more and no less,” said Daniel R. Wilson, national & federal programs director for Compassion & Choices, a leading end-of-life choice advocacy group.

“This proposal would remove a barrier doctors have cited that prevented them from engaging in these conversations because they are not reimbursed for them,” said Wilson. “Now Congress needs to pass legislation to compensate doctors for initiating these conversations and penalize healthcare providers that do not honor patients’ express wishes for end-of-life care.”

Compassion & Choices has long advocated for compensating physicians for engaging in end-of-life care conversations, including it as part of the Affordable Care Act. But this provision was stripped from the bill before it became law.

In addition, Compassion & Choices is a founding collaborator in the Campaign to End Unwanted Medical Treatment, a growing coalition of 19 organizations whose goal is to ensure that consumers are empowered and have access to a full range of well-coordinated medical care and treatment. The CMS proposal is a core objective of the campaign.

Compassion & Choices supports the Care Planning Act of 2015 that would create a Medicare benefit for people facing grave illness to work with their doctor to define, articulate and document their personal goals for treatment.  Sponsored by U.S. Senators Mark Warner (D-VA) and Johnny Isakson (R-GA), this bipartisan bill will help patients avoid excessive or unwanted medical treatment and receive only the care they want, consistent with their wishes, across care settings.

California Aid-in-Dying Bill Still Under Consideration

Supporters Feel Optimistic about Bill Despite Hearing Postponement

MichaelSaum3

(Sacramento, CA – July 7, 2015) The authors of a bill that would allow terminally ill adults the option to request a doctor’s prescription for medication to shorten their dying process decided not to present it, SB 128, before the Assembly Health Committee to give Assemblymembers more time to consider the bill.

“SB 128 is still alive and well, even though we weren’t ready for it to be heard before the Assembly Health Committee,” said Compassion & Choices California Campaign Director Toni Broaddus. “Seven out of every ten California voters want to see this bill become law, so we will not stop until we make that happen.”

A bipartisan poll last month showed 69 percent of California voters, including 70 percent of Latinos and 60 percent of Catholics, support SB 128, also known as the End of Life Option Act. The bill is authored by Senate Majority Leader Bill Monning, Senate Majority Whip Lois Wolk and Assemblymember Susan Talamantes Eggman.

The End of Life Option Act was inspired by the public advocacy of Brittany Maynard, a 29-year-old Californian with terminal brain cancer. She had to move to Oregon last year to utilize its death-with-dignity law to end her unbearable suffering so she could die peacefully.

“This issue is urgent for dying Californians like Jennifer Glass, Christy O’Donnell, Michael Saum and hundreds of others who are suffering unbearably at the end of their lives,” added Broaddus.  “We are redoubling our commitment to passing the End of Life Option Act for all other Californians who want and need the option of medical aid in dying.”

The End of Life Option Act was closely modeled after the death-with-dignity law in Oregon, which has worked well for 17 years, without a single documented case of abuse or coercion. Four other states authorize the option of medical aid in dying: Washington, Montana, Vermont and New Mexico.

“This battle is far from over,” added Broaddus. “We owe it to Brittany Maynard’s family and terminally ill Californians to pursue every available path to give them relief from unbearable suffering.”

Calif.-Pac. United Methodist Church Endorses Aid-in-Dying Bill

Assembly Health Committee Scheduled to Vote on Legislation on Tuesday

(Los Angeles, CA – July 2, 2015) Compassion & Choices praised the California-Pacific Conference of The United Methodist Church today for unanimously passing a resolution to support the End of Life Option Act (SB 128). The endorsement is timely because the California Assembly Health Committee is scheduled to vote on the bill this Tues., July 7.

SB 128 would allow mentally competent, terminally ill adults the option to request a doctor’s prescription for medication that they could take to die painlessly and peacefully if their suffering becomes unbearable.

The California-Pacific Conference is a regional body of The United Methodist Church. The group includes 80,000 members from nearly 360 local churches throughout Southern California, parts of Central California, Hawaii, the Pacific Islands, Guam and Saipan.

“Endorsements by respected Christian organizations are key to the passage of the End of Life Option Act,” said Toni Broaddus, California Campaign Director. “Everyone should have the option, together with our families, our faith leaders and our doctors, to make the end-of-life decisions that are right for us in the final stages of a terminal illness.” More

Latino Labor Leader Dolores Huerta Endorses Medical Aid-in-Dying Bill

Civil Rights Activist Urges Latino Legislators to Vote for Bill 

(Sacramento, CA – June 25, 2015) Latino labor leader and civil right activist Dolores Huerta today publicly endorsed the End of Life Option Act (SB 128) and encouraged Latino legislators to vote for it. Her endorsement is critical because she is a leader in the labor, civil rights, and Latino communities.  Several Latino legislators serve on the Assembly Health Committee, which is scheduled to vote on the bill July 7th.

“We are honored to have the support of Dolores Huerta because her endorsement carries great weight across California and especially in the Latino community,” said Toni Broaddus, California Campaign Director for Compassion & Choices. “We hope her leadership will help convince legislators who are on the fence about the importance of the legislation prior to the vote in the Assembly Health Committee.”

Huerta’s endorsement follows Tuesday’s release of a bipartisan poll conducted by Goodwin Simon Strategic Research andProbolsky Research showing 70 percent of Latino voters and 60 percent of Catholic voters support the End of Life Option Act.

Huerta co-founded the United Farm Workers with César Chávez. She now joins other prominent Latinos who have publicly endorsed the End of Life Option Act. They include actor/director and activist Edward James Olmos and star Mauricio Ochmann from the popular Telemundo telenovela “El Señor de los Cielos.”

“I came to Sacramento to urge members of the Assembly to support SB 128, the End of Life Option Act,” said Huerta. “This bill will affirm a fundamental right for terminally ill and mentally competent patients to choose how their final days are lived. This is a basic civil rights issue offering a compassionate and dignified end-of-life choice that should be left between a patient and doctor.”

Sponsored by Senate Majority Leader Bill Monning and Senate Majority Whip Lois Wolk, SB 128 was inspired by California death-with-dignity advocate Brittany Maynard. The bill is closely modeled after the death-with-dignity law in Oregon, which has worked well for 17 years, without a single documented case of abuse or coercion.

“We are honored that Dolores Huerta, civil rights leader, champion for working families, and recipient of the Presidential Medal of Freedom, is working in support of SB 128, the End of Life Option Act,” said Senator Monning. “As Dolores has stated, this is a fundamental human rights issue and a choice that should be afforded to every qualified, terminally ill patient in California.”

Four other states authorize the option of medical aid in dying: Washington, Montana, Vermont, and New Mexico. Legislators have introduced medical aid-in-dying bills in the District of Columbia and at least 23 other states besides California.

“Doc2Doc” Consultation Service to Combat Unwanted Medical Treatment Crisis

Free Service Helps Physicians Provide End-of-Life Care Patients Want 

(Washington, DC – June 15, 2015) Responding to reports that millions of older Americans receive unwanted medical treatment, Compassion & Choices today launched a new, free “Doc2Doc” consultation service to ensure patients receive the end-of-life care they want.

According to a 2014 poll conducted by Purple Insights, nearly one out of four Americans (24%) aged 50 or older ­— the equivalent of about 25 million people — say that either they or a family member have experienced excessive or unwanted medical treatment.

Better and more frequent doctor-patient communication could help prevent this excessive and unwanted medical treatment, according to a 2014 report by the Institute of Medicine, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.

To improve doctor-patient communication, Doc2Doc is specifically tailored to offer practicing physicians a free, confidential and readily available telephone consultation from a seasoned medical director with decades of experience in end-of-life medical care.

“As physicians, I think we all secretly wish we could solve all of our patients’ healthcare crises by ourselves,” said Dr. David Grube, a national medical director for Compassion & Choices and a former chairperson of the Oregon Board of Medical Examiners. “But I believe we all recognize that it is our duty to consider any tools that minimize our patients’ suffering, especially at the end of life when curative treatments are no longer a viable option.”

Doc2Doc is based on the premise that a physician’s informed communication with each patient about the full range of end-of-life options should center on the healthcare goals of the patient, not the doctor. This communication is necessary to weigh the benefits and burdens of various treatment options to align them with the patient’s values and priorities. Ideally, these conversations often are uncomfortable, but are critically important, and should begin soon after a diagnosis of terminal illness and continue throughout the progression of it.

“Doc2Doc may not be the answer for every physician or situation,” said Dr. Grube. “But I think it is a resource worth exploring for physicians who care for dying patients and want guidance about how they can best support their patients’ decisions.”

The Doc2Doc consultation may include answers about these end-of-life care options:

  • Hospice, palliative care and effective pain and symptom management.
  • How to follow current clinical practice guidelines.
  • How specific state laws affect end-of-life care.
  • How to communicate with patients, pharmacists and family members.
  • What to expect in a patient-controlled death.
  • How to handle patients’ inquiries or requests concerning withdrawal of life-sustaining treatment.
  • How to handle a badly suffering, terminally ill patient’s request for assistance in achieving a painless, peaceful death.
  • Voluntarily stopping eating and drinking (VSED), including appropriate supportive care, to help a badly suffering patient to achieve a peaceful death. VSED is authorized nationwide.
  • Medical aid in dying: a medical practice that offers terminally ill, mentally competent adults the option to request a prescription for medication that they can ingest to shorten their dying process. Medical aid in dying currently is authorized in five states, Oregon, Washington, Montana, Vermont and New Mexico, but legislators in the District of Columbia and at least 24 other states have introduced medical aid-in-dying bills.

Physicians who want to utilize the Doc2Doc service can call the Compassion & Choices toll-free number: 800.247.7421, email: [email protected], or visit the Compassion & Choices website at: www.compassionandchoices.org/what-we-do/doctors-to-doctors.

In addition, Compassion & Choices, in collaboration with 18 leading aging and healthcare organizations, is conducting “The Campaign to End Unwanted Medical Treatment” to encourage healthcare providers and institutions to honor patients’ wishes.