(Washington, D.C. – July 29, 2014) A new poll shows that nearly one out of four older Americans (24%) say that either they or a family member have experienced excessive or unwanted medical treatment, the equivalent of about 25 million people. The survey also reveals that older Americans strongly support holding doctors accountable when they fail to honor patients’ end-of-life healthcare wishes. See full poll here.
“Twenty-five million Americans receiving excessive or unwanted medical treatment is 25 million Americans too many. This survey demonstrates that older Americans clearly trust their doctors, but they also expect them to honor their end-of-life medical wishes,” said Daniel Wilson, national and federal programs director for Compassion & Choices, the nation’s leading end-of-life advocacy organization, which sponsored the poll.
This survey was conducted by Purple Insights, the research division of Purple Strategies, a bipartisan communications firm. Purple Insights conducted 1,007 interviews among adults 50+ between January 31st and February 7th, 2014. The margin of error is +/- 3.1%.
The poll shows older Americans want both incentives and sanctions to ensure physicians respect patients’ preferences. Six out of 10 (61%) of those polled support reimbursing doctors for end-of-life consultations; nearly two-thirds (65%) support withholding payment to healthcare providers who fail to honor their end-of-life medical wishes.
Older Americans would take both personal and political action to prevent or respond to unwanted treatment. Clear super majorities of the survey respondents would discuss (93%) or write down (90%) their advance directive, or change (91%) or speak (84%) to their own doctors. Two-thirds (66%) say they would “take political action to protect patients’ rights to their own choice in end-of-life care.” Four out of 10 said they would “take legal action” (41%) or “not pay for the treatment” (40%) in response to unwanted medical treatment.
Nineteen out of 20 poll respondents (95%) said it is important for healthcare providers to respect their end-of-life medical wishes. Almost eight out of 10 (79%) would be angry if their healthcare providers did not honor those wishes. Most are very confident their families (73%) and doctors (63%) will honor their medical wishes. Fewer than half are very confident that emergency rooms and intensive care units (47%), nursing homes and assisted living facilities (28%) will honor those wishes.
“We cannot put the entire burden on consumers, especially on seniors, to protect themselves from unwanted care during a medical crisis,” said Compassion & Choices Chief Program Officer Mickey MacIntyre. “We need carrot-and-stick policies that encourage medical providers to learn their patients’ end-of-life healthcare wishes, and to honor them.”
The Patient Self-Determination Act of 1990 authorizes Medicare and Medicaid to deny payment to healthcare providers who fail to inform patients of their rights about end-of-life choices. A 2010 presidential memorandum to the secretary of health and human services (the agency charged with determining eligibility for payment under the Patient Self-Determination Act) reasserted the right to patient self-determination.
Other bills are pending in both the U.S. House of Representatives and Senate that would strengthen protections for end-of-life autonomy. They include the “Personalize Your Care Act of 2013” (H.R. 1773), authored by Congressman Earl Blumenauer (OR) and cosponsored by a bipartisan group of 57 other House members. The Personalize Your Care Act would provide Medicare and Medicaid coverage for voluntary consultations between patients and their doctors about advance care planning.
If you would like to see the Unwanted Medical Treatment Survey in it’s entirety, click here.