A recent report by the Institute of Medicine is entitled: Dying in America. Among other things, it documents how poorly Americans understand their options at the end of life. The IoM recommends that doctors get paid for having end-of-life discussions with their patients. This idea was unpopular back in 2009, and led some to accuse the government of trying to establish “death panels,” designed to limit treatment options and to ration health care.
But this is a distortion. According to the IoM report:
The  provision would have reimbursed clinicians for the time spent in advance care planning with patients. Such conversations would have included discussion of the documents that can help ensure that patients’ wishes regarding care are followed in the event they become unable to express them (source listed below).
Recent polls have show that the majority of Americans strongly support such discussions, and a growing number have established advance directives for themselves and their loved ones. Nonetheless, a recent Forbes article makes the alarming claim that death panels are “on the rebound.” Why all this suspicion?
The main reason may be that advance directives (e.g., living wills or durable powers of attorney for health care) are not perfect, and they are not always honored. A patient’s prognosis is not always easy to predict. And families are sometimes reluctant to go along with their loved ones’ wishes, even when they are clearly stated.
Yet for all of these concerns, greater clarity in the face of serious illness is not a bad thing. In our technologically-advanced society, we are often able to keep the bodily shell alive, which merely prolongs the dying process. For people of faith, this is unnecessary, for a better life awaits us.
We should all have advance directives – and doctors should be paid for advising us about them.