Avoiding a 'Death Panel' Redux

Abstract

This paper examines why the “Advance Care Planning Consultation” provision was removed from H.B. 3200, the House healthcare reform legislation, in 2009 — despite the fact that an overwhelming majority of the American public is in favor of end-of-life consultations and advance care planning — and how something like it might have been able to be retained. Although the negative rhetoric surrounding the proposed legislation contributed to its failure, we contend that its demise was also caused by its failure to reflect the fundamental goal of end-of-life consultations — namely, facilitating open and honest conversations about end-of-life issues with patients and their families so that patients may begin to acknowledge the inevitable, make appropriate decisions for their end-of-life care, and, when the time comes, die in as much comfort and with as much dignity as possible. Any future legislation created to incentivize physician-initiated end-of-life planning needs to more explicitly reflect this goal in order to garner wider public and political support.