Removing Obstacles to a Peaceful Death

39 Pages Posted: 17 Feb 2018 Last revised: 2 Mar 2018

See all articles by Kathy L. Cerminara

Kathy L. Cerminara

Nova Southeastern University - Shepard Broad College of Law

Barbara A. Reich

Western New England University School of Law

Date Written: 2018

Abstract

We all will die, but the American health care system often impedes a peaceful death. Instead of a quiet death at home surrounded by loved ones, many of us suffer through overutilization of sometimes-toxic therapeutic interventions long past the time when those interventions do more good than harm. This article proposes revisions to health professional training and payment policy to eliminate as much as possible physical and existential suffering while progressing through the terminal phase of illness. The solution lies in seamless progression from treatment with integrated palliative care to hospice before death, but provider attitudes and payor practices must change for that to occur. Thus, the article proposes increased training in communicating truthfully about prognosis and prospective benefit of therapies; further adoption of interprofessional practice, which would familiarize more professionals with the team-based approach characteristic of palliative care; and revision of payment mechanisms to incentivize high-quality care whether it is of low or high intensity.

Keywords: end of life, hospice care, medical ethics, palliative treatment, medical fees, advance directives, health care proxies, terminal care, clinical coding

Suggested Citation

Cerminara, Kathy L. and Reich, Barbara A., Removing Obstacles to a Peaceful Death (2018). Elder Law Journal, Vol. 28, p. 197, 2018, Available at SSRN: https://ssrn.com/abstract=3116268

Kathy L. Cerminara

Nova Southeastern University - Shepard Broad College of Law ( email )

3305 College Avenue
Ft. Lauderdale, FL 33314
United States
954-262-6193 (Phone)
954-262-3835 (Fax)

HOME PAGE: http://www.nsulaw.nova.edu/faculty/profiles/index.cfm?ID=18

Barbara A. Reich (Contact Author)

Western New England University School of Law ( email )

1215 Wilbraham Road
Springfield, MA 01119
United States
413-782-1432 (Phone)

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