Newswire

The Life Matters Media Newswire aims to serve as a comprehensive portal of all news related to end of life decision making and care. We aggregate stories from other media outlets in one place- here, where you can access them easily. We also strive to produce original content covering stories we feel are receiving scant attention.


Physician Assisted Suicide Conference Draws Supporters And Opponents To Chicago

We think there are a lot of well-intentioned people here. Most of them have the best of intentions, but they refuse to stop and think about the implications of the policies they are pursuing.

Hundreds of patients, ethicists and medical providers attended the World Federation Conference in downtown Chicago to voice support for physician-assisted suicide, also known as “death with dignity.” The conference, made up of 49 right-to-die organizations from around the world, also drew numerous protestors from religious and disability rights groups.

Hosted by the non-profit Final Exit Network, the event aimed to encourage grassroots organization to support “death with dignity” laws and change attitudes.

“We believe that legislation does not go far enough. We believe that it is the right of every competent adult, suffering from severe, intractable illnesses which have deprived them of quality of life, to choose to hasten their death,” said Janis Landis, vice president of Final Exit Network, in a statement to Life Matters Media.

They would dictate to me how much pain and suffering I have to endure at the end of my life. They want to limit my right to choose.

Protestors with Not Dead Yet

Protestors with Not Dead Yet

Proponents of “death with dignity” legislation say such laws increase patient freedom at the end of life, because the seriously ill can avoid suffering and die on their own terms. In Oregon, the first state to legalize physician-assisted suicide, terminally ill adults may self-administer a prescribed lethal dose of barbiturates.

But some disability advocates, medical providers and religious organizations argue physician- assisted suicide is unnecessary and endangers the most vulnerable patients. The American Medical Association, the nation’s largest organization of doctors and medical students, does not support it.

Adam Vallard, a member of Not Dead Yet – a national disability rights group opposing all forms of aid in dying legislation – said he worries doctors could pressure disabled patients to end their lives early.

“There is this movement of right-to-die advocates who are not making distinctions between allowing someone to die with dignity and steering someone to assisted suicide. We see this as a larger trend in our society to devalue lives that are costly,” Vallard said. “We think there are a lot of well-intentioned people here. Most of them have the best of intentions, but they refuse to stop and think about the implications of the policies they are pursuing.”

Other protestors held signs, wore skeleton masks and chanted. Some conference attendees said they were told to avoid them. Many reported being instructed to avoid conversation out of fear of inciting violence.

Ken Leonard, a board member of the Hemlock Society of Illinois, called the protestors “religious extremists” and misinformed.

“Most of them are there because they believe it is God telling them to do so,” Leonard said. “They would dictate to me how much pain and suffering I have to endure at the end of my life. They want to limit my right to choose.”

Tucker

Kathryn Tucker, executive director of Disability Rights Legal Center

Kathryn Tucker, executive director of the Disability Rights Legal Center and former legal counsel to Compassion & Choices, one of the nation’s leading advocacy groups for the legalization of physician-assisted suicide, said she works to ensure disabled Americans receive the care they want at the end of life.

“Dying these days has become a long, arduous journey,” Tucker said in her presentation. “Choices will expand, aid in dying will become increasingly available, we will see more clinical practice guidelines and more evidence that the process is becoming normalized.”

Physician-assisted suicide is legal in five states: Oregon, Washington, Vermont, Montana and Hawaii.

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Support For Medicare Coverage Of End Of Life Discussions Among Providers

Courtesy WikiMedia Commons.

Courtesy WikiMedia Commons.

Many medical providers, end of life care activists and hospice nurses support Medicare reimbursement for end of life conversations between physicians and patients.

Medicare could soon begin reimbursing doctors if proposed billing codes from the American Medical Association are approved. Almost five years ago, similar proposals were dropped from the Affordable Care Act amid allegations that coverage for end of life conversations would lead to “death panels.”

“Each year, the AMA provides CMS with revisions to the CPT (Current Procedural Terminology) coding system that is used to price thousands of physician services. In a typical year, there are hundreds of codes that are either new, revised or deleted,” according to a CMS statement sent to Life Matters Media.

The Centers for Medicare and Medicaid Services may choose to establish payment and cover the sessions as described by the code; not pay for the specific code, but cover the sessions as part of another code; or deny payment altogether. A decision is expected this fall.

Sessions for some 50 million Americans could be covered by Medicare, and some private insurers have already started reimbursing doctors for time spent helping patients complete advance health care directives. Interest in doctor-patient communication has increased as baby boomers age.

“We think it’s really important to incentivize this kind of care,” Dr. Barbara Levy, chair of the AMA committee that sends codes to CMS, told The New York Times. “The idea is to make sure patients and their families understand the consequences, the pros and cons and options so they can make the best decision for them.”

The hope is that doctors will encourage more seriously ill patients to complete advance health care directives and identify “goals of care.” An advance directive may take the form of a living will, power of attorney or the Five Wishes collection. The overall purpose of such forms is to help ensure one’s end of life wishes are carried through in case of illness or incapacity.

“Just as important as the completion of these documents are the discussions that patients have with their physicians and other health care providers, as well as their family members,” said Donald Schumacher, president and CEO of the National Hospice and Palliative Care Organization, in a statement to Life Matters Media. “Discussing advance care planning before a person finds him or herself in a medical crisis will help ensure the patient is more likely to get the care that he or she wants.”

Research shows patients that discuss their care options when facing a serious or life-limiting illness report a higher quality of life. “Family caregivers also benefit from discussions held between physicians and patients,” Schumacher added.

When health care reform was signed into law in 2010, many Democrats wary of being identified with “death panels” dropped all proposals associated with end of life planning, despite support from many in medicine.

According to Politifact, a Pulitzer Prize-winning fact checker, comparing end of life counseling to “death panels” was 2009′s “Lie of the Year.” Former vice presidential candidate and Alaska governor Sarah Palin was the first to coin the term “death panels” on her Facebook page after the release of an early draft of the bill. Some conservatives charged that vital care would be cut off to the aged and ill if doctors recommended they receive less aggressive treatments.

Karen N. Long, president of the Chicago End-of-Life Care Coalition, said she believes many oppose coverage for end of life discussions out of ignorance.

“Everyone in this field has been working on this for a long time. It’s very much needed, because it helps patients think about what’s important to them, what they consider a ‘good’ quality-of-life,” Long told LMM. “I think most of the controversy goes back to the conflated issue of ‘death panels,’ where some individuals misquoted and misunderstood what was in the proposed law.”

Dr. June M. McKoy, director of geriatric oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago, described coverage for end of life counseling as a “double edged sword,” because physicians must be careful not force their medical advice or religious and political beliefs upon patients.

“Doctors do not live in a vacuum,” she told LMM. “Can doctors learn not to be paternalistic? To also be quiet and listen? To be a facilitator?”

McKoy recommends doctors develop a trusting relationship with their patients and bring up end of life-related discussions more than once, because a patient’s wishes can change.

She called the “death panels” controversy “farfetched and ludicrous,” because most medical centers have “layers” to protect patients, and that most doctors work to honor their patients’ wishes.

“Coverage can be a great thing, because it gets the conversation going. Many people don’t get the chance to make their own end of life decisions — somebody else makes it for them. It helps to have decisions in writing,” she added. “It helps families, too. I have seen families torn terribly apart after a parent dies, when siblings stop talking to each other, because they disagree about the parent’s medical care.”

Loretta Downs, a hospice volunteer and end of life care activist, supports coverage for end of life counseling because she fears receiving unwanted treatments in case of incapacity.

“I just turned 65, and Medicare is spending a great deal of money on various medical tests that are triggered by turning 65,” she told LMM. “It would be helpful and practical to include payment for a conversation with my primary care physician about protecting me from unwanted medical treatment if I unexpectedly became hospitalized in critical condition and unable to voice my choices for treatment.”

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Reimbursing Doctors For End Of Life Discussions

Medicare could soon begin reimbursing physicians for end of life conversations with patients, almost five years after similar proposals were taken out of the Affordable Care Act.

Bypassing the political process, some private insurers have already started reimbursing doctors for time spent helping patients complete advance health care directives, The New York Times reports. Interest in doctor-patient communication has risen as the millions of baby boomers age.

Sessions for some 50 million other Americans could be covered by Medicare if recent requests from the American Medical Association, the nation’s largest association of physicians and medical students, are approved. The AMA recently created codes for end of life conversations and submitted them to the Centers for Medicare and Medicaid Services (CMS).

“Each year, the AMA provides CMS with revisions to the CPT (Current Procedural Terminology) coding system that is used to price thousands of physician services. In a typical year, there are hundreds of codes that are either new, revised or deleted,” according to a CMS statement sent to Life Matters Media. “Advanced care planning was among the codes sent to us by the AMA.”

CMS may choose to establish payment and cover the sessions as described by the code; not pay for the specific code, but cover the sessions as part of another code; or deny payment. A decision is expected this fall.

“We think it’s really important to incentivize this kind of care,” Dr. Barbara Levy, chair of the AMA committee that sends codes to CMS, told the Times. “The idea is to make sure patients and their families understand the consequences, the pros and cons and options so they can make the best decision for them.”

The signature of President Obama on the Affordable Care Act. Courtesy WikiMedia Commons and whitehouse.gov

The signature of President Obama on the Affordable Care Act. Courtesy WikiMedia Commons and whitehouse.gov

When health care reform was signed into law in 2010, many Democrats wary of being identified with “death panels” dropped all proposals associated with end of life planning, despite support from many medical professionals, caregivers and ethicists.

According to Politifact, a Pulitzer Prize-winning fact checker, comparing end of life counseling to “death panels” was 2009′s “Lie of the Year.” Former vice presidential candidate and Alaska governor Sarah Palin was the first to coin the term “death panels” on her Facebook page after the release of an early draft of the bill. Some conservatives charged that vital care would be cut off to the aged and ill if doctors recommended they receive less aggressive treatments.

Karen N. Long, president of the Chicago End-of-Life Care Coalition, said she believes patients will benefit from one-on-one conversations with doctors about their “goals of care.”

“Everyone in this field has been working on this for a long time. It’s very much needed, because it helps patients think about what’s important to them, what they consider a ‘good’ quality-of-life,” Long told LMM. “I think most of the controversy goes back to the conflated issue of ‘death panels,’ where some individuals misquoted and misunderstood what was in the proposed law.”

An advance health care directive may take the form of a living will, power of attorney or the Five Wishes collection. The overall purpose of such forms is to help ensure that one’s end of life wishes are carried through in case of illness or incapacity.

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Desmond Tutu’s Support For Aid-In-Dying Legislation Highlights Divide

Retired Anglican Bishop Desmond Tutu has thrown his support behind Britain’s controversial aid-in-dying bill, highlighting the divide between Anglican leaders who support “Death with Dignity” legislation and others who argue it reduces the sanctity of life.

“I have been fortunate to spend my life working for dignity for the living. Now I wish to apply my mind to the issue of dignity for the dying,” the Nobel peace laureate and anti-apartheid leader wrote in an editorial published in The Guardian. “I revere the sanctity of life — but not at any cost.”

Tutu at the German Evangelical Church Assembly, 2007

Tutu at the German Evangelical Church Assembly, 2007. Courtesy WikiMedia Commons.

Tutu, the 82-year-old archbishop emeritus of Cape Town, South Africa, acknowledged his own mortality in the editorial. “I have come to realize that I do not want my life to be prolonged artificially,” he said. “I think when you need machines to help you breathe, then you have to ask questions about the quality of life being experienced and about the way money is being spent.” He was hospitalized last year for a persistent infection.

Tutu said he is closer to his end than to his beginning, and that death should not be taboo, since humans must “make way for those who are yet to be born.” He wishes to be buried in a modest wooden coffin with rope handles.

He further described former South African President Nelson Mandela’s end of life care as “disgraceful.”

“On Mandela Day we will be thinking of a great man,” he said. “On the same day, the House of Lords will be holding a second hearing on Lord Falconer’s bill on assisted dying. Oregon, Washington, Quebec, Holland, Switzerland have already taken this step.”

Mandela, who was imprisoned 27 years for his anti-apartheid activity, became South Africa’s first black president in 1994. He died in December at 95, after facing a prolonged lung infection that left him incapacitated.

“What was done to Madiba (Mandela) was disgraceful. There was that occasion when Madiba was televised with political leaders, President Jacob Zuma and Cyril Ramaphosa. You could see Madiba was not fully there. He did not speak. He was not connecting. My friend was no longer himself. It was an affront to Madiba’s dignity,” Tutu added.

But not all bishops support aid-in-dying legislation, including the current Archbishop of Canterbury, putting Tutu at odds with church teaching.

Leaders of Britain’s major faiths issued a joint rebuttal to the bill, led by Lord Charles Falconer, calling it a “grave error” which would have a “serious detrimental effect” on society.

The Most Rev. Justin Welby, the Archbishop of Canterbury, Cardinal Vincent Nichols, leader of the Roman Catholic Church in England and Wales, and the Rev. Martyn Atkins, general secretary of the Methodist Church, are among the 23 leaders who issued a direct plea to the British Parliament before the bill’s hearing.

“As leaders of faith communities, we wish to state our joint response to Lord Falconer’s Assisted Dying Bill,” according to the editorial published in The Telegraph. “We do so out of deep human concern that if enacted, this bill would have a serious detrimental effect on the well-being of individuals and on the nature and shape of our society.”

However, George Carey, the former Archbishop of Canterbury, said it would not be “anti-Christian” to change the law on assisted dying, reflecting Tutu’s concerns about aggressive end of life treatments.

“Until recently, I would have fiercely opposed Lord Falconer’s Bill. My background in the Christian Church could hardly allow me to do otherwise,” he wrote in an editorial published in the Daily Mail. “Today we face a terrible paradox. In strictly observing accepted teaching about the sanctity of life, the Church could actually be sanctioning anguish and pain — the very opposite of the Christian message.”

On July 18, after nearly 10 hours of debate in the House of Lords, the bill progressed to committee. In 2006, a similar attempt to legalize assisted dying for terminally ill, mentally competent adults failed to progress this far.

AIDINDYING_BRITAINAccording to the Assisted Dying Bill, a terminally ill adult with a life expectancy of less than six months may request life-ending drugs from his or her doctor. Prospective patients must be informed about palliative medicine and other end of life treatments, and self-administer the drugs. Adults facing Alzheimer’s and dementia, even if terminally ill, would not be eligible.

The Church of England operates similar to a confederation, with autonomous provinces around the world sharing a common tradition. Churches officially recognized as part of the Anglican Communion include the Episcopal Church of the United States, the Anglican Church of the Southern Cone of America and the Anglican Church of Southern Africa. It is the third largest Christian tradition.

The Very Rev. Matthew L. Buterbaugh of St. Matthew’s Episcopal Church in Kenosha, Wis., told Life Matters Media churches in the Anglican Communion have a history of intense debate over social issues.

“It is interesting the former Archbishop of Canterbury supports it and the current one does not, and the one in the middle, Rowan Williams, has said nothing. I would be surprised if Britain did not go forward with the bill, given my understanding of English politics,” Buterbaugh said. The Archbishop of Canterbury is considered the first bishop among equals, and local provinces may disregard his opinions.

“The last time aid-in-dying was debated in the Episcopal Church was in the early 90s. We have an official policy saying we oppose it, but one of the overarching themes of Anglicanism, is that you will have lots of wiggle room,” he added. “I’ve been around a lot of people who’ve died, and in my own opinion, keeping people unnaturally alive for so long prolongs human suffering. In some cases, aid in dying could be a humane option.”

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New Jersey Debates ‘Death With Dignity’

A New Jersey legislative panel has advanced a bill that would allow physicians to prescribe life-ending medications to some terminally ill, mentally competent adults.

The New Jersey Death with Dignity Act, based on a 1994 Oregon law, passed the Assembly Health and Senior Services Committee 8 to 4. The bill must pass the full Assembly and Senate before heading to Gov. Chris Christie.

If passed, prospective patients with a life expectancy of six months or less would be required to prove they are capable of making their own end of life decisions. Hospitals and doctors would not be required to participate.

After two verbal requests, patients would submit a written request for the life-ending medication. The request requires the signatures of two witnesses. Fifteen days must pass between the patient’s initial verbal request and the writing of a prescription. Patients would be guaranteed the freedom to rescind their request, and they must self-administer the drug.

“This discussion is about revisiting a statute last looked at in 1978 that never took into account an individual’s right to control their body and their circumstances,” said Assemblyman John Burzichelli in a press release. “Like society, medicine, palliative care and hospice services have changed dramatically since then. While there are many choices available right now that may be right for certain people, there is one more choice, not currently available, that deserves an honest discussion.” Burzichelli, a Democrat, sponsored the legislation.

A similar bill advanced to this point in the previous Legislature, but it was never was brought to a vote. Christie’s office declined to comment on the possibility of a veto.

A 2012 Fairleigh Dickinson University PublicMind poll found 46 percent of New Jersey voters supported “Death with Dignity,” while 38 percent opposed it.

The legislation has faced strong opposition from religious and disability-rights groups.

Courtesy WikiMedia Commons

Courtesy WikiMedia Commons

Marie Tasy, executive director of New Jersey Right to Life, calls the legislation “bad medicine.” “Clearly there are ways to alleviate a person’s suffering without eliminating the human being, and that is the path I hope our state will take,” she said. “The bill doesn’t protect patients, there is a lot of room for error. There is no oversight once a medication is prescribed, and it is a recipe for elder abuse.”

Tasy’s concerns are echoed by Not Dead Yet, a national disability rights group that opposes all forms of aid in dying legislation. Diane Coleman, president and C.E.O., told Life Matters Media she believes that advances in pain medicine have made the legislation unnecessary. “Palliative care options work, and there is no need to cross this line and drastically change the law that can become a risk to so many others,” she said.

New Jersey criminalized the practice in 1978, but physician-assisted suicide is legal in four states: Oregon, Washington, Vermont and Montana.

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Daniel Gaitan serves as a content producer...More