End of life care is one of the most important realms of a hospital. Being that it is such a sensitive time in a patient’s life, people expect the best care for themselves or their loved ones. But a new report shows that Americans might not be getting the care that they want or need.

Reuters reports on end of life care at American hospitals and medical facilities. Are doctors and other medical community members meeting the patient’s desires at the end of their life? What should this care include?

What inspired the study?

The interest in conducting the study was sparked by allegations that under the 2010 Affordable Care Act physicians who would give patients advice about end-of-life issues would be part of ‘death panels’ that would judge who would live and who would be left to pass on. But the proposal never became the law. Experts say physicians need training in how to talk to patients about planning for their deaths, because more than 25% of U.S. adults have given scarce or no thought to how they would like to pass on. This is the common practice despite the fact that surveys show that many Americans fret about the expensive costs of care near the end of life.

The report shows that more efficient treatment and talks with patients about their options could actually lower costs. Patients and/or their families often end up spending more on end of life care than they need to and/or fail to even get the exact care that they need.

Reuters reports, “The report recommended that insurers and healthcare providers provide incentives to hold down the need for emergency services and that the use of electronic healthcare records be increased. Public health organizations and consumer and religious groups also should encourage people to decide about how they wish to be treated if they are nearing death, the report recommended.”

CBS news also reported on Americans getting treatment that they do not want. Many Americans are unfortunately forced into costly end of life treatment that makes them uncomfortable because of a system that has a ‘perverse incentive’ for aggressive care and not enough conversation about what people want according to the report.

Despite the fact that people emphasize a desire to die at home, free from pain, the opposite usually occurs. The majority of Americans do not document their wishes on end-of-life care and even those who do have to deal with a medical system that is not well suited to give them the death they want. The conclusion is breathing and feeding tubes, powerful drugs and other treatment. Unfortunately these things often fail to prolong life and can make the final stage of life extremely uncomfortable.

“The report blamed a fee-for-service medical system in which ‘perverse incentives’ exist for doctors and hospitals to choose the most aggressive care; inadequate training for those caring for the dying and physicians who default to life-saving treatment because they worry about liability,” according to CBS.

Living wills tend to be unpopular and not effective; they are also scarce. Therefore the medical community often takes full advantage of this common problem to prescribe an endless series of treatment for patients.

So which type of plan would be best? CBS reports, “The report praised programs in palliative care, which focuses on treating pain, minimizing side effects, coordinating care among doctors and ensuring concerns of patients and their families are addressed.” This form of care has increased rapidly in the last few decades and is now available in numerous U.S. hospitals, but like the report said, most doctors are not trained in it.

Experts say that having a plan or having a doctor to give you your options could save you and/or your (and by default the government) loved ones money anyways. When one is given such choices one can choose what course is best suited for them.

Fox news also commented on the report.

Physicians need training in how to speak to patients about planning for their deaths since more than a quarter of U.S. adults have not thought about how they would like to be treated in their last days.

“That has occurred even though polls show that many Americans worry about the potential high costs of care near the end of life and do not want to be a burden on family members, the study said. A 2011 analysis showed that a patient's directive limiting treatment near the end of life could save $5,585 per death in areas of the United States with high healthcare costs,” according to Fox.

Experts are encouraging people to be more self aware as it would be much more beneficial to them in the end. 


Gerry Oginski
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NY Medical Malpractice & Personal Injury Trial Lawyer