Doctors can now receive reimbursement from Medicare for talking to their patients about end of life medical care. The conversation should not be one-sided nor should it be the only end of life conversation people have.
A recent article in the Washington Post, entitled "When a doctor and patient disagree about care at the end of life," is an interesting look at the interaction between one doctor and his elderly cardiac patient.
The doctor's chart indicated that the patient did not wish to be resuscitated in the event of a cardiac arrest. When the doctor asked the patient to confirm this, the patient responded that he did want to be resuscitated. The doctor then essentially tried to talk the patient out of the change explaining that given his age and health resuscitation was unlikely to work.
The patient got his way of course, and the doctor changed the chart. However, the patient went away angry.
These conversations between doctors and patients about end of life care are very important, but they cannot be one-sided. Doctors need to listen to patients and understand the reasons that patients have for their preferences. In this story, the doctor was able to do that during the patient's next visit.
Another lesson that should be taken away from the story is something the author does not state.
These conversations should be had with family members and estate planning attorneys before the patient even has the opportunity to have the conversation with the doctor. People should make their end of life preferences known by getting living wills and health care powers of attorney.
Living Will, Health Care Power of Attorney, Estate Planning