New York Law Safeguards Patient’s Right to End-of-Life Information
Newly passed state legislation, the Palliative Care Information Act, requires doctors to offer to explain all treatment options—hospice, aggressive pain management, and other palliative care, as well as life-prolonging interventions—to patients diagnosed as terminally ill. It is up to the patient whether or not he wishes to conduct such a discussion. The same information must be offered to the appropriate surrogate if the patient lacks capacity to understand and make informed decisions.
Studies indicate that there are many benefits when patients and physicians engage in candid conversations concerning terminal illness. The patients more frequently accept that their illness is terminal and usually choose pain-relieving regimens rather than aggressive life-sustaining treatments. This may lead to a better quality of life during one’s final months. A study published in The New England Journal of Medicine found that cancer patients who received palliative care as part of their cancer treatment lived nearly three months longer than patients who did not.
Other studies have shown that open discussion and understanding of all options can lower the likelihood that expensive but futile medical choices will be made. The Archives of Internal Medicine has published research indicating that when doctors discussed hospice alternatives, patients were almost three times as likely to choose that course, which costs much less than aggressive hospital-delivered regimens and is covered by Medicare.
The Journal of the American Medical Association has published research indicating that after such physician discussions, patients were more likely to complete do-not-resuscitate orders and were less frequently placed on mechanical ventilators. Patients did not experience an increase in serious depression. On the contrary, the study found that the psychological suffering of patients and family members was greater when such conversations did not take place. The worst quality of life during the last week of life was associated with aggressive treatments.
To read related blog commentary by David C. Leven, executive director of Compassion & Choices of New York, click here.