'Right-to-die' laws make palliative care more important than ever

The debate over medical assisted-suicide laws has only intensified since the passage of a California law making the Golden State the largest to allow the practice, and the laws make effective palliative care more vital than ever, according to Kaiser Health News.

Many palliative-care patients erroneously believe its purpose is assisted death, when in fact its function is to create an environment of optimal comfort and quality of life for seriously ill patients, independent of how much longer they live.

In the wake of the California law, palliative care providers must bear in mind how much the prospect of the end of their lives frightens patients, R. Sean Morrison, M.D., a professor of geriatrics at palliative care medicine at Mt. Sinai's Icahn School of Medicine in New York, told KHN. Indeed, he added, such laws increase the need for high-quality palliative care, because without it, those patients' only options are "an assisted death or living with intractable suffering."

Adoption of palliative care is on the rise nationwide, with 90 percent of providers with 300 beds or more offering such a program, but access is far lower among smaller hospitals, where a little more than half run palliative care programs. California is ahead of the curve on palliative care access, with another recent law requiring access under the state Medicaid program's managed care plans, but a February report from the California HealthCare Foundation indicated major gaps remain. Residents lack access to community-based palliative care in nearly half of the state's 58 counties, and in 19 of those counties they don't have access to inpatient programs either, according to the foundation's analysis.

Kaiser Family Foundation research indicates that fewer than 1 in 5 patients have discussed their wishes for end-of-life care with their doctors, even though 90 percent believe doctors should. The passage of the law will likely spur many doctors into action on end-of-life discussions, according to experts; after Washington passed a similar law, providers increasingly realized they couldn't push discussion off on someone else, according to the article.

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