Docs Urged To Have End-of-Life Talks Under New Calif., Federal Rules

Some providers are seeking guidance and new resources in response to California's new physician-assisted death law and other policies that encourage doctors to have end-of-life discussions, the Sacramento Bee reports (Buck, Sacramento Bee, 12/21).

Background

In California, Gov. Jerry Brown (D) in October signed into law a bill (ABX2-15) that legalizes physician-assisted death in the state under certain conditions (California Healthline, 12/1). The law has not yet taken effect.

Nationally, Medicare on Jan. 1, 2016, will start reimbursing physicians who discuss end-of-life options with their patients.

Barriers to End-of-Life Talks

Research shows that the while the majority of patients want to discuss their end-of-life options, few have actually had such conversations.

According to the Bee, initiating end-of-life discussions can be difficult for providers.

Ben Rich, professor emeritus of internal medicine and bioethics at UC-Davis, said, "The end-of-life discussion is partly avoided by physicians because it's an acknowledgment of the limits of medicine," adding, "There's an understandable reluctance to have that kind of conversation and defer it until you don't have any other options."

End-of-Life Discussion Resources

Some groups are offering education and other outreach programs to help providers discuss end-of-life care options with their patients.

For example, Compassion & Choices earlier this month announced a campaign to help educate physicians and patients about California's new "right-to-die" law.

Other resources include:

• The Conversation Project, which offers a questionnaire to help individuals begin thinking about end-of-life talks;
• Doc2Doc, sponsored by Compassion & Choices, which has two providers available to answer questions from doctors around the country; and
• "Go Wish" playing cards, developed by the Coda Alliance, which have end-of-life conversation starters printed on them (Sacramento Bee, 12/21).