By Sylvia Hampton
March 7, 2010 (San Diego)--When the health reform discussion turned into a three ring circus last summer on the wave of words and statements like “death panels will kill granny,” an important fact got lost in the shuffle. The idea for family counseling programs with doctors on end-of-life care was brought forth by the insurance companies and added to the mix by a Republican congressman. It made so much sense to the Democrats that they included it in the bill.
It saved money for the insurance companies by making sure the hospitals and doctors were not practicing defensive medicine by adding wasteful medical spending on terminal patients. It made sense to doctors and caregivers by focusing on palliative care with the support of the families and patients.
I learned what this meant when caring for my mother and my aunt before they each died in 2002. Palliative care is therapy with the goal of relieving symptoms and improving quality of life by offering support and guidance to the patient and family. It does not attempt to alter the course of the disease, but make the patient as pain-free and comfortable as possible. Otherwise known as hospice, it has gained tremendous support among the public over the last thirty years.
When my brother-in-law, a physician, was dying of cancer over ten years ago after an operation that showed there was absolutely no hope for recovery and his days were numbered, his doctors handled his case in a routine manner. One day when my sister, a former nurse, got off the hospital elevator to visit him she heard what she described as the most agonizing wailing in pain and wondered who that could be. It was her husband. She ran to the desk and confronted the nurses who were ignoring the painful cries and demanded he get morphine. The nurse said, “He can’t have more until 2pm.” My sister said, “But he is suffering horrible pain!” to which the nurse responded, “Doctors orders.” Why? “Because he may become addicted.”
At that point my sister went ballistic and demanded the morphine be given immediately. They appeared very relieved and gave it. He died peacefully a day or two later. This is the kind of event that happens too often, mostly for legal reasons.
Patients and their families can work out in advance how to manage end-of-life care and sign off on a living will and advance directives before that time comes. My husband and I did just that years ago. If people do not want to have this counseling and do not want advance directives or living wills, they don’t have to have them. But using this as a political football to kill health care reform and cause the whole process to be Obama’s “Waterloo” is not only trickery, but downright stupid and often against good medical judgment.
Recently the California HealthCare Foundation spoke with administrative and medical leaders from various types of hospitals across the state to gain insights into how palliative care programs are set up, what the benefits and challenges are, and how clinical staffs respond to them. Among 325 hospitals responding to a 2008 survey, 43% have palliative care programs.
They found that typical benefits include “cost-savings, improved patient and staff satisfaction, and enhanced reputation. Physicians can be more efficient because palliative care staff handle the more time-consuming interactions with patients and families. Care can be highly individualized to patients’ and families’ needs by combining curative and comfort measures.”
Let your elected officials know how you feel about having this included in the health reform.
Sylvia Hampton is a community activist inducted into the San Diego County Women’s Hall of fame for 2008 for her work in the fields of healthcare reform, social justice and reproductive health. She is the past president of the League of Women Voters of San Diego County and served on President Nixon’s Title X Family Planning Council. Her monthly Community Forum column is published in the Rancho Bernardo Sun, Diamond Gateway Signature, and her Soapbox in the East County Magazine. Opinions are Sylvia’s alone and not to be interpreted as the policies of the League of Women Voters or East County Magazine.