Despite Support for Palliative Care, Doctors and Patients at Odds Over Emphasis on Cost

By Jennifer Popik, JD
Robert Powell Center for Medical Ethics

Jennifer Popik, J.D. Robert Powell Center for Medical Ethics

79% of physicians believe too much money is spent saving lives, a view held by only 37% of the general population, according to a Regence/National Journal poll  published November 15th.

One of the survey questions asked 500 board-certified doctors and 600 members of the general public to agree with one of two options:

The health care system spends far too much trying to extend the lives of seriously ill patients which diverts resources from other priorities, adds to our country’s financial difficulties, and increases the cost of health care for everyone.

…OR…

The health care system in this country has the responsibility, the medical technology, and the expertise to offer treatments to seriously ill patients and spend whatever it takes to extend their lives.

55% of the general public agreed with the second, pro-life alternative, while only 21% of physicians concurred. (The survey has a margin of error of +/-4.0%.)

Nearly every surveyed physician agreed that there needs to be a higher national priority on providing and paying for palliative care.  Generally speaking, palliative care is care or treatment for seriously ill patients which focuses on reducing the severity of symptoms, but it is care that can be provided alongside of curative treatment.  Palliative care also attempts to provide physical, emotional, and spiritual support to patients and their families.

Decent palliative care immobilizes one of main argument of those who promote physician assisted suicide. Those who advocate doctor-prescribed death say that lethal prescriptions are necessary because patients, particularly those with terminal illness, experience uncontrollable pain.

The better answer to patients in pain is not to kill them, but to make sure that the medicine and technology currently available to control pain is used more widely, competently, and completely.  This is where effective palliative care can step in and fill the gap. 

Sadly, however, the survey provides further evidence that instead seeing palliative care being as a supplement to curative treatment, too many see it as a substitute–a way to cut back on money for life-preserving measures– instead providing “comfort measures” as those whose lives could otherwise be saved die.

In a recent Los Angeles Times story titled, “The promise and pitfalls of palliative care,” Melissa Healy writes, “If fully integrated into the nation’s hospitals, palliative care could lower the nation’s healthcare expenditures by reducing healthcare usage — to the tune of more than $6 billion a year, according to a 2010 estimate by the Institute of Medicine, which advises the federal government on medical matters.”

Praiseworthy promotion of palliative care, which can be a positive alternative to legalized euthanasia, must not be allowed to become an excuse for denying needed life-saving treatment. 

For documentation that America can afford unrationed health care, see  www.nrlc.org/MedEthics/AmericaCanAfford.pdf

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