FP Report -- November 1999
Congress considers end-of-life bills
Congress is considering several bills on end-of-life care, and the Academy has commented on them:
The Pain Relief Promotion Act (S. 1272 and H.R. 2260) says using controlled substances to assist in a suicide is illegal. The AAFP opposes the act because it would allow federal law enforcement agencies to determine when pain management crosses over into assisted suicide.
The Conquering Pain Act (S. 941 and H.R. 2188) has many elements the Academy supports. The legislation would provide information on pain management rights to patients in federal programs, initiate demonstration grants to family support networks, authorize a surgeon general's report on pain and symptom management, and facilitate coverage of pain management by federal and private payers.
However, the Conquering Pain Act also asks federal agencies to develop performance measures for pain management and palliative care. The Academy calls that provision an "inappropriate intrusion into medical care" and suggests any such guidelines should be advisory, not mandatory.
"There is a lack of consensus in the medical community about what constitutes medically futile care even when the patient's condition is irreversibly terminal," says the Academy in an Oct. 13 statement to a Senate panel. "The culture of medicine is weighted toward hospital-based, high-technology, acute care interventions."
AAFP's statement accents the need to incorporate patients' and families' wishes into care plans and encourages more research into therapies for end-of-life pain.
At press time, the House was expected to vote on its bills in October, and it was not known when the Senate would act on the companion bills.
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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