[Congressional Record Volume 152, Number 134 (Thursday, December 7, 2006)]
[House]
[Pages H8899-H8901]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




SUPPORTING THE GOALS AND IDEALS OF PLAN AHEAD WITH AN ADVANCE DIRECTIVE 
                                  WEEK

  Mr. BURGESS. Mr. Speaker, I move to suspend the rules and agree to 
the resolution (H. Res. 934) supporting the goals and ideals of Plan 
Ahead with an Advance Directive Week.
  The Clerk read as follows:

                              H. Res. 934

       Whereas life and death situations confront hundreds of 
     thousands of persons within the United States each year due 
     to life threatening illness or injury;
       Whereas advance directives offer individuals the 
     opportunity to discuss with loved ones and family members in 
     advance and decide what measures would be appropriate for 
     them when it comes to end-of-life care;
       Whereas the preparation of an advance directive, would 
     advise family members, medical providers, and other persons 
     of how an individual would want to be treated in certain 
     crisis situations;
       Whereas physicians, other health care providers, clergy, 
     legal counsel, and family members should, or may, provide 
     guidance and insight into determining the final wishes of a 
     person when an advance directive is being prepared;
       Whereas to avoid any legal or medical confusion due to the 
     emotions involved in end-of-life decisions, it is in the best 
     interest of all Americans that each person over the age of 18 
     communicate his or her wishes by creating an advance 
     directive; and
       Whereas the designation of the first week of April each 
     year as Plan Ahead with an Advance Directive Week would give 
     honor and respect to all persons as they make critical 
     decisions about their end-of-life care and allow death with 
     dignity according to their own decisions: Now, therefore, be 
     it
       Resolved,  That the House of Representatives--
       (1) supports the goals and ideals of Plan Ahead with an 
     Advance Directive Week;
       (2) encourages each person in the United States who is over 
     the age of 18 to prepare an advance directive to assist his 
     or her family members and medical professionals and others as 
     they honor his or her final wishes; and
       (3) encourages medical, civic, educational, religious, and 
     other nonprofit organizations to encourage individuals to 
     prepare advance directives to ensure that their wishes and 
     rights with respect to end-of-life care are protected.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Burgess) and the gentleman from New Jersey (Mr. Pallone) 
each will control 20 minutes.
  The Chair recognizes the gentleman from Texas.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks on this legislation and to insert extraneous material on the 
resolution.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today in support of House Resolution 934, 
supporting the goals and ideals of Plan Ahead with an Advance Directive 
Week. The resolution encourages all Americans to take time to discuss 
with their loved ones what their wishes would be in a health care 
situation where that person is unable to communicate.
  As many of my colleagues are aware, an advance directive may comprise 
two types of legal documents that enable individuals to plan for and 
communicate end-of-life wishes in the event an individual is unable to 
convey them due to failing health.
  The first type of advance directive is what is known as a living 
will. It documents a person's wishes concerning medical treatments at 
the end of life. The second type of advance directive is a medical 
power of attorney or a health care proxy which allows individuals to 
appoint a person they trust as their health care agent. This person is 
authorized to make medical decisions on another's behalf.
  Mr. Speaker, living wills and medical powers of attorney are valuable 
tools to help communicate the wishes about future medical care. 
Thoughtfully prepared advance directives can ease the burden on those 
who must make health care decisions for us.
  In conclusion, I want to encourage all Americans to set aside time to 
have what may well be one of the most important conversations that a 
family can have.
  At this time, I would like to thank Dr. Gingrey for helping bring 
this important issue to the American people, and I urge my colleagues 
to support the resolution.
  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of House Resolution 934, legislation 
which supports the goals and ideals of Plan Ahead with an Advance 
Directive Week. Advance directives are an integral part of any care 
delivery plan. Simply put, advance directives are statements by 
competent persons which articulate that person's medical, legal and 
personal wishes regarding medical treatment in the event of future 
incapacity.
  When advance directives are available, medical professionals, 
families and loved ones are best able to make critical care decisions 
should a patient become unable to make sound judgments about their 
health care.
  This resolution encourages those 18 years of age and older to prepare 
advanced directives. It also encourages medical, civic, educational, 
religious, and other nonprofit education to promote advance directive 
preparation, particularly amongst their constituencies. Many 
organizations are already leading the effort to provide guidance for 
patients on advance directive preparation, including the American 
Medical Association, the American Hospital Association, the American 
Academy of Family Physicians and the National Hospice and Palliative 
Care Organization.
  H. Res. 934 enjoys the support of the National Consensus Project for 
Quality Palliative Care, a coalition of leading U.S.-based palliative 
care organizations dedicated to address the needs of health care 
professionals who care for patients with advanced, chronic or life-
threatening illnesses, as well as the needs of patients' families.
  I would like to thank Representative Gingrey for bringing this 
resolution before us today, and I encourage my colleagues to support 
this resolution.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, I would like now to recognize the gentleman 
from Georgia (Mr. Gingrey), a fellow physician who is the author of 
this fine piece of legislation for 5 minutes.
  Mr. GINGREY. Mr. Speaker, first of all, I thank my colleague for 
yielding me this time, and I also thank my friend from New Jersey for 
his support.
  Mr. Speaker, I rise today in support of H. Res. 934, a resolution 
that supports the goals and ideals of a Plan Ahead with an Advance 
Directive Week. This resolution is supported by Members on both sides 
of the aisle. It is endorsed by the National Hospice and Palliative 
Care Organization, and it is backed by the Cobb County Medical Society 
in Georgia, and commended to me by my friend and colleague, child 
psychiatrist Dr. Durk Huttinback.
  As a physician for nearly 30 years, I wholeheartedly believe in 
executing advance directives. Every individual in this country, in 
every stage of life, should have conversations with their families, 
friends and loved ones regarding their wishes as they pertain to end-
of-life care. Advance directives help clarify the desire of individuals 
to their health care providers, their care givers and family members 
during these difficult and trying times.
  Advance directives are valuable tools to help communicate wishes 
about future medical care. Thoughtfully prepared advance directives can 
ease the burden on those who must make health care decisions for us. 
This resolution encourages all Americans to set aside time for what may 
very well be one of the most important conversations a family can ever 
have.
  Giving advanced direction to those who are providing your medical 
care and explaining to your loved ones your wishes are essential ways 
to ensure that these wishes are fulfilled if those painful times 
present themselves and communication is not possible.
  Mr. Speaker, I believe advance directives are a great avenue for 
facilitating these vitally important conversations, and therefore I 
encourage my colleagues to support this resolution.

[[Page H8900]]

  The Federal Government can encourage the American people to have 
these conversations and take these important actions. By passing this 
resolution, groups like the National Hospice and Palliative Care 
Organization, as well as hospitals and nursing homes around the country 
can use this momentum to intensify the work they already are doing to 
notify and educate the American public on the importance of advance 
directives.

                              {time}  1130

  Advance directives are available to individuals through many 
different avenues. Each State government has a medical power of 
attorney form that a citizen can fill out and have witnessed. This then 
authorizes the appointed agent to make health care decisions on that 
individual's behalf.
  In addition to State government and public health departments, there 
are many organizations and hospitals around the country that have 
advance directives available for patients and loved ones who may find 
themselves facing these tough decisions.
  So, Mr. Speaker, I cannot say it enough. This resolution simply 
encourages everyone to take a moment and discuss with their loved ones 
what their wishes would be in a health care situation where they are 
unable to communicate.
  I encourage my colleagues to please take this opportunity to support 
these many fine organizations and institutions around the country who 
work tirelessly to support the simple goals of education and awareness. 
In addition and perhaps most importantly, this is a chance to take a 
moment and do what is in the best interest of patients and families in 
our great country. Please join me in supporting House Resolution 934.
  Mr. PALLONE. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, it is my great honor to recognize another 
physician from Georgia, Dr. Tom Price, for 3 minutes.
  Mr. PRICE of Georgia. Mr. Speaker, I want to thank my colleagues. I 
want to thank Congressman Burgess, physician colleague and Congressman 
colleague, for yielding me time and allowing me to participate in this.
  In our lives we plan for all sorts of things. Some of them are 
trivial and some not. We plan for vacations. We plan for changes in our 
jobs. We plan for changes where we live, moving. We plan for changes in 
education. But most of us don't plan for the time when end-of-life 
decisions must be made. And what, Mr. Speaker, could be more personal 
than those decisions, when none of us, none of us, would want others 
making uninformed decisions on our behalf?
  So I rise and commend my colleague Dr. Gingrey, my fellow colleague 
from Georgia, for his leadership and his wisdom in bringing this issue 
forward. It is extremely important. I also want to commend our own Cobb 
County Medical Society for their leadership and their persistence in 
maintaining attention on this vital matter.
  We all take for granted the fact that we make these personal medical 
decisions, and most often we are able to make those decisions 
ourselves. But occasionally we are not conscious or competent to make 
these decisions, and sometimes that happens in a split second.
  As an orthopedic surgeon, I would often treat patients or folks who 
were involved in automobile accidents, and sometimes they would arrive 
in the emergency in a coma, unable to participate in decisions about 
how they would want their care to proceed. Very important life and 
death decisions. And without advance directives, then their families 
had no guidance on the direction of these decisions. That is why 
advance directives are so remarkably important. They allow people to 
make decisions about the care that they would want to receive if they 
happen to become unable to speak or act for themselves.
  The term ``advance directives,'' as has been noted, really 
encompasses two types of legal documents for each individual. They 
answer the questions what and who. What would individuals want to be 
done? That is through a living will. And who would make those decisions 
for them if they were unable to make themselves? That is the medical 
power of attorney or health care proxy.
  I also think it is interesting to note that although these are legal 
documents, they do not require an attorney to execute, which may be 
good news for folks. So I would encourage, as the others have, to make 
certain that they give the time and effort to this activity and make 
certain that they proceed with fulfilling the obligation, actually the 
responsibility that they have to their loved ones.
  So I want to commend Congressman Gingrey once again and I want to 
mention really it is our desire to ask people to be prepared. Be 
prepared, as the resolution states, to avoid any legal or medical 
confusion due to the emotions involved in end-of-life decisions. It is 
in the best interest of all Americans that each individual over the age 
of 18 communicate his or her wishes by creating an advance directive. 
So it is wholly important that this House of Representatives supports 
the goals and ideals of Plan Ahead with an Advance Directive Week; that 
we encourage each individual to fulfill their responsibility for those 
forms and we encourage medical, civic, educational, religious, and 
other nonprofit organizations to ask their members as well to fulfill 
their obligation for a living will and a medical durable power of 
attorney.
  I want to encourage all my colleagues to support this resolution.
  Mr. PALLONE. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, we have had good participation from the 
House Physicians Caucus this morning, and I just wanted to make note of 
that.
  Mr. Speaker, I yield 2 minutes to our third speaker, who is one of 
our newest Members, another physician colleague from Houston, Texas, 
the recently elected Shelley Sekula Gibbs.
  Ms. SEKULA GIBBS. Mr. Speaker, I thank the Congressman from Texas, 
Dr. Michael Burgess, for yielding.
  I appreciate the opportunity to rise and speak in support of the 
gentleman from Georgia, Dr. Phil Gingrey's, House Resolution 934, which 
encourages the creation of a week that would be dedicated to the 
support and development of advance directives.
  Advance directives are a legal document that every American should 
explore and hopefully will find useful. An advance directive is 
something that has been very helpful in my own family since I lost a 
spouse to cancer and then subsequently lost my father to cancer.
  Now, the advance directives that come into play are something that 
would not take over unless the individual lost consciousness and went 
into a coma. Other than that, a person is able to call their own shots 
and make their own decisions. But if a person slips into coma, an 
advance directive can be very helpful in telling your family and your 
physicians and hospital staff in advance how you want to be taken care 
of. And this is very important, Mr. Speaker, and very important for all 
of us that we take the time to help clarify those decisions before a 
person slips into a coma and is unable to communicate.
  Providing a family physician and the family members an advance 
directive can reduce confusion and reduce guesswork about what you 
really want for your treatment during end-of-life time if you should 
slip into a coma. Since illness can come unexpectedly and not all of us 
have the chance to make those wishes known personally, an advance 
directive can be very useful and can remain in a drawer or with your 
family physician, in your file, so that you can be at ease knowing you 
have made that kind of decision known in advance.
  Once again I would like to thank the gentleman from Georgia, Dr. Phil 
Gingrey, for bringing this resolution to the floor.
  Mr. PALLONE. Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, just a housekeeping detail: I would point 
out that the House has previously passed this legislation. It went over 
to the Senate. Some modest changes were made, and this is now the 
legislation that will conform to those changes.
  Mr. Speaker, I have no further requests for time, and I yield back 
the balance of my time.
  Mr. PALLONE. Mr. Speaker, I would also urge support of the bill.
  Mr. LEVIN. Mr. Speaker, I rise in support of House Resolution 934, 
which supports the goals and ideals of Plan Ahead with an Advanced 
Directive Week and encourages Americans to prepare advance directives 
to ensure

[[Page H8901]]

that their wishes and rights with respect to end-of-life care are 
protected.
  This is an issue I became involved with back in 1990 when I 
introduced the Patient Self-Determination Act in the House. Senators 
John Danforth and Pat Moynihan introduced the companion bill in the 
Senate. The measure became public law in 1991. Among other things, the 
Act requires all Medicare and Medicaid provider organizations, 
including hospitals, nursing facilities, home health agencies, and 
hospices to provide written information to patients at the time of 
admission concerning an individual's right under State law to make 
decisions concerning medical care, including the right to accept or 
refuse medical or surgical treatment and the right to formulate advance 
directives. It also required these organizations to provide written 
information to patients with respect to advance directives. But even 
with laws like the Patient Self-Determination Act in place, only about 
29 percent of Americans have a living will.
  Advance directives, which include a living will stating the 
individual's preferences for care and a power of attorney for health 
care, are critical documents that each of us should have. As important 
as it is to encourage Americans to prepare advance directives, Congress 
is in a position to do more to help families make these arrangements. 
Last year I introduced H.R. 2058, the Advance Directives Improvement 
and Education Act. This bipartisan bill would build on current advance 
directive laws to educate Americans about living wills, give people the 
opportunity to discuss options with their doctors, and ensure that 
their wishes are honored.
  In a word, the purpose of H.R. 2058 is to encourage all Americans to 
think about, talk about and write down their wishes for medical care 
near the end of life should they become unable to make decisions for 
themselves. It would also ensure that people's advance directives are 
honored, even if the directive is issued in one state and end-of-life 
care is given in another. The bill also encourages all Medicare 
beneficiaries to prepare advance directives by providing a free 
physician office visit for the purpose of discussing end-of-life 
choices, and directs the Department of Health and Human Services to 
conduct a public education campaign to raise awareness of the 
importance of planning for care near the end of life.
  Let me conclude by again stating my support for the resolution before 
the House with the hope that we can build on this effort in the next 
Congress.
  Mr. PALLONE. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Texas (Mr. Burgess) that the House suspend the rules and 
agree to the resolution, H. Res. 934.
  The question was taken; and (two-thirds of those voting having 
responded in the affirmative) the rules were suspended and the 
resolution was agreed to.
  A motion to reconsider was laid on the table.

                          ____________________