[Congressional Record Volume 154, Number 65 (Wednesday, April 23, 2008)]
[Extensions of Remarks]
[Page E704]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


[[Page E704]]
 H. CON. RES. 323, EXPRESSING CONGRESSIONAL SUPPORT FOR THE GOALS AND 
              IDEALS OF NATIONAL HEALTH CARE DECISIONS DAY

                                 ______
                                 

                               speech of

                        HON. SHEILA JACKSON-LEE

                                of texas

                    in the house of representatives

                        Tuesday, April 22, 2008

  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise today in strong support 
of H. Con. Res. 323, expressing Congressional support for the goals and 
ideals of National Health Care Decisions Day. I would first like to 
thank my distinguished colleague Phil Gingrey of Georgia for 
introducing this important piece of legislation. This legislation 
recognizes an important initiative to encourage patients to express 
their wishes regarding healthcare and for providers and facilities to 
respect those wishes, whatever they may be.
  National Health Care Decisions Day is designed to raise public 
awareness for the need to plan ahead for health care decisions related 
to end-of-life care and medical decision-making whenever patients are 
unable to speak for themselves and to encourage the specific use of 
advance directives to communicate these important decisions. The 
Federal Patient Self-Determination Act requires that all Medicare-
participating healthcare facilities inquire about and provide 
information to patients on Advance Directives; it also requires these 
facilities to provide community education on Advance Directives (42 
C.F.R. Sec. 489.102). All healthcare facilities are required to: 
provide information about health care decision-making rights; ask all 
patients if they have an advance directive; educate their staff and 
community about advance directives; not discriminate against patients 
based on an advance directive status.
  It is estimated that only a minority of Americans have executed 
advance directives, including those who are terminally ill or living 
with life-threatening or life-limiting illnesses. Advance directives 
offer individuals the opportunity to discuss with loved ones in advance 
of a health care crisis and decide what measures would be appropriate 
for them when it comes to end-of-life care. The preparation of an 
advance directive would advise family members, health care providers, 
and other persons as to how an individual would want to be treated with 
respect to health care. Forty-two percent of Americans have had a 
friend or relative suffer from a terminal illness or coma in the last 5 
years and for a majority of these people and 23 percent of the general 
public, the issue of withholding life sustaining treatment came up. An 
overwhelming majority of the public supports laws that give patients 
the right to decide whether they want to be kept alive through medical 
treatment. By more than eight-to-one (84 percent-10 percent), the 
public approves of laws that let terminally ill patients make decisions 
about whether to be kept alive through medical treatment. One of the 
most striking changes between 1990 and 2005 is the growth in the number 
of people who say they have a living will--up 17 points, from 12 
percent in 1990 to 29 percent now.
  Patients and families are often not fully informed of the relevant 
risks and potential benefits of artificial nutrition and hydration 
(ANH). In addition, financial incentives and regulatory concerns 
promote the use of ANH in a manner that may be inconsistent with 
medical evidence and with the preferences of patients and their 
families. Because ANH is associated with uncertain benefits and 
substantial risks, it is essential to ensure that decisions about its 
use are consistent with the patient's medical condition, prognosis, and 
goals for care. Therefore, decisions about ANH require careful 
consideration of its risks and potential benefits.
  Establishing National Health Care Decisions Day will encourage health 
care facilities and professionals as well as chaplains, attorneys, and 
others to participate in a collective, nationwide effort to provide 
clear, concise, and consistent information to the public about health 
care decision-making, particularly advance directives. As a result of 
National Health Care Decisions Day, recognized on April 16, 2008, more 
Americans will have conversations about their health care decision, 
more Americans will execute advance directives to make their wishes 
known, and fewer families and health care providers will have to 
struggle with making difficult health care decisions in the absence of 
guidance from the patient.
  I strongly urge my colleagues to join me in supporting this important 
piece of legislation.

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