[Congressional Record (Bound Edition), Volume 158 (2012), Part 9]
[House]
[Page 12177]
[From the U.S. Government Publishing Office, www.gpo.gov]




                            END OF LIFE CARE

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Oregon (Mr. Blumenauer) for 5 minutes.
  Mr. BLUMENAUER. Mr. Speaker, our colleague, Jim McDermott, sent each 
of us a letter with a Time magazine cover article by Joe Klein entitled 
``How to Die.'' This article is jarring to many because it's an issue 
that most would rather not confront. As a result, there's a great deal 
of unnecessary pain, confusion, and suffering. It masks one of the most 
important issues in health care, which, despite the manufactured 
controversy over ``death panels,'' is a rare, sweet spot in the health 
care debate. It can improve the quality of life, in some cases the 
length of life, and most importantly we can help people understand 
their circumstances and get the care that they want. If this happens, 
the cost of health care will go down even as satisfaction and quality 
goes up.
  For most Americans, the protocols followed by almost every hospital 
and practitioner will be to give the maximum amount of the most 
aggressive care in end-of-life situations. Especially if patients have 
the money or insurance, they will be hooked up in their final stages of 
life to be resuscitated, their ribs cracked, and hearts massaged. There 
will be tubes inserted, chemicals pumped, and defibrillators will shock 
people, even if they have no awareness of what's going on, other than 
that they are being tortured.
  When people are given the information, resources, and choices, the 
outcomes are much different. A telling story in The Wall Street Journal 
last February pointed out how doctors die differently. These are people 
with knowledge and where money is not usually a consideration. They can 
get any health care they want, but as a group, they regularly choose 
less intense, aggressive treatment and more palliative care. They are 
choosing the comfort and consciousness of being with family and friends 
in awareness over being hooked up in an ICU and struggling in their 
last minutes.
  Doctors have a better quality of life, and it costs less money. Why 
can't all Americans spend their final days like doctors? The truth is, 
they can. My legislation--Personalize Your Health Care--was developed 
with leaders in health care insurance and palliative care. Patients and 
doctors alike would help make sure that patients and other health care 
professionals work with patients to help them understand what they're 
confronting, what their choices are, determine what works best for them 
and their families, and then make sure that whatever their decision is, 
that choice will be honored. Over ninety percent of Americans agree 
that this is the right approach.
  There's an interesting little secret here that extreme treatments not 
only deteriorate your quality of life, but they're no guarantee of 
giving you more hours to live. Studies have shown that managing the 
pain perhaps in the hospice, along with the love and company of 
families in a familiar setting, in some cases actually leads to 
patients living longer. People can actually enjoy their remaining 
hours, and there are more remaining hours to enjoy.
  If most of us were to script our departure, it would probably be to 
go quietly in the middle of the night in the comfort of our own bed. 
The second-best scenario would be to go at home in that same bed 
surrounded by family and friends, comfortable, and conversing until the 
end. The least favored option, I suspect, would be semiconscious with 
tubes in our bodies in an ICU setting with the institutional hum around 
and strangers bustling about. Is that anybody's hope for their final 
memories? Sadly, that's the fate that awaits many people who do not 
personalize their health care.
  I strongly encourage my colleagues to look at this bipartisan 
legislation, H.R. 1589, and then to do what you can to have a 
thoughtful and rational conversation about this policy. Let's modernize 
Medicare to give people the care they want, to find out their choices, 
and make sure that those choices are respected.
  We owe it to the American public, and we owe it to our families and 
friends to make sure that every American can have the same high quality 
of life in their final weeks as doctors have.

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