[Congressional Record (Bound Edition), Volume 159 (2013), Part 4]
[House]
[Page 5419]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  1010
                            END-OF-LIFE CARE

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Oregon (Mr. Blumenauer) for 5 minutes.
  Mr. BLUMENAUER. Mr. Speaker, Monday in the blink of an eye, hundreds 
of people at the Boston Marathon were faced with an awful decision. 
None of them woke up that morning expecting they, or a loved one, was 
going to need emergency care in a life-threatening situation. We tend 
to think of end-of-life care as the province of a terminally ill 
person, often elderly, but that's just one circumstance, and not 
necessarily the most common.
  The decisions need to be made instantly about whether to amputate a 
limb, and a decision must be made that moment. If a person is in shock 
or unconscious, who helps make that decision for them?
  Last week, I had two more circumstances where people in my life were 
faced with totally unexpected life-threatening circumstances that 
brought these questions into sharp perspective. Anybody, anywhere, any 
time. How do we make sure that these decisions, which are made every 
day in every State in virtually every city, are made in accordance with 
the best interest and wishes of the patient and the patient's family?
  I've been working for the last 5 years for the Federal Government to 
be a better partner with families. It's called end-of-life care, and 
the Federal Government, the Department of Health and Human Services, 
and Congress are missing in action. Medicare will spend billions of 
dollars on the most expensive, invasive, painful, and in some cases, if 
not unnecessary, at least questionable care, often regardless of the 
wishes of the patient and their family. Yet Medicare won't pay $100 or 
$200 for that medical professional to have a conversation with the 
patient and their family.
  It's time for us to step up. We need to make sure that we clear up 
the questions in everyone's minds about the choices, the consequences, 
what the patient and the family want, and most critically, make sure 
those wishes are honored. Like my friend, whose heart stopped this 
weekend, totally unexpectedly, we don't know when or where a loved one 
will be in this position. But there's no excuse we don't do everything 
we can to help families and encourage everyone that is close to us, 
that works with us, to take their own steps to identify who speaks for 
them when they can't, and what they want to happen.
  This is personal for me. I had these jarring reminders that one of 
the greatest gifts each of us can give our families is to have a 
thoughtful and frank discussion about what our wishes would be for 
medical care if we're unable to suddenly make those decisions. It's 
also one of the greatest gifts that this Congress can make to the 
people we represent by doing our job so that the Federal Government is 
a better partner in making sure those conversations are possible.
  Please cosponsor our bipartisan Personalize Your Care Act, H.R. 1173, 
and then sit down and have this conversation with your family. It's not 
always the easiest, but it is far better than making your loved ones 
guess and feel guilty.

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