[Congressional Record (Bound Edition), Volume 160 (2014), Part 10]
[House]
[Page 14872]
[From the U.S. Government Publishing Office, www.gpo.gov]




                INSTITUTE OF MEDICINE END OF LIFE REPORT

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Oregon (Mr. Blumenauer) for 5 minutes.
  Mr. BLUMENAUER. Mr. Speaker, for the last 6 years, I have been 
spending a significant amount of time making sure that the Federal 
Government is a better partner in helping families as they deal with 
some of the most difficult times they will ever encounter, as a loved 
one enters their last stage of life.
  This often involves an elderly spouse or relative, but not 
necessarily. This is a challenge that faces all of us, regardless of 
age, health, or family circumstance. The youngest, healthiest, most 
vital member of your office could suffer an accident or come down with 
a disease this afternoon.
  We all must at some point face this challenge that requires that we 
do a better job of meeting those needs, helping our families understand 
the circumstances and choices and that we make their wishes known, and 
that those wishes are respected.
  This afternoon there is an important landmark in this effort to 
protect families, as the Institute of Medicine releases key facts and 
recommendations on improving the quality and honoring individual 
preferences at the end of life. It is entitled ``Dying in America,'' 
sort of a jarring title, but it should be required reading for everyone 
in government, health care, insurance, anyone who is involved with this 
complex web that should be supportive of families in their time of 
need, but too often fails them.
  This report makes clear that most people nearing the end of life are 
not physically, mentally, or cognitively able to make their own 
decisions about care, and that the majority of those patients will 
receive acute care from physicians who don't even know them.
  The default is often for more hospital days, intensive care, and 
emergency care, which means that there are more transitions about care 
settings, which can be unnerving for patients and complicate their 
care. All this combines to jeopardize the quality of end of life care, 
while obviously adding to its cost and complexity.
  This panel of experts, after months of intense study, makes a 
compelling case that we all should be working to provide comprehensive 
care for individuals nearing end of life, how it should be seamless, 
high quality, integrated, patient-centered, family-oriented, and 
consistently accessible around the clock.
  It should be tailored to the needs and desires of the families, and 
the resources that we can save by doing it right can be redirected to 
enhance the quality of their last days. Often done right, it will 
enable them to live longer as well as more comfortably.
  This report is an opportunity for all of us to step back and make 
sure we are doing everything we can to play our part in meeting the 
critical responsibilities not just for our constituents, but for our 
family members.
  Dr. Phil Roe and I have introduced H.R. 1173, the Personalize Your 
Care Act. There are 60 bipartisan cosponsors focusing on the Federal 
Government placing value on this relationship, on these critical 
conversations, and empowering families and patients to control the 
circumstances that matter so much to them.
  We strongly urge that everyone looks at this Institute of Medicine 
report and that you cosponsor the Personalize Your Care Act. I 
congratulate the Institute for the careful research, the clear 
analysis, and the strong recommendations. It is an important step to 
make sure that critical assistance to support our families, that they 
deserve and demand, is available.

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