The objective is to integrate standard medical care with social services. Together, the planning and care would ease the difficulty of dying and create a new model of high-quality care that is affordable, the 21-member committee concluded in the report, dubbed “Dying in America.”
Few people die suddenly. Rather, they are killed by conditions that worsen over time to kill them. Planning would help them decide if they want to do things like go on a ventilator, or go through another round of chemotherapy, or be resuscitated after their heart stops.
The report laid out a road map for end-of-life planning. Planning should begin early and includes regular conversations tied to lifetime landmarks, such as getting a driver’s license, getting married or signing up for Medicare. The conversations will not only help clarify what patients want, it will help their families and health care workers provide care and potentially reduce costs.
“Without adequate advance care planning the default decision is for clinicians to treat a disease or condition, no matter the prognosis,” said Dave Walker, co-chairman of the committee and former U.S. comptroller general. “This is far from a patient-centered, family-oriented approach that honors the preferences for care for those near the end of life in an affordable and sustainable manner.”