Delegates focus on needs of terminally ill patients

The AMA promotes advance directives and palliative care as ways to address difficult end-of-life challenges.

By Kevin B. O'Reilly, amednews staff. July 3, 2006.

Chicago -- More than a year after the Terri Schiavo controversy and less than six months after the U.S. Supreme Court rebutted a second challenge to Oregon's physician-assisted suicide law, the AMA House of Delegates adopted a host of initiatives at its Annual Meeting designed to make end-of-life planning and palliative care easier for physicians and patients.

The house adopted a Board of Trustees report, "Lessons from Terri Schiavo," calling on the AMA to encourage health plans and motor-vehicle departments to include advance-directive information when individuals enroll or obtain or renew their driver's licenses. A separate resolution directs the AMA to work with Medicare to give new enrollees information about advance directives.

"We want to maximize opportunities for patients to discuss end-of-life plans with other family members," said AMA Trustee Robert Wah, MD. "These opportunities should be used to prompt patients to think about advance directives and make the availability of advance directives more widespread."

The house also adopted a Board of Trustees report on palliative and end-of-life care that:

Stresses an interdisciplinary approach to palliative care.
Calls for subspecialty certification from the American Board of Medical Specialties.
Encourages all physicians to become skilled in palliative medicine techniques and familiarize themselves with appropriate coding.
Advocates for reimbursement of evaluation and management codes reflecting prolonged time spent on face-to-face care outside the hospital setting.

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