Compassion & Choices Urges Federal Government to Rescind Waiver Compromising Patient Autonomy
The policy could result in some people receiving unwanted medical treatment while others are denied the care they want and need.
by Alyson Lynch
May 20, 2020
A key provision of the 1990 Patient Self-Determination Act requires hospitals and other healthcare facilities to inform people about policies regarding their legal right to fill out an advance directive and to accept or refuse medical treatment. In April, the Centers for Medicare and Medicaid Services (CMS) waived this time-tested, 30-year-old requirement for patient-directed care in response to the COVID-19 pandemic. Compassion & Choices penned a letter to the U.S. Department of Health & Human Services Secretary Alex Azar, who oversees CMS, encouraging him to reverse the waiver and take action to protect patients. The letter was signed by 12 like-minded advocacy organizations and more than 5,000 Compassion & Choices supporters.
The letter makes four recommendations: First, to reinstate the requirements under the Patient Self-Determination Act that encourage hospitals to inform people about their advance directive policies; second, to issue guidance to urge physicians to engage in advance care planning visits with patients before hospitalization available via telehealth through Medicare; third, to allow electronic authentication of advance directives for certifying patient wishes; and finally, to urge clinicians to utilize advance care planning tools that address COVID-19 realities.
Corinne Carey, Compassion & Choices’ senior campaign director in New York and New Jersey, recently tested positive for COVID-19, as did her husband, David. She says that experience has raised the urgency of clarity about end-of-life care preferences in their household. “For me, for my family, it’s really important to know what level of care you and your loved ones want should any of you face a healthcare crisis,” Carey says.
Compassion & Choices remains vigilant in influencing and monitoring federal lawmaking and rulemaking to ensure people in the United States get the care they want at the end of life, including during the challenging COVID-19 pandemic. As the letter states, “Now, more than ever, individuals need to engage in informed discussions about what end-of-life care they want or don’t want if they get seriously ill and who will make healthcare decisions on their behalf if they are unable to do so.”
If you believe people should be informed and empowered to choose the end-of-life care they receive, add your name and declare your support today.