“Improving shared decision making and advance care planning that reduces the utilization of unnecessary medical services and those not consistent with a patients’ goals for care.”
There is a stated need to “stabilizing aggregate societal expenditures for medical and related social services…”
In a word, the goal is to save money, and everything else in the “Dying in America” report is window dressing. The IOM urges all medical personnel to receive training in palliative care, and urges efforts to discuss such issues with patients and family in advance. Not stated is the fact that the bottom line of palliative care is death. The “care” is a temporary one, unlike a hoped for “cure.” The message to friends and relatives of the aged sick is to carefully tailor the emphasis on the need to “reduce suffering” and permit a dignified death; too rare is the message “Let’s try to save this life.”
There is no need for a death panel: The awe most of us have for medical professionals make families reluctant to challenge the tantalizing message of “care.” Few of us would dare point out that their message of “palliative care” is a perversion of the usual meaning of care. Care is intended to lead to cure and life – rather than a cessation of attempts to heal, preliminary only to certain death.
The Institute of Medicine’s “Dying in America” is not a medical document. It addresses the interaction of the patient, the family, and the medical profession, yet the committee that prepared it included no members of the public, no clergy, and no advocates for the elderly.
The document targets those who can be conveniently classified as “near the end of life,” and has the goal to “contribute to a more sustainable care system.” A noble goal, but not at the cost of diminished or restricted medical care, whether or not we elderly are deemed to be “near the end of life.”
First take care of our medical health. Your financial health will have to wait.