Rush to Judgment

America is in the throes of a major health care transition as hospitals are increasingly trying to impose cost-cutting measures that government and private insurers are demanding. Hospitals pass along those pressures to the physicians but at the end of the day it is the patient who may pay the price especially if he or she is already terminally ill.

Two new laws passed within the last year in New York may well increase the chances that the lives of certain patients will be seen as expendable. The first one the Palliative Care Information Act passed on August 10 2010 requires health care practitioners to offer their patients information on palliative care and hospice care. Two months ago the state legislature directed a wide range of medical facilities — hospitals nursing homes home care special-needs assisted- and enhanced assisted-living residences — to establish policies and procedures to provide patients with “advanced life-limiting conditions and illnesses” (as the law puts it) access to information and counseling regarding appropriate options for their conditions.

Palliative care according to the legislation is defined as “health care treatment including interdisciplinary end-of-life care in consultation with patients and family members to prevent or relieve pain and suffering and to enhance the patient’s quality of life.”

Hospitals have come under pressure as a result of the new law to move patients to a hospice program as soon as they determine a cure is no longer possible. In most cases palliative care and hospice if provided in accordance with halachah could be a great benefit to the patient and the family. Since a cure is no longer possible the patient can go home and the hospice medical director and other health professionals will be there to help the patient. In addition there are some home care benefits as well.