Medicare Hospice Benefit Policy Essay

Introduction People have moral and ethical values that assist them in making decisions about their healthcare on a daily basis. What if a person found out that they had a terminal illness and only had months to live? What if those few months would be filled with treatments, pain and suffering, tear filled family members, and high cost medical bills? Physician- assisted suicide remains a debated topic which causes physicians, nurses and those involved to take a look at what they value and what they are willing to do in order to carry out a patient’s wishes.

Recommendation-hospice to evaluate. Palliative care will continue to

In the Franciscan program change team used evidence based practice by doing the following: Identifying a problem, the problem being that physicians and systems do not reliably address the needs of people approaching death. The team researched the evidence and found that unlike most other population management programs, that addressing the needs of people approaching death does not depend on laboratory values, medications, or strict service utilization algorithms to target individuals and Instead it relies on physician perceptions. When physicians were ask to refer patients that were gravely ill who would benefit from it supportive services the evidence showed that the request was to vague and to difficult to incorporate into practice and

Medicare beneficiaries might need to jump through some hoops to get that palliative care. Hospice is one of the services covered for Medicare beneficiaries and is obviously a necessary service at the end of life. In the past, Hospice had four benefit periods, two-90 day periods, one-30 day period and one unlimited period. Prior to 1998, if a member entered the unlimited period but did not die, they lost all future Medicare Hospice coverage.

There are three implications that would occur if a change in law were past, one would be the change in palliative care. Adequate palliative care is a prerequisite to the legalization of medical aid in dying. Patients should never have to choose death because of unbearable pain, which can be treated but cannot be accessed. It is wrong to deny grievously ill patients the option of medical aid in dying because of systematic inadequacies in the delivery of palliative care. Safeguarding patients by building a strong patient physician relationship must be established so that there is no foul play in the outcome.

Oftentimes, grief can be a challenging thing to overcome as a healthcare provider. It not only stymies people from making sound decisions, but it can end up with blame focused in areas where it should not be. This is with particular regard to patient families. In the case of this 72-year-old patient, there are a number of issues in this situation that are both unethical and downright illegal, including the fact that the patient’s living will is not currently being respected. Legal/Ethical issue 1: The legality of the living will parameters Both the legal and ethical issues of this situation have the do with the legality of the living will.

In view, the BBA was successful in containing the costs of home health services and resulted in savings in overall costs of care for older cancer patients. However, the drop in utilization of home health services did not seem to negatively affect outcomes. The BBA may have contributed to the trend of increasing use of hospice

According to Karaim in 2013 “Decisions about sustaining life, allowing it to end or even hastening death are among the most difficult choices terminally ill patients and their families can face” (para 1). Patients going through this have a bountiful number of things going

This highlights the importance of education and understanding of end-of-life options, as it can help reduce stigma and increase empathy towards those who are facing terminal illnesses. It also emphasizes the need for open and honest conversations around death and dying, as well as the ethical and moral considerations surrounding

This is a part of the stage where finding recovery and answers challenge doctors and the loved ones that are suffering. In the Institute of Medicine’s critical report Dying in America, there is an idea that emphasizes the importance of making a decision for the patient that is on the stage of death. JoAnn Grif, writer of Dying in America, identifies that decisions for a patient should be made before as a living will from the patient’s own preference and decision. Letting the doctor know so it can improve communication and awareness for the individual that is on treatment, and this consent should ahead of time and planned out. Although, how soon should patients reveal a will to their doctor, some will ask.

These personal decisions should not be left to governments. End of life decisions belong inside families. (Meier, 2005) Allowing the government to disregard a family’s wish violates their values or beliefs. ("NYCLU Urges Legislature to Let Families Make Medical Decisions for Incapacitated Patients", 2006)

References Bipartisan bill encourages Americans to complete ‘advance directives,’ plan for life-sustaining health decisions| News Releases| U.S. Senator Chris Coons of Delaware. (2015, November 18). Retrieved from http://www.coons.senate.gov/newsroom/releases/release/bipartisan-bill-encourages-americans-to-complete-advance-directives-plan-for-life-sustaining-health-decisions Nursing Care and Do Not Resuscitate (DNR) and Allow Natural Death (AND) Decisions. (2012, March 12). Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Ethics-Position-Statements/Nursing-Care-and-Do-Not-Resuscitate-DNR-and-Allow-Natural-Death-Decisions.pdf Olin, J. (2012, February 24).

In the documentary, Bill Moyers talks to three terminally ill patients, their families, and their doctors about the concerns with physician-assisted suicide (PAS). PAS allows a terminally ill patient to hasten an inevitable and unavoidable death through a lethal dose. The patients considered PAS in order to end their prolonged suffering. The legal role of advance directives in end of life issues allows a patient to specify how he wishes to be treated by a healthcare provider during a progressively weakened state. Advance directives may provide patients with freedom to choose end of life treatment, but moral and religious implications, the ethical battle between a physician’s duty to care and inner-conscious, and state laws pose threats to PAS.

The Death with Dignity Act has two arguments: those who believe we have the right to choose how and when we die, and those who believe we do not possess that right; that we should not interfere with the natural order of life. Every year, people across America are diagnosed with a terminal illness. For some people there is time: time to hope for a cure, time to fight the disease, time to pray for a miracle. For others however, there is very little or no time. For these patients, their death is rapidly approaching and for the vast majority of them, it will be a slow and agonizing experience.

The dying patient no longer has quality of life, they have lost their independence, are lonely, are forced to endure inevitable pain, are publicly humiliated, are suffering immensely, and are forced to watch their loved ones grieve because of them. It is an innate Constitutional Right to choose how to die, since we all will die. There comes a point when the poking and prodding becomes too much, when the patient wants to just die in silence in the loving arms of their