The Palliative Care Information Act in Real Life

Abstract

New York's Palliative Care Information Act took effect on February 9, 2011. Sponsored by the advocacy group Compassion and Choices New York, the law on its face simply mandates that physicians practice good medicine in caring for patients with a poor prognosis. Violations of the law are punishable by fines of up to $5,000 for repeated offenses, and willful violations by a jail term of up to 1 year. One problem is the vagueness of the category of "terminal illness" on which the law focuses. Whereas the prognosis of patients with advanced cancer can often be estimated, 75% of people in the United States die of conditions other than cancer, such as cardiovascular diseases. Even more troubling is the law's heavy-handed intrusion into the doctor-patient relationship—New York is attempting to prescribe legislatively what should be a subtle, intimate conversation between doctor and patient that often happens over time. Some physicians are naturally more comfortable than others in talking with patients about these issues, but there are specific skills that all can learn. These tasks are difficult. If we acknowledge, however, that how we care for patients as they near the end of their lives reflects our core understanding of what it means to be human, we can accomplish the goals of New York's legislation in a more appropriate and far-reaching manner. (PsycINFO Database Record (c) 2012 APA, all rights reserved)