Priorities

Freshman Sen. Mark Warner, D-Va., is courageous to submit a bill that encourages doctors and hospital staff to counsel terminally ill patients about foregoing extraordinary medical care. It's a tricky dilemma, asking doctors to launch into an uncomfortable conversation with a dying patient.

In their grief, the family of a dying patient wants every possible measure taken, measures that often are expensive and don't improve the quality or length of life.

It is uncomfortable to ask a loved one to decide to what extent he or she wants medical treatment for the patient. Warner wants the medical community to make sure patients and families know what options are available to make the decision earlier, saving peace of mind as well as money.

Living wills, which spell out how far the patient wants doctors to go in treatment, do-not-resuscitate orders and other advanced directives, give the patient more control over how he or she dies. It's an uncomfortable conversation, but an essential one so families and medical personnel know what the patient desires.

Unfortunately, the ins and outs of how these directives work often aren't shared with patients. That's where the system needs repair, Warner said. The tricky part of the bill asks for more counseling and education of patients and penalizes health-care providers who don't partake with lower Medicare reimbursements. There's a negative emotional reaction to the government wanting patients to die quicker to save money.

Although that doesn't seem like much of a stretch, Warner emphasizes that the requirement is only for counseling. Patients and their families who want every possible treatment available can have them, he said.

Will this save money? Yes, that's a part of its benefit.

More importantly it's a conversation every family should have. It's a conversation every doctor should start.