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Letters to the 107th Congress

July 29, 2002

The Honorable Ron Wyden
United States Senate
516 Hart Office Building
Washington, DC 20510

Dear Senator Rockefeller:

On behalf of the American Bar Association, I am writing to commend you and your co-sponsors for introducing the Advance Planning and Compassionate Care Act of 2002. This legislation takes several important steps beyond the 1990 Patient Self-Determination Act (PSDA) which introduced the term "Advance Directive" to the American vernacular. The American Bar Association supported the enactment of the PSDA and has continued to encourage greater access to the tools of advance planning, greater uniformity and portability of advance directives, and greater responsiveness to the needs of patients in health care systems at all stages of life, including end-of-life care.

The Advance Planning and Compassionate Care Act takes several modest but vital steps towards these goals. Under its provisions there will be an opportunity to discuss advance directives with an appropriately trained individual upon admission to a health care facility, which will help transform the existing paper-disclosure requirement into a meaningful vehicle for discussion and understanding. This will do much to combat the misperception that advance planning means merely signing a form. Good advance planning is, in essence, good communication, not mere form-drafting.

The portability and research mandates concerning advance directives are seriously needed to move public policy beyond the current Balkanization of legal formalities that characterizes current advance-directive law. In addition, the mandate to examine the feasibility and desirability of creating a uniform advance directive will generate much-needed fresh thinking on the strategies that may best encourage advance planning. Sadly, twelve years after the PSDA, the majority of adults still avoid the necessary task of planning for end-of-life decision-making.

The National Information Hotline will provide a valuable consumer tool for information about advance directives and end-of-life care options. Finally, the mandates for standards development, evaluation and demonstration projects, as well as coverage provisions, will help fill the inexcusable chasm in current knowledge, regulation, and financing of end-of-life care under Medicare and Medicaid. Historically, end-of-life decision-making and quality of care have been relegated to the shadows of health and long-term care policy. This Act will help the public and policy makers understand the issues and options in the light of day.

The ABA strongly supports this legislation. We commend your leadership in seeking to enhance patient autonomy and end-of-life care, and we stand ready to be a resource in these efforts.


Robert D. Evans
Director, Governmental Affairs Office

107th Congress Letters Home

Governmental Affairs Office
740 Fifteenth Street, NW
Washington, DC 20005
ph: 202-662-1760
fx: 202-662-1762

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