Updates from the Committee on Health

End-of-Life Counseling Bill Signed by Governor
August 16, 2010

Physicians treating patients diagnosed with a terminal illness or condition will be required to offer the patient information about options for end-of-life care including hospice, aggressive pain management, palliative sedation, and other palliative care, under a bill signed into law by Governor David A. Paterson.

“So many patients go through their last days or weeks of life without knowing, understanding, or thinking through their care options,” said Assembly Health Committee chair Richard N. Gottfried, sponsor of the bill. “Some patients want aggressive care to the end, and some would prefer other options such as hospice care. But without information, patients and their families cannot make informed thoughtful choices.”

“For over a century, New York law has recognized the fundamental concept of ‘informed consent’ by patients. This new law builds on that. Many physicians find these issues very difficult to raise with patients, or they may be consciously or unconsciously guided by their own preferences or fears,” Gottfried said. “Ordinarily, the law shouldn’t tell doctors how to relate to their patients. But sometimes we have to help overcome obstacles to good practice.”

The new law requires physicians and nurse practitioners caring for patients diagnosed with a terminal illness to offer information and counseling on the available options for palliative and end-of-life care. The physician or nurse practitioner may do this personally or by referral to another physician or nurse practitioner. Information or counseling would not have to be provided to a patient who does not want it. Where a patient lacks capacity to understand and make informed choices, the information and counseling shall be offered to the appropriate surrogate, such as a health care agent designated by the patient in a signed health care proxy or a family member under the recently-enacted Family Health Care Decisions Act.

“Dignity at the end of life is a gift not only to the dying, but also to their loved ones. For the family, those final memories are often among the most poignant and enduring,” Gottfried said. “Dying patients and their families should have information and counseling available that includes a full range of information about end of life care options including hospice care, aggressive pain management, and palliative sedation. The patient is then empowered to control his or her own health care decisions with full information.”

The bill, A.7617/S.4498, was sponsored in the Assembly by Mr. Gottfried and in the Senate by Senate Health Committee chair Thomas K. Duane.