Planning for the End of Life: Advocating for Advance Directives

Asaad Traina. Class of 2017 White Coat Ceremony.
Asaad Traina. Class of 2017 White Coat Ceremony.

Last week I had the privilege of speaking about advance directives from a medical student’s perspective at a press conference held by Rep. Peter Welch (D-VT). Rep. Welch is proposing a bipartisan piece of legislation that would provide a $75 incentive for Medicare patients who complete an advance directive (AD). Even in my very limited clinical experience, I have seen the devastating effects of not having an advance directive. Families are often unsure or disagree about who should be making medical decisions for their loved ones. Some family members are left to make life-or-death decisions without proper guidance, often leaving them with a terrible sense of guilt. Many of these problems could be avoided by simply filling out an advance directive that clearly appoints a surrogate decision maker, and outlines goals of care that can help guide medical decision making.

During my outpatient rotations, I was disturbed by the number of patients who did not have advance directives, and the widespread misconceptions that prevented them from filling one out. Many believed that an AD would prevent them from changing their mind in the future or would prevent them from receiving “full care.” Even as a medical student, I saw that I had an opportunity to educate my patients about ADs, encourage them to have those difficult conversations with their loved ones, and fill out the form.

I am very grateful for this experience, particularly to Dr. Robert Macauley, for impressing upon me the importance of ADs. Beyond his incredible lectures on medical ethics in the first years of medical school, I have had the privilege of attending Ethics Case Conference and having personal conversations with Dr. Macauley that have broadened my understanding of end-of-life care and medical ethics in the real world.

I am also very excited about this new legislation proposed by Congressman Welch, and am hopeful that it will be passed soon. I am proud that a congressman from Vermont is sponsoring this significant initiative, and glad that I am at a medical school that facilitates my participation in such important activities.

Read more about the advance directives legislation in a press release from Rep. Peter Welch.

What are your thoughts about this topic?