I recently blogged about the Medicare Choices Empowerment and Protection Act (S. 2240). I have since heard quite a few bioethicists criticize this bill.
Much of this criticism seems appropriate. There are a lot of ill-informed and misinformed advance directives out there. If enacted, this legislation would prompt MORE of them. In short, this legislation seems focused on the volume and number of advance directives, NOT on their quality.
The only caveat to that assessment would be if DHHS develops some very good accreditation criteria. Perhaps DHHS will certify only advance directives completed with sophisticated interactive patient decision aids. That would help ensure that the government’s $75 is paying for “good” advance directives.
I am informed by one highly respected clinician ethicist that one such certifiable interactive advance care planning tool is MyDirectives. It prompts the patient to think about values prior to making choices about future care plans, allows very flexible choices including time-limited trials in a more effective manner than a paper document, is easy to update (since the directive created is digital), and is easily retrievable from the web (in fact has the potential to automatically populate EMRs).