A Closer Look At End of Life Counseling

The term "death panel" was intended to conjure up some ghastly images that people could associate with President Obama's health care reform.

The phrase, made up by reform opponents, seemed to do the trick as polls showed an increasing unease with the president's plan and town-hall meetings erupted in charges that the government wanted to interfere with life and death decisions.

Doctors who engage in end of life counseling with their patients would be reimbursed for their service, under a provision in the House version of the reform bill passed last month. The Senate bill, which passed Christmas Eve has no such language.

The New York Times today gives us an in-depth look at the practice and the decision to administer drugs that possibly speed death in very sick patients. The practice of palliative (or terminal) sedation is carried out at hospices run by large hospitals, including New York's Beth Israel Medical Center and New York-Presbyterian Hospital, the Times reports.

Palliative sedation is a tricky moral issue for the medical community. Doctors tell the Times that the goal isn't too strictly hasten death but to comfort the patients. But the practice clearly can speed death. Combining drugs such as the sedative lorazepam and morphine can slow breathing and heart rate and make it impossible for patients to eat or drink, the Times reports. Critics say the practice is no more than a slow euthanasia.

Some doctors who treat the terminally ill disagree with the characterization.

"“Do I consider myself a Dr. Death who is bumping people off on a regular basis?” I don’t think so. In my own head I’ve sort of come to the realization that these people deserve to pass comfortably,” Dr. Edward Halbridge, hospice medical director at Franklin Hospital on Long Island, tells the Times.