Monday, December 27, 2010

Having The Last Word

Effective Jan. 1, U.S.Medicare will pay physicians who counsel patients seeking information regarding end of life planning.  This includes patient-generated health care advance directives that instruct doctors whether or not to use extreme measures in a medical crisis to keep him /her alive or when (s)he becomes incapable of making that decision due to senility.

However, Medicare coverage is unavailable to Americans living outside the U.S.  And because of the pervasive influence of the Catholic Church in the Philippines on matters regarding public policy in general and control over personal autonomy, especially in the matter of beginning and end of life decisions,  I had assumed that hospitals here did not offer patients such health care options as advanced directives and DNR (do not resuscitate) orders.  Fortunately, it turns out that I was wrong.

When I checked in to undergo a procedure at The Medical City Hospital, a non-sectarian medical center located in Pasig City, Metro-Manila, I was given a pamphlet that discusses these these and other choices, such as living wills and  SPA's (special power of attorney for health care).  I confirmed that these patient-generated instructions are also honored  in Catholic medical facilities as wells.  

A patient who chooses to issue these orders and who has a family member at hand who will ensure compliance if they are ever needed is of course at an advantage. But even for the those expatriates whose next if kin, if any,  is thousands of miles away and not readily accessible to look after his / her wishes, an advance directive and / or DNR order if properly implemented can prevent needless suffering and depletion of the individual's  and / or family's finances resources.

For more information about these rights and how to ensure access to them, contact your physician or any hospital patient services / customer services department.

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