Policies on medical decisions concerning the end of life in Dutch health care institutions
Article Abstract:
Many Dutch hospitals and nursing homes have written policies for euthanasia and physician-assisted suicide (EAS), but not for other medical decisions at the end of life such as withholding medical treatment and do-not-resuscitate orders. Researchers sent questionnaires on this topic to 558 health care institutions in the Netherlands, and 480 responded. Seventy-percent of hospitals, 74% of nursing homes and 16% of homes for the disabled had written EAS policies. Those that didn't cited the physician's responsibility for these decisions as the primary reason. Many stated that they wanted to develop such policies in the future. Fewer institutions had written policies on terminating life without request, because this action would never be possible. Sixty percent of hospitals, 35% of nursing homes and 17% of homes for the disabled had guidelines for one or more of the following end-of-life actions: treatment refusal by the patient, withholding treatment, pain control or do-not-resuscitate orders. Most did not have guidelines for all four of these actions.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1996
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Health USA: A national health program for the United States
Article Abstract:
The Health USA Act of 1991 would reform health care financing by creating state health programs that would receive over 80% of their funding from the federal government. Individuals and families could enroll in any health plan approved by the state or in the state health plan. The state program would pay hospitals and health plans directly. The health plans would then pay the healthcare providers. All US residents would receive comprehensive medical, preventive and long-term-care benefits. Coverage would no longer be connected to employment, giving residents continuous coverage even if they lose their jobs. Health USA would cost an estimated $479 billion in 1991, but would reduce total national health spending by $11.5 billion, mostly through reductions in administrative and health services costs.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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