WASHINGTON -- The federal government may soon require hospitals and doctors to provide patients with information on living wills, documents that allow patients to stipulate when they want life-support systems turned off.
Critics warned that the move would result in government-sanctioned mercy killings, but supporters said it would help patients from being kept alive against their wishes.
A provision tucked away in a deficit-cutting bill approved early Saturday by the Senate Finance Committee would require hospitals and doctors participating in the Medicare program to ask patients whether they had signed a living will and offer information about the wills to interested adults.
Hospitals and doctors who did not comply with the requirement would not be able to treat Medicare patients, a major source of revenue for most health-care providers. Medicare is the federal health insurance program for 33 million elderly and disabled Americans.
Finance Committee aides said the provision, which still must be approved by the full House and Senate, was drafted in consultation with the Bush administration and was acceptable to administration officials.
Living will advocates predicted the federal directive would help millions of Americans who do not want to be kept alive by extraordinary means when there is little or no hope of recovery.
"We think it's a tremendous step
forward," said Shirley Neitlich, a spokeswoman for the Society for the Right to Die and Concern for Dying. "What it says is that people must be apprised of their rights to advance directives."
Public interest in living wills has surged since the Supreme Court ruling in June denying the family of Nancy Cruzan their request to have her feeding tube removed.
Doctors have said Ms. Cruzan is permanently unconscious and could live for years in her present condition.
But critics of living wills warned that they can be used to withhold medical treatment from patients who stand a chance of recovery. Critics predicted that if the provision becomes law, unsuspecting patients would sign the wills without fully understanding them.
"Somebody who is checking into the hospital and offered a living will to sign along with reams of other paper is likely to sign it without having the slightest idea of what is being signed," said Rita Marker, director of the International Anti-Euthanasia
Ms. Marker, who termed the Finance Committee provision "indescribably awful," said the government would be on the side of mercy killings if it promoted living wills to patients.
She and other critics questioned whether the government's main interest in living wills is as a cost-cutting device to reduce Medicare spending.
Laws recognizing living wills have been adopted in 41 states, according to Ms. Neitlich.