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1 AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES

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4 Resolution: 8
5 (A-09)
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7Introduced by: Texas Delegation
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9Subject: Registry for Advance Directives
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11Referred to: Reference Committee on Amendments to Constitution and Bylaws
12 (Daniel W. Van Heeckeren, MD, Chair)
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15Whereas, End of life is an emotional and expensive period for many patients and their families;
16and
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18Whereas, End-of-life care is often not only the most expensive health care given to a patient
19during their lifetime but, in many cases, also the most futile; and
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21Whereas, Many patients would not submit to certain levels of end-of-life care if they were
22capable of deciding for themselves and were given the choice; and
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24Whereas, Advance directives give patients the ability to choose the level of care they wish to
25receive at the end of their lives; and
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27Whereas, Advance directives are often not accessible to families and health care professionals
28when needed, such as in the case of accidents or emergent situations; and
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30Whereas, A central registry of advance directives, accessible by health care professionals,
31would facilitate families and health professionals being made aware of a patient’s directives and
32allow the patient’s preferences for end-of-life care to be respected; and
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34Whereas, Medicare, as the insurer for the majority of elderly in our country, would be a logical
35agency to administer a national registry of its enrollees’ advance directives, which could be
36verified in a manner similar to verifying their insurance coverage; therefore be it
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38RESOLVED, That our American Medical Association support establishment of an advance
39directive registry by the Centers for Medicare & Medicaid Services (CMS) for all Medicare
40patients, to be maintained by CMS in a manner that would make it accessible for verification by
41health care professionals (Directive to Take Action); and be it further
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43RESOLVED, That our AMA support a CMS requirement for all Medicare patients to register the
44advance directive of their choice to facilitate and respect their end-of-life preferences. (Directive
45to Take Action)
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47Fiscal Note: Staff cost estimated at less than $500 to implement.
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49Received: 05/06/09
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 3 Resolution: 8 (A-09)
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1RELEVANT AMA POLICY
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3D-330.938 Advance Health Care Directives to Medicare Enrollees
4Our AMA will work with the Centers for Medicare and Medicaid Services to use the Medicare
5enrollment process as an opportunity for patients to receive information about advance health
6care directives. (Res. 8, A-06)
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8D-440.948 Advance Directive
9Our AMA will work with members of Congress to develop incentives to individuals who prepare
10advance directives consistent with our current AMA policies and legislative priorities on advance
11directives. (Res. 922, I-07)
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13H-140.946 Advance Directive for Each Nursing Home Resident
14The AMA encourages nursing homes to discuss with resident patients or their health care
15surrogates/decision maker as appropriate, a care plan including advance directives, and to have
16on file such care plans including advance directives; and that when a nursing home resident
17patient's advance directive is on file with the nursing home, that advance directive shall
18accompany the resident patient upon transfer to another facility. (Sub. Res. 229, A-97; Reaffirm:
19Res. 3, A-99; Reaffirmed: BOT Rep. 9, A-08)
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21D-85.997 Lessons Learned from Terri Schiavo
221. Our AMA will communicate with key health insurance organizations, both private and public,
23to encourage them and their institutional members to include information regarding advance
24directives and related forms and will also communicate with state Departments of Motor
25Vehicles to recommend the distribution of information about advance directives to individuals
26obtaining or renewing a driver’s license. 2. Our AMA Ethics Resource Center will update its web
27content regarding advance directives, including links to other appropriate resources with
28permission from the relevant organizations. (BOT Rep. 22, A-06)
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30D-140.968 Standardized Advance Directives
31Our AMA will endorse the "Uniform Health-Care Decisions Act," which was drafted and adopted
32by the National Conference of Commissioners on Uniform State Laws (NCCUSL) in 1993, and
33work with our state medical societies to advocate for its adoption in the states. (BOT Action in
34response to referred for decision Res. 220, A-07)