No Health Reform Plan Features Major Medicare Changes

Jerald Winakur, MD, a geriatrician, who also teaches at the Center for Medical Humanities and Ethics at the University of Texas Health Science Center at San Antonio, said none of the proposals are suggesting that "doctors substitute advance care planning for medical care."

"No one is proposing death panels or outside experts to decide who lives and dies. I would not be a part of such a system nor would any physician I know," he said.

But of the flip side, "any system that refuses to reward the work of healthcare professionals for doing advance care planning and conferencing with families during difficult times is pre-ordained to be cold and bureaucratic, sterile, and unempathetic," Winakur said. "It will subject our frail elderly and anyone who finds him or herself with an end-stage disease at the end of their lives to inappropriate, unnecessarily expensive, and possible futile care."