As an intern admitting emergency-room patients to a Cincinnati hospital, I saw it happen again and again: Late-stage cancer patients in the midst of medical crises would roll into our ER in need of a ventilator as expected complications mounted. We would ask for their advance directives, who had their power of attorney, and whether they had considered "do not resuscitate" orders or hospice. Too often, these concepts were unfamiliar, even for patients who had been undergoing cancer treatments for months or years. If it ever makes its way out of Congress, a bipartisan bill introduced this month in the Senate Finance Committee would correct some of the structural problems that lead to this sad and costly phenomenon.
