June 24, 2009: Obama Says Medical Costs Can Be Trimmed by Cessation of Unwanted ‘Extraordinary Measures’ for Terminally Ill Patients

President Obama, in a televised “town hall” event held in the White House to discuss health care reform, suggests that one way to trim medical costs might be to cease performing expensive and futile treatments—“extraordinary measures”—on terminally ill patients who do not want such interventions and would not benefit from them. Currently, doctors who have no particular instructions will perform “extraordinary measures” to stave off a terminally ill patient’s death, even for a matter of hours, no matter how intrusive or expensive the procedure. Obama tells his listeners that families need better information so they don’t unthinkingly approve “additional tests or additional drugs that the evidence shows is not necessarily going to improve care.” In some instances, he says, “Maybe you’re better off not having the surgery, but taking the painkiller.” He notes the experience of his recently deceased grandmother, Madelyn Dunham, was diagnosed with terminal cancer and given less than nine months to live. When she broke her hip, she and her family had to decide whether to put her through a long, expensive, and painful hip-replacement procedure. “[A]nd the question was, does she get hip replacement surgery, even though she was fragile enough they were not sure how long she would last?” he says. [Los Angeles Times, 6/25/2009] Obama is not advocating that life-extending treatments be forcibly denied to terminally ill or elderly patients (see July 23, 2009 and July 23, 2009), but his remarks will be misconstrued as advocating just such a position (see June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23-24, 2009, and July 24, 2009, July 28, 2009, July 28, 2009, July 28, 2009, July 31, 2009 - August 12, 2009, August 7, 2009, August 10, 2009, Shortly Before August 10, 2009, August 11, 2009, and August 12, 2009).