West Palm Beach Doctor Gail Austin Cooney tells Senate how to improve health care

WASHINGTON – Gail Austin Cooney was diagnosed with stage 3 ovarian cancer in 2008, but the West Palm Beach resident had a few things in her favor.

First, she is a doctor. Second, her specialty is hospice and palliative medicine – a holistic approach to treatment that focuses on minimizing discomfort and stress, providing education and giving emotional and psychological support. In fact, she had just created a palliative care program at Sari Center , a local cancer institute. She was one of first patients in her own program.

Cooney, 59, now in remission, is an associate medical director at the Hospice of Palm Beach County . She and three other witnesses spoke Wednesday at a Senate committee hearing about how to improve health care for individuals, especially the elderly, with advanced illnesses. Cooney talked about her experience with palliative care and why it should be a more prominent part of modern health care.

"The key message is that palliative care puts a focus on quality of life while pursuing curative treatments," she told senators on the Special Committee on Aging. "As difficult as my experience was … I had access to superb palliative care, and I knew to ask for it. Most people don't know to ask."

The senators and witnesses discussed the importance of clear communication between health care providers, supplementary treatment such as palliative or hospice care and informed end-of-life planning.

"I have had the experience of loved ones dying with great dignity and without pain and in

a manner consistent with their own wishes," said Sen. Sheldon Whitehouse, D-R.I., who chaired the hearing. "I've also had the experience of loved ones dying with treatment being administered against their will. The machinery of health care took over and trampled what she wanted."

Albert Gutierrez, president and CEO of Saint Joseph Regional Medical Center in Mishawaka, Ind., said older individuals should have the "difficult conversation" with their family or doctor while they are healthy to decide what kind of treatment they want during a serious illness or at the end of their lives.

In 2009, Democratic representatives proposed legislation to support end-of-life planning for Medicare patients. The legislation was shot down by some conservatives who said end-of-life planning would encourage elderly patients to forgo medical treatment.

"There's a huge capacity for misunderstanding in this area. The trick here is to avoid misunderstanding and find areas that are important where we can agree to go forward," Whitehouse said.

The next step for the committee is to determine which issues are most important and could garner bipartisan support, Whitehouse said. It is possible to pass legislation within the next year.

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