The John D. Thompson Hospice Institute for Education, Training and Research, Inc.
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State Leadership Perspective


     One of the mainstays of our inalienable rights in this country is the "right to choose." The application of this right to health-care choice was clearly evidenced in 1990 when the U.S. Congress adopted the Patient Self-Determination Act requiring all providers of health care in all settings to query patients as to whether or not they had executed advance directives pertaining to their health care, particularly the withholding or withdrawing of life-sustaining treatment. This right has been reinforced in Connecticut by our Living Will statute.2

     The PAL Partners takes the next step in protecting and preserving choice and access to care for those who may face am irreversible illness. Attorney General Blumenthal, through the administrative process, has created a new opportunity for our citizens to choose how they wish to be cared for if faced with irreversible illness.

     Those who receive a diagnosis of am irreversible illness will, be devastated by the news. Not only is the afflicted person torn apart, but his or her family becomes an integral part not only of the devastation, but of the decision making that must begin from the point of diagnosis. It is important

SENATOR GEORGE L. "DOC" GUNTHER, N.D., 21st Senatorial District, Deputy Minority Leader, currently serving his 16th term. A retired Naturopathic physician, "Doc" has served on the Public Health Committee since he arrived in the Senate in 1967, serving twice as Senate Chairman. He currently is Ranking Member. Other committees he currently serves on are Regulation Review (Ranking Member) and Legislative Management. He also is Co-Chair of the Bi-State Long Island Sound Committee and is a Commissioner on the Atlantic States Marine Fisheries Commission. SENATOR TONI HARP, 10th Senatorial District, currently serving her third term as the Connecticut State Senator from the 10th Senatorial District towns of New Haven and West Haven. She is currently serving as an Assistant Senate Majority Leader and the Chair of the Legislature's Public Health Committee Also appointed the Vice-Chair of the Appropriations Committee, Chair of the Appropriations Committee's Health and Hospitals subcommittee, and a member of both the Executive and Legislative Nominations and Commerce Committees. She also chairs the Medicaid Managed Care Council.

that when we are in good health, and calmer minds prevail, we have the opportunity to think about the possibility of such events, and to decide, before we have to, what course of action we would want followed. Many of us do this when we complete our wills and living wills. The PAL initiative makes us aware of the opportunity to receive palliative and hospice care so that in the process of putting our advance directives in order we can also express our choices with regard to the penultimate chapter of our lives, not just the last chapter.

      As members of Connecticut's legislature, we are proud to support this endeavor. The State of Connecticut is the home of the first hospice in the United States. The Connecticut legislature was integral to the funding that supported an important "new" model of health care, hospice, that then swept the nation and has been replicated in all 50 states in a similar fashion, through the PAL Partners initiative those who champion the interests of the patients and their families facing irreversible illness will be encouraged to replicate the PAL initiative across the country.

      Connecticut's leadership role in PAL must now take the form of funding initiatives to educate and train health-care providers with regard to the implications and implementation of physician assisted living programs. As with other advance directives, providers will be the pivot point from which consumers will receive the information critical to their decision-making it is essential that providers be fully versed in the tenets of hospice care, the identification of individual need for hospice, and the means for insuring that each and every patient and family who needs and desires hospice services will receive them.


1.The Patient Self-Determination Act was signed into law as part of

the Omnibus Budget Reconciliation Act of 1990 (OBRA, 1990).

2.Conn. Gen. Statutes Section 19a-575 et seq.

The Hospice Institute for Education, Training and Research, Inc.
100 Double Beach Road
Branford, CT 06405