Medicare’s July 8 decision to pay physicians to counsel their patients on end-of-life care should not be voluntary but mandatory, for if this decision is put off to the end or near end, a patient may not be and often is not capable of making a rational choice.

There are few people who would not prefer a quick and painless end. The case is most important for those who end up with Alzheimer’s or other mind-altering conditions.

Philip Thompson, M.D.

Portland

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