It’s time to support sensible and sensitive measures for the terminally ill.

Americans are a death-denying society, held in the sway of a medical-industrial complex that too often believes there is one more treatment option to pursue regardless of cost or quality of life, an ingrained phobia against even discussing the topic, or because it is too painful to contemplate one’s end. We are encouraged to plan for our final days, and to execute advance directives to insure that our wishes are honored, yet only 26 percent of us actually do.

When the authors of the Affordable Care Act proposed to provide Medicare reimbursement to doctors for time spent discussing end-of-life options with their patients, opponents screamed “death panels” and the provision was eliminated.

Fortunately the cultural conversation may be changing.

Last year the prestigious Institute of Medicine issued a report entitled “Dying in America,” concluding that our system for handling end-of-life care is gravely deficient and should be overhauled at almost every level. Baby boomers caring for elderly parents, and aging spouses facing the loss of their partners are witnessing how badly things can go when they have never discussed what their loved ones want at the end of their lives. The survivors have been writing heart-breaking accounts of their struggles against the inertia of high-tech medicine.

Spurred by this public discussion and the writings of such visionary physicians as Harvard’s Atul Gawande, whose recent book, Being Mortal, is a New York Times bestseller, health care institutions all over the country are considering significant steps toward a more humane approach to the treatment of those approaching life’s end. Palliative care, whose goal is the relief of pain and anxiety throughout the cycle of illness, though not yet routinely taught in medical schools, has become a recognized subspecialty. Here in Monterey County, CHOMP and Salinas Valley Memorial Hospital offer excellent palliative care.

THE SURVIVORS HAVE BEEN WRITING HEART-BREAKING ACCOUNTS.

Similar recognition has been awarded to the hospice movement, which seeks to provide patients with less than six months to live with a pain-free, home or home-like alternative to the hospital environment few would have chosen if their wishes were honored.

These advances are vitally important, as they represent two legs of the three-legged stool that supports a humane approach to end-of-life care. But there is another, equally essential leg that is not currently available in California: medical aid in dying for the terminally ill. As admirable and effective as they are, neither palliative care nor hospice may be sufficient to guarantee a peaceful departure. Citizens in five other states have assurance that if they have less than six months to live and do not want to die in great pain or a drug-induced coma, subjecting their families to horrific memories of their last days, they can take control of the their deaths by availing themselves of a “Death with Dignity” law. The time has come for our state to respect the autonomy of the dying and afford them this option.

SUSAN MEISTER is a writer specializing in health care issues and a resident of Pebble Beach.