H.R.647: Palliative Care and Hospice Education

A Review of H.R.647: Palliative Care and Hospice Education and Training Act

H.R.647: Palliative Care and Hospice Education and Training Act will serve as an amendment to the Public Health Service Act. It aims to increase the number of permanent faculty in palliative care at accredited medical schools and nursing schools, and social work schools (Palliative Care, 2019). It seeks to promote research and education in the sphere of palliative care and establish conditions that would contribute to the development of faculty careers in academic palliative medicine. According to the bill, the Department of Health and Human Services (HHS) will have to support Palliative Care and Hospice Education Centers and help them advance the training of palliative care professionals. Thanks to the legislation, these centers will be able to provide traineeships to people who want to receive advanced-education nursing degrees and social-work degrees in palliative care.

Background and Relevant Facts

Currently, palliative care training is often not integrated into curriculums of different medical and nursing schools or lacks substantial knowledge which would be applied by students in the future. According to some studies, many students claim that they do not consider themselves prepared to provide their clients with end-of-life care and express a desire to be taught with the help of experiential methods such as role-playing (Alt-Gehrman, 2019).

Li et al. (2019) demonstrated that end-of-life training for nursing students significantly increased the level of competency of such students who, after completing the course, reported that they were prepared for providing palliative care after graduation. The legislation will address the existing lack of knowledge among nursing students by integrating palliative care training into curricula and awarding grants to those who wish to further their expertise in end-of-life care.

History of the Legislation

This piece of legislation has been promoted by major palliative care advocacy groups for more than six years with the intent to expand the existing end-of-life training and hospice education in nursing schools. Initially, the act was introduced in 2017 and was titled H.R.1676 – Palliative Care and Hospice Education and Training Act (Palliative Care, 2017). It was expected that the bill would become law in 2018, but after being passed in the House of Representatives, it was then stalled at the Committee on Health, Education, Labor, and Pensions.

The stalling was a result of some senators’ misunderstanding of the bill’s purpose since they perceived it as a way to promote medical assistance in dying (Stone, 2019). Currently, the situation is similar, the new version of the bill was passed in the House in October of 2019. Later, it was sent to the Senate and then referred to the aforementioned committee, where it was once again put on hold. It is unclear what the exact reasons behind the stalling now are, but it is possible to suggest that some senators are influenced by activists who believe that the bill will legalize assisted dying.

Support and Opposition

The main supporters of the legislation are advocacy groups such as the Oncology Nursing Society, which are interested in promoting palliative care training among nursing students. The supporters of the bill believe that there is an existing demand for skilled professionals in the sphere of palliative care, and ensuring better education for them will considerably increase the number of such people.

Among those who oppose this bill are different activists who claim that palliative care is a good concept, which in practice leads to poor services and imposed death (Grimstad & Caranica, 2020). These people believe that adopting legislation that would expand training and increase funding for palliative care faculty will lead to the promotion of euthanasia. Thus, such individuals oppose the bill fearing that its consequences will be detrimental to the health of clients of palliative care professionals.


The main stakeholders in the bill are patients with serious illnesses who will considerably benefit from this legislation since they will be able to receive better services. If the bill becomes a law, nursing students will have an opportunity to undergo advanced palliative care training, which will develop their professional skills and allow them to better assist their clients. Clinics and hospices will similarly profit from more experienced and prepared professionals who will provide exceptional services to the patients based on the latest research.

It is hard to define any stakeholders to which passing the bill will bring disadvantages since its main goal is positive and beneficial for every party involved. Nevertheless, the segments of society who believe that palliative care is a premise of euthanasia will suffer if the bill becomes a law.

The Impact on Nurses

The bill will positively affect nurses’ ability to provide quality care because it will offer them an opportunity to become educated in providing palliative care in hospital, educational, home, and hospice settings. The training will allow them to gain a deep insight into the latest and most advanced palliative care practices, which they will be able to successfully implement in their practice. Completing the training will make them better professionals and increase their value as employees at their facilities. The bill will fund positions of palliative care faculty members who will be able to focus on research in this sphere and develop new methods for providing better care, which nurses will adopt at work.

Assisting the Passage or Defeat of the Bill

Nurses who are willing to participate in the process of passing or defeating this bill can directly notify their legislators about their ideas. They can write a letter to them and describe their thoughts concerning the palliative care legislation and provide possible changes that they would like to introduce to the existing document. Also, nurses can raise awareness about the bill using their social media, where they can write a post supporting or opposing the bill.


Alt-Gehrman, P. A. (2018). Qualitative exploration of the perceptions of nursing undergraduates regarding family care at end-of-life [Unpublished doctoral dissertation]. Marquette University.

Grimstad, J., & Caranica, I. (2020). Palliative care: A pathway to imposed death. Web.

Li, J., Smothers, A., Fang, W., & Borland, M. (2019). Undergraduate nursing students’ perception of end-of-life care education placement in the nursing curriculum. Journal of Hospice & Palliative Nursing, 21(5), 12–18. Web.

Palliative Care and Hospice Education and Training Act, H.R. 1676, 115th Cong. (2017). Web.

Palliative Care and Hospice Education and Training Act, H.R. 647, 116th Cong. (2019). Web.

Stone, A. (2019). . ONS Voice. Web.

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