Monday, March 09, 2009

Duty to Die in Idaho! Legislature Close to Passing Futile Care Bill

The legislative process has become so overwhelming, that unless one hires a professional lobbying group to keep track, laws can pass quietly without any public attention at all.

That seems to be the case in Idaho, where the Senate has passed a Texas-style futile care bill. The bill is so bad, it permits doctors who want to refuse wanted treatment to violate a patient's written advance directive. From the bill, S. 1114, section 394504A (4):

If the ethics committee agrees with the attending physician that the treatment requested by the patient, the patient's advance directive or surrogate decision maker is medically inappropriate or futile, the attending physician and health care facility shall take reasonable action to assist the patient or surrogate decision maker to arrange the patient's transfer within fifteen (15) days to another health care provider selected by the patient or surrogate decision maker who is willing to assume the treatment of the patient. The health care facility shall provide reasonably necessary lifesustaining treatment within the capacity and capability of the health care facility until the patient is transferred or until the expiration of the fifteen (15) day period described above, whichever occurs first. Following the patient's transfer or upon expiration of the fifteen (15) day period described above, whichever occurs first, the attending physician and health care facility shall not be obligated to provide additional treatment that has been determined to be medically inappropriate or futile by the ethics committee. The patient or his surrogate decision maker shall remain responsible for the costs incurred in transferring the patient to another health care provider in addition to the cost of any health care provided prior to the transfer.
So what precisely is care deemed medically futile or inappropriate? The term isn't defined precisely, meaning it is what the doctors or ethics committees say it is.

But catch this part of the bill authorizing guardians to refuse or withhold life-sustaining treatment if:
The respondent is in a persistent vegetative state...which is irreversible and from which the respondent will never regain consciousness;(b) The respondent is chronically and irreversibly comatose; (c) The provision of such treatment would merely prolong dying, would not be effective in ameliorating or correcting all of the respondent’s lifethreatening conditions, or would otherwise be futile in terms of the survival of the respondent; or (d) The provision of such treatment would be virtually futile in terms of the survival of the respondent, and the treatment itself under such circumstances would be inhumane.
This idea of "prolonging the dying," used to be called extending life. If that is what the patient wants, it is the quintessential purpose of medicine! If this section of the bill is found to apply to the futile care portion of the proposal, imagine the possibilities to force the most weak and vulnerable out of the lifeboat. Duty to die--here we come!



At March 09, 2009 , Blogger Ianthe said...

Well there you go. Who SAYS the person will never regain consciousness, is in a permanent coma, a pvs, etc.? The doctors. Why do people BELIEVE them? Where do they get the NERVE? From people believing them. Because they are "trained professionals." Trained seals have more intelligence and character than they and those who accept what they say do. They are out of control and people who accept their word as gospel have no more critical reasoning ability than they do.

At March 10, 2009 , Blogger Ianthe said...

Prolonging "dying" is prolonging life, and showing respect for time. We (well, not all of us, but "we") lost respect for those around the same time news media felt entitled to ask and report people's ages.

I was wondering why Texas until it occurred to me that maybe the medical cost burden of illegal immigrants had had something to do with it. Maybe? Maybe not? I just wouldn't have expected it there. Does Idaho have a "cost" problem? Yes the wrong climate and/or topography can send people a little wacko but I still don't get it about those two states. Or Virginia, for that matter. Or any of them. The problem of course is what's happened to our culture, and the way doctors and medicine are now, and a whole bunch of people involved in "health care" who don't need to be but need jobs and are the real cause of "cost" problems. Sure they help drive the death train. They want their salaries. It's them we can do without. God forbid they should have to do actual work, though. Not that they would be competent at it. Oh there are a whole bunch of people I'd throw out of the country if I could, and let the rest of the world deal with them, just keep things in order here, and be an example to the world, but gee, that wouldn't be "nice," would it. That damned U.N. and the "culture of nice" that was behind it and has had far too much influence and the "one-world" approach are part of what have given us the death culture.

At March 10, 2009 , Blogger SAFEpres said...

Not again. There's so much crap that it's hard to keep up with. We should get the names of the politicians sponsoring this bill and campaign against their reelection, even if we don't live in Ohio.

At March 10, 2009 , Blogger ethx said...

You should note that, in the language authorizing guardians to withhold/withdraw treatment, sections B),C),and D),are taken almost exactly from the "Baby Doe" rules.This is probably designed to make it harder to challenge or overturn in court.

At March 11, 2009 , Blogger Ianthe said...

ethx: I think it's designed with that purpose in mind too. What are the "Baby Doe" rules, though?

At March 11, 2009 , Blogger SAFEpres said...

"baby doe" refers to a tragic 1982 case in which parents withheld simple surgery from their baby because she had down syndrome, thus causing her lungs to be digested by stomach acid while she was simultaneously starved. The court ruled that "right to privacy" gave these parents the right to withhold this surgery from the infant, even though she would have been able to live a completely normal life as a person with down syndrome if she had had the surgery. The parents were so crass that they wouldn't even name their baby, thus the name, "Baby Doe." The Reagan administration intervened in a similar 1983 case in which the child was also not given a name; because of their intervention, the baby survived and her parents were allowed to retain custody. But, laws that Reagan's administration passed forbidding that kind of discrimination against disabled infants in the medical and child protection fields was found unconstitutional on the grounds of privacy and struck down in 1987. The resulting rules governing such cases are now called "Baby Doe" rules.

At March 11, 2009 , Blogger SAFEpres said...

P.S. I forgot to mention that in the 1982 case, other couples came forward and offered to adopt the little girl. But, the parents wouldn't allow that, contributing to the restrictions placed on overturning such abusive parental actions in court.

At March 11, 2009 , Blogger SAFEpres said...

Wesley mentioned these cases in Final Exit and Culture of Death.

At March 13, 2009 , Blogger Cathy said...

Do not forget that both hospitals and insurance companies exist to make a profit. Hospitals do not want to be stuck with a huge uncollectible bill for end of life care for the uninsured; insurance companies don't want to pay for expensive end of life care for the insured. Denying that care will improve both their balance sheets a great deal. It is no surprise at all to me that these laws were passed in the reddest of red states. Republicans represent the interests of big business. Any time the corporate agenda and the conservative social agenda conflict, the Republicans choose the corporate agenda. It's not like passing this law will get Idaho to elect a Democratic majority to the state legislature. It was a no-lose proposition.

At March 13, 2009 , Blogger SAFEpres said...

If death is so great, than the doctors and legislators supporting this legislation can prove their point by going first!


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