If the title to this post sounds familiar, it should. Not for the first time, a “Death With Dignity” bill is being considered by the legislature. On the face of it, it’s still a bill that would restrict “eligibility” for getting lethal doses in order to commit suicide to people with “terminal conditions.” But when you get into the actual definition, it’s clear that the sponsors of this bill want “terminal condition” to mean something other than what the rest of us mean.
This comes as no shock. This expansive bill has been introduced several times by assisted suicide zealots in the New Hampshire legislature over the past few years. Here’s what I wrote back in 2009 regarding the bill introduced that year – which looks to be identical to one introduced this year:
Definition of “terminal condition”:
XIII. “Terminal condition” means an incurable and irreversible condition, for the end stage of which there is no known treatment which will alter its course to death, and which, in the opinion of the attending physician and consulting physician competent in that disease category, will result in premature death.
Read that definition carefully, terminality is defined as having a condition that is irreversible and will result in a premature death. My partner would fit that definition. Many people I work with also fit the definition.
None of them are dying.
Keep in mind that this definition is to be used only in terms of eligibility for assisted suicide. It doesn’t, for example, apply to hospice services which are limited by federal rules to those who are deemed as having six months or less to live.
So, no guarantee of palliative care for people with significant disabilities or conditions, unless they’re thought to be close to death. That would be expensive.
OTOH, this bill would offer help with easy and successful suicide for anyone with a serious, significant, potentially life-shortening condition/disability at any time at all.
So, no guarantee of medical support to make life easier, but a “hand out” to those who want to die, even if they’re not dying.
I don’t think this can be written off as just sloppy wording. The sponsors involved are legislators, and if we assume competence on their parts, then we can also assume that they are fully aware of the importance of the specific definitions used in a bill when it comes to applying it in the real world as law.
Make no mistake. This bill, if passed, will guarantee an easy suicide to just about any person with diagnoses of quadriplegia, spinal muscular atrophy, HIV/AIDS, and many other conditions disabilities. Nothing to help people who could have many happy years with the right supports – just an easy and cheap out.
There’s a Judiciary Committee hearing on the bill February 4th. It looks like an attempt to fast track this and not only get a vote that legalizes assisted suicide, but opens the doors to anyone with a significant disability or chronic condition defined as “eligible.” It looks like we’re in a new “pushing the envelope” phase in the incrementalist/slippery slope strategy of the assisted suicide lobby in the U.S.
Here’s a link to the current bill.
Yes! Steven Drake! This is frightening as the definition of “terminal” in this proposed law allows the indiscriminate “sorting” of patients whose deaths will be hastened by the treating physician and the consulting physician and the hospitals for the fiscal expediency of the hospital. There is already an epidemic of Hospitals buying up the practices of physicians who then become employees of the hospitals which means that both patients and physicians are losing their autonomy over life and death decisions and Medicare/big insurance and Big Hospitals will bargain over what will be covered under Medicare insurance. .
It looks like this proposed law is designed to remove the autonomy from the patient and to give the physicians and hospitals the autonomy and legal cover to place unilateral DNR Code Status into the medical charts of the patients based solely upon their unilateral decision of two physicians that any further medical treatment is medically futile. Patients will lose their right to give informed consent to the shortening of their lives. .
Obviously, the “sorting” will depend on whether or not the “indicated treatments” of these “terminal” patients will be reimbursed to the hospitals/physicians by Medicare and their partners, big insurance.
Medicare and their private partners, Big Insurance, have NOT been reimbursing for non beneficial over treatments of the elderly/disabled, mistakes, errors, exceeding the Diagnosis Related Group Cap for the disease/cancer, and any complications thereof for many years now. The Unilateral Covert and Overt(default) DNR code status that is now epidemic has permitted hospitals to limit or withhold life-extending and life-saving treatments that they KNOW will not be reimbursed under existing Medicare and Private Insurance reimbursement protocols.
It is Medicare and Big Insurance who is really deciding what is medically futile and therefore, fiscally futile, for the hospitals and clinics and covert rationing of treatments by the hospitals with unilateral covert and overt(default) DNR code status has been a reality for many years.
This proposed bill would settle the “medical futility” question and unilateral DNR Code Status would be legalized, wouldn’t it?
Really bad news for the disabled and the elderly on Medicare/Medicaid. It looks like the involuntary euthanasia of the elderly and the disabled that is now hidden from view will become transparent and defended as public policy that serves the greatest good for our for-profit health care system.
When I worked in Germany for the Department of the Army in the late 40’s and was sent on temporary duty to work for a Judge Advocate Attorney who was reviewing “war crimes” cases, I was so proud of my country —so sure that my beloved country would NEVER engage in crimes against humanity. Now! I’m not so sure! I believe that it is a crime to shorten or attempt to shorten a competent patient’s life without his/her informed consent unless “medical futility” is proven under some “due process procedure” that is recognized in state law. . .
It looks like the concept of “managed care” is only possible when terms like “medically futile” and “terminal” are defined by Medicare and Medicaid AND their private partner, big INSURANCE while the public debate over what defines “terminal” and “medical futility” continues to hide actual practices such as the involuntary euthanasia of the elderly and the disabled and the poor to preserve the private profits of big insurance and big hospital. This is done by means of unilateral covert and overt(default) DNR Code status that is extrapolated into the medical charts of the elderly, the disabled, and the poor.
RATIONING has been going on for many years and is manifested in the form of reimbursement protocols developed by Medicare/Medicaid, as influenced by their senior partner, Big Insurance, that, in reality, have for many years been RATIONING treatments for the elderly, the disabled, and the poor to protect the profits of the for-profit sector of our healthcare industry that is dominated by the private insurance sector. Both political parties are complicit in this arrangement and won’t tell on each other because they have allowed BIG private interests to invade the people’s Medicare/Medicaid Purse. .
However, it is the Republicans who appear to be working to make sure that PRIVATE Insurance will continue to have access to the Public Purse of Medicare and Medicaid, the people’s social programs and safety nets for the elderly, the disabled, and the poor. .
In today’s Kansas City Star, there is an article on the first page entitled “Advocates for disabled dread KanCare move” that questions whether private insurance under KanCare will cut services (for the profit motive) to the physically and the developmentally disabled patients who will be covered by private insurance instead of Medicaid? The Kansas City Star reports that this is Gov. Sam Brownback’s signature man aged health care program for Medicaid consumers.
The unilateral DNR, covert and overt(default), is a direct response by the for-profit and the not for profit hospitals to the reimbursement protocols that hastens death and shortens life for fiscal expediency of the insurance company, the hospital, and state and federal government without the informed consent of the patients. Unilateral DNRs are seldom discovered because of course, by design, there are no legal mandated procedural protections for patients against the informal placement of “DNR” in their medical/hospital charts.
Only Missouri, as a result of the Nancy Cruzan case, requires that there be two signatures as witnesses to the DNR placed in the hospital chart but Missouri has not enforced this law since the 1991 PSDA and has apparently surrendered to the under-the-radar public policy that defines unilateral DNRs as merely ethics violations or “clerical” errors for which there is no private right of action available or no prosecution of the unilateral DNR as a crime. The patient is generally already dead or on Hospice and the matter is moot for patient and for the survivors, who have no legal recourse (as intended).
It has been over a year since I complained to The Missouri Attorney General’s Office by way of my complaints to the Kansas City Police Department that the unilateral DNR in my husband’s hospital chart constituted “elder abuse” under Missouri law. I have received no official response to my complaints under the signature of the counsel for the Department of Health and Human Services or from the Office of the Attorney General. . .