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!
