MY FAVORITE IDAHO IS ABOUT TO JOIN NEIGHBORING OREGON IN ITS CULTURE OF DEATH - IF ONLY THOSE CALIFORNIANS WOULD STOP MIGRATING TO NEIGHBORING STATES

The sinking ship Titanic


Someone on this lifeboat needs to die so that there is a better
chance the others will live; we are all in the lifeboat known
as the world. Who will it be?

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!

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I have looked more closely at the awful Idaho futile care bill, S 1114, which I first addressed earlier today. Here are two more extremely objectionable clauses that show the intent to create a duty to die for the most infirm--and expensive for which to care--among us. From section
394504A (6) of the bill:

If an ethics committee has determined that the requested treatment is medically inappropriate or futile, but the patient is later readmitted to the health care facility within six (6) months following such ethics committee determination, the attending physician may rely on the prior ethics committee determination and withhold or withdraw treatment consistent with the prior ethics committee determination if the attending physician and one (1) physician member of the ethics committee determine that the patient's condition either has not improved or has deteriorated since the prior ethics committee determination and that the prior ethics committee determination still applies to the patient's condition, and they document their conclusion in the medical chart.

Thank about that! If a patient survived five or six months post ethics committee meeting declaring futility, doesn't it prove the committee was wrong?

But don't worry: The due-process-of-law-denying ethics committee process itself is a sham: It isn't even mandatory:

(8) The ethics committee review as provided in this section shall be purely voluntary. Nothing in this chapter shall require a health care facility to establish or utilize an ethics committee, nor shall this chapter require a health care provider or surrogate decision maker to submit a matter to the ethics committee before withdrawing or withholding health care to a patient.

I guess that means the doctor has the right to just say no based on his or her own biases regarding the "quality" of a patient's life!

Doctors should not have the right to decide whose life is worth living. As German physician Christoph Wilhelm Hufeland stated back in 1806, which I quoted in Forced Exit:

It is not up to [the doctor] whether...life is happy or unhappy, worthwhile or not, and should he incorporate these perspectives into his trade...the doctor could well become the most dangerous person in the state.

That was true then, and it is true now. We give physicians the literal power over life and death at each of our perils.