Friday, September 5, 2008

Bill AB 2747 Immediate Action Required!

Bad Medicine
By Brian Johnston

AB 2747 appears, at first blush, to have a lot of diverse options made available to vulnerable patients. But a more careful reading and understanding of its origins and its "implementation plan," gives one pause.

AB 2747 was sponsored by 'Compassion in Choices' the new name for the Hemlock Society, America's leading 'right to die' organization. Hemlock changed its name, in part, because of the unsavory "death promotions" of some of its founders.

It is important to understand that the right to die movement seeks to promote its philosophy of "death as the answer" for emotionally vulnerable patients in a variety of situations. Incapacity, impairment, or when emotionally devastated by terminal prognosis; in general, if someone 'wants to die' who are we to stop them?

This philosophy is most clearly seen in a little known, but deadly aspect of California law. The legality of committing suicide by ceasing to eat or drink has been established in California (Bouvia Decision) and this "right" has explicitly been extended to those who are not in any way terminal. Liz Bouvia herself, a quadriplegic, is still alive, although the case, based on an episode of suicidal depression, is 20 years old. One of the most important aspects of the case is that it requires physicians who do not agree with the suicidal action to abet the suicide anyway.

Which brings us to AB 2747. Much of what this bill mandates will actually be carried out in the thousands of 'long-term care homes' and various other "health care facilities" that do not have on-site physicians. (Section 442.5) In this case the medical director of the facility is ordered to call in "community-based organizations that specialize in end-of-life care case management"... to fulfill the law. Note that the mysterious organizations described do not provide health care, but "end of life case management." Sounds suspiciously like "Compassion in Choices,' doesn't it? After all they have one specialty in this kind of "case management" - close the case.

And what is the actual law to be fulfilled? The patient must to be told of their legal options.

"Mandatory" counseling, but not in writing.

Now, as I said, AB 2747 has a lot of other words in it. And many of those words are things that you and I would want to hear should we be in such emotionally vulnerable condition: "Palliative care;" "hospice care;" "disease-targeted treatment." It is suggested that the advice will be 'comprehensive.' Amazingly, it is not required that any of these other options be in writing. Yet 'knowing what's legal' will now be the only mandatory legal requirement for ALL patients with any type of terminal diagnosis in the state of California. And the principal counselors will apparently be a private death-specialty organization.

Good doctors didn't want to do this. California's oncologists opposed the bill until an amendment lifted the burden to 'read their rights' to vulnerable patients off of the oncologist's shoulders.

So, the only legal requirement is that the patient must be told all their 'legal' options. If the actual health-care provider thinks that spelling out the law is not what is needed at the time, they are required to transfer the patient to someone who will push "the legal option.'

So who will do this 'counseling?' As in most other jurisdictions which allow suicide to be abetted, the patient is required to be directed to an indefinite, shadowy group who, "specialize in end-of-life case management."

And for those patients, the case is closed.

AB 2747 is on the Governor’s desk

Ask Governor Schwarzenegger to VETO this bill NOW
Call: (916) 445-2841 FAX (916) 558-3160

Brian Johnston is director of the CPLC. Formerly Commissioner on Aging for the State of California, he has served on the state’s Board of Examiners of Nursing Homes, and the Board of Directors of the National Legal Center for the Medically Dependent and Disabled. He is author of the book Death As A Salesman: What’s Wrong With Assisted Suicide.

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