Monday, February 15, 2016

Colorado assisted suicide bill should be defeated.

This article was written by Jennifer Ballentine and published in the Denver Post on Feb 13, 2016.

Jennifer Ballentine is vice president of Hospice Analytics in Colorado Springs.

Jennifer Ballentine
Colorado's legislators should be commended for hearing many hours of open testimony on the controversial End-of-Life Options Act (House Bill 1054), which would legalize physician-assisted death. At the end of the second hearing earlier this month, amendments were adopted to address concerns.

After all the wordsmithing and window-dressing, however, the amended bill still does not address the biggest problem of all, one that should worry both supporters and opponents of physician-assisted death.

In a nutshell: Although the bill lays out specific eligibility requirements and a detailed process by which people may request and receive life-ending drugs, the bill completely lacks any requirement for documentation, oversight, or enforcement.

Quite simply, all the so-called "safeguards" in the bill are a fairy tale.

Without documentation, processes can be sidestepped or skipped altogether. Without enforcement, protection is meaningless. Without reporting, no one can know whether the law has been used appropriately, misused, or even abused.

This is a significant change from last year's bill and a complete break with other enacted laws governing physician-assisted death.

In other legislation and laws, the doctor must document the process in the patient's medical record.

Not in this year's bill.

In other legislation and laws, the doctor is required to submit two brief checklists to the state health department, affirming that the process was followed.

Not in this year's bill.

In other legislation and laws, the state health department is charged with developing regulations for clear compliance with the law, reviewing a "sample" of the doctors' checklists, and publishing a public report on use of the law.

Not in this year's bill.

In other legislation and laws, a dispensing record for the lethal prescription must be filed with the state, creating an opportunity for retrieving unused deadly drugs from the community.

Not in this year's bill.

Last year's bill required that a death from prescribed lethal drugs under this law — likely taking place at the patient's home with no doctor in attendance — be reported to the coroner. (In most Colorado jurisdictions, all deaths at home without doctor attendance are already reportable.)

The coroner would then confirm with the person's doctor that the process under the law was followed. If so, no further investigation or autopsy would be required. While this coroner confirmation was absurdly light, it at least provided a chance for some third-party scrutiny and a potential deterrent to anyone inclined to abuse the law.

Not in this year's bill.

This year's bill allows the attending doctor — who has presided over the entire process and "ensured" all safeguards have been observed — to "certify" in some undefined way that the death occurred in accordance with the law.

Think about this: It's like asking a security guard — who could be very conscientious and alert but also could be sound asleep, hanging with friends, or handing the burglars the keys — to "certify" that the building and all its occupants and valuables are safe, so who needs those pesky cameras or logs of door checks or any supervision by the office manager?

In many meetings over the past two years in Colorado, advocates for physician-assisted death have cited the "evidence" from the public reports in Oregon as "proof" that the law is working, there is no misuse or abuse, all is well. But this bill, should it pass in Colorado, will rob everyone of any way to know for sure what is happening.

The only possible explanation for this frightening negligence is that the sponsors, in a tight budget year, wish to avoid any financial cost to the state. It is disappointing to see the safety of patients, doctors, healthcare providers, and communities put at risk by political expedience.

Whether you think physician-assisted death is good or bad, this bill is bad, and should be defeated.

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