Oklahoma Bans ‘Quality of Life’ Health-Care Rationing

This article was published by National Review online on May 26, 2020

By Wesley J Smith

Wesley Smith

As many in the bioethics movement push various schemes to ration health care based on “quality of life” — such as the odious QALY (quality adjusted life year) system beloved of the New England Journal of Medicine — some are pushing back and insisting that health-care coverage and treatment public policy be predicated on the intrinsic equal dignity and moral worth of all patients.

Toward that end, Oklahoma’s governor just signed into law a bill that outlaws such invidious and bigoted discrimination. From HB 2587:

The Legislature finds and declares that:

1. Physical and mental disabilities, age or chronic illness should in no way diminish a person’s right to life, human dignity and equal access to medical care;
2. Historically, persons with disabilities, advanced age or chronic illness have faced discrimination in the health care system, including the denial of access to life-sustaining care;
3. Such discrimination is inconsistent with our society’s commitment to human dignity and the full inclusion of persons with disabilities throughout society;

Such discrimination is now legally prohibited:

An agency shall be prohibited from developing or employing a dollars-per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual’s disability, including age or chronic illness, as a threshold to establish what type of health care is cost effective or recommended. 

An agency shall be prohibited from utilizing such adjusted life year, or similar measure, as a threshold to determine coverage, reimbursement, incentive programs or utilization management decisions, whether it comes from within the agency or from any third party.

More of this please, the sooner the better! Considering how shamefully and lethally New York and some other states treated the elderly residing in long-term care facilities during the worst days of the COVID-19 crisis, it is very clear that these laws are desperately needed.

Oklahoma Death Certificate Accuracy Act passes.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Great news: I have remained silent about Oklahoma Bill SB 108, The Death Certificate Accuracy Act, to not create unnecessary attention for this important bill. We can celebrate now that SB 108 passed in the Senate on February 25 by a vote of 35 to 10 and passed in the House on April 17 by a vote of 59 to 36.

SB 108, that was sponsored by Senator Gary Stanislawski and Representative Sean Roberts, is clear legislation that requires the cause of death to be accurately reported on the death certificate. Among other things SB 108 states:

A certifier completing cause of death on a certificate of death who knows that a lethal drug, overdose or other means of assisting suicide within the meaning of Sections 3141.2 through 3141.4 of this title caused or contributed to the death, shall list that means among the chain of events under cause of death or list it in the box that describes how the injury occurred. If such means is in the chain of events under or in the box that describes how the injury occurred, the certifier shall indicate "suicide" as the manner of death.

Oklahoma Death Certificate

The bill later states:

A certifier who knowingly omits to list a lethal agent or improperly states manner of death in violation of subsection E of Section 1-317 of this title shall be deemed to have engaged in unprofessional conduct as described in paragraph 8 of Section 509 of Title 59 of the Oklahoma Statutes.

The bill then declares that a violation of any provisions of this section constitutes a felony.

Assisted suicide is not legal in Oklahoma, but in states where assisted suicide is legal, the assisted suicide law requires the doctor to falsify the death certificate. When a person dies by assisted suicide, the doctor is required to declare the cause of death as the medical condition that the person was living with, rather than declare death by assisted suicide.

This is just one of the many lies and cover-ups that the assisted suicide lobby uses to hide the truth about assisted suicide.

Thank you to everyone who made this happen.

Oklahoma Death Certificate Accuracy Act (HB 1495) passes.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

In most jurisdictions where euthanasia and/or assisted suicide have been decriminalized, the statutes state that the physician must lie on the death certificate by listing the cause of death as the disease or injury that led the person to request death by lethal drugs.

For instance, Ontario's Bill 84 requires physicians and Coroners to lie on the death certificate by stating that the person died as a result of the injury or disease, and not medical assistance in dying (euthanasia). Bill 84 states:

Medical assistance in dying
2.2 For the purposes of this Act, a worker who receives medical assistance in dying is deemed to have died as a result of the injury or disease for which the worker was determined to be eligible to receive medical assistance in dying in accordance with paragraph 241.2 (3) (a) of the Criminal Code (Canada).

Oklahoma, where assisted suicide is prohibited, passed HB 1495 in the House (62 - 26) to counter the concept that physicians or coroners can / must lawfully lie on death certificates.

I have always stated that if there is nothing wrong with assisted suicide, why are doctors required to lie about it?

Thank you Oklahoma legislators for identifying one of the assisted suicide lobby lies. Lying on a death certificate denies effective oversight of the assisted suicide law.

Kansas & Oklahoma are tightening their assisted suicide laws.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Kansas Legislature

The Kansas legislature is debating Resolution No 5010, a resolution that opposes assisted suicide and promotes improvements to palliative care. The Resolution states:

Be it resolved by the House of Representatives of the State of Kansas, the Senate concurring therein: That the legislature strongly opposes and condemns physician-assisted suicide because the legislature has an unqualified interest in the preservation of human life; and

Be it further resolved: That the legislature strongly opposes and condemns physician-assisted suicide because anything less than a prohibition leads to foreseeable abuses and eventually to euthanasia by devaluing human life, particularly the lives of the terminally ill, elderly, disabled and depressed whose lives are of no less value or quality than any other citizen of this state; and

Be it further resolved: That the legislature strongly opposes and condemns physician-assisted suicide even for terminally ill, mentally competent adults because assisted suicide eviscerates efforts to prevent the self-destructive act of suicide and hinders progress in effective physician interventions, including diagnosing and treating depression, managing pain and providing palliative and hospice care; and

Be it further resolved: That the legislature strongly opposes and condemns physician-assisted suicide because assisted suicide undermines the integrity and ethics of the medical profession, subverts a physician's role as healer and compromises the physician-patient relationship; and

Be it further resolved: That the Secretary of State transmit a copy of this resolution to the Governor of the State of Kansas, the Kansas Secretary of Health and Environment and the Kansas Medical Society.

The Euthanasia Prevention Coalition urges members of the Kansas legislature to support Resolution 5010.

Oklahoma Legislature

On March 6, 2017; the Oklahoma House passed HB 1495 , the Death Certificate Accuracy Act by a vote of 62 - 26. HB 1495 will hopefully lead to change by creating pressure on states that have laws that force doctors to lie on death certificates.

HB 1495 makes it a felony to knowingly lie on a death certificate by improperly stating the manner of death.

Even though assisted suicide is a prohibited act in Oklahoma, the Euthanasia Prevention Coalition supports HB 1495 because it creates awareness of the cover-up that exists in the states that have legalized assisted suicide and it further builds opposition to assisting a suicide in Oklahoma.

Oklahoma's Non Discrimination in Treatment Act.

The following article was written by Wesley Smith and published on his blog on July 14, 2013 under the title: Why we Need Medical "Non Discrimination" Laws.

Wesley Smith

By Wesley Smith - July 14, 2013

A medical system deeply dedicated to Hippocratic values of patient equality and uninfected by the “quality of life” virus would not need laws prohibiting discrimination against the sickest and most seriously disabled patients. Alas, doctors don’t take the Hippocratic Oath anymore and are under increasing pressure to consider costs when discussing treatment options. 

Moreover, Obamacare’s potent threat to establish future rationing of the kind seen in the UK threatens to institutionalize discrimination against the medically vulnerable. 

In such an invidious milieu, anti-discrimination laws that govern the practice of medicine, alas, become necessary. One was enacted recently in Oklahoma that seems a good model for the nation. From, the Non Discrimination in Treatment Act:

A. A health care provider shall not deny to a patient a lifepreserving health care service the provider provides to other patients, and the provision of which is directed by the patient or a person legally authorized to make health care decisions for the patient:
1. On the basis of a view that treats extending the life of an elderly, disabled, or terminally ill individual as of lower value than extending the life of an individual who is younger, nondisabled, or not terminally ill; or
2. On the basis of disagreement with how the patient or person legally authorized to make health care decisions for the patientvalues the trade-off between extending the length of the patient’s life and the risk of disability

Hopefully, this will make it much harder for hospital bioethics committees and doctors to force patients off of wanted efficacious life-extending treatment.

This is a body blow to Futile Care Theory, as futilitarian Thaddeus Mason Pope acknowledges. That is a necessary corrective, with so many attempts now in advance directive and POLST proposals that would allow doctors to overrule surrogate decision making–even a patient’s own advance medical directive.

Link to articles on the Rasouli case.

- Rasouli case: End of life often means ending life.

- Sunnybrook doctors ability to cut-off life support goes to the Supreme Court of Canada.