Dear Everyone,
We need your help! The statement below is one that I sent to the new Chairman of the House Health Committee, Dr. Bob England, M.D., (D-Cleveland, Rutherford, District 112) detailing serious concerns with Bill S1046 - Advance Directives and Health Care Power of Attorney. He requested that I e-mail him. I also sent the statement to Representative Marilyn Avila (R-Wake, District 40), and Representative Joe Boylan (R-Moore, District 52), two very good, solid, and concerned legislators on this Committee.
The Bill is terribly pro-death, constitutes "back-door" euthanasia, and will wind up shortening the life of "Grandma" to cut healthcare costs. Think about it. Do you want your own Grandmother's life shortened just because at times she can't think straight? This Bill will enable hospital staff, including nurse practitioners and physician assistants, to declare her demented, withdraw care, and thus passively euthanize her.
The pressure to "move people along," in a harried, stress-filled healthcare delivery system is tremendous. This past week there was a newsreport about a woman, Edith Rodriguez of Los Angeles, who actually died in the ER waiting area, while hospital staff did nothing. She spit up blood for 45 minutes. Even the 911 dispatcher refused to help. The dispatcher told the woman's husband that since they were already at the hospital, no ambulance would be sent. For the full story, go here. This is the awful healthcare environment we are presently in, and it is getting worse. I hope this statement to Dr. England will help non-physicians understand more fully what's at stake here.
Please forward this statement to any pro-life physicians, citizen advocates, or defenders of the elderly that you know. Help me expand the list of e-mail addresses above. We need to generate more controversy. If we don't fight this Bill aggressively on Tuesday, July 10, 2007, at 12 noon, while it is still in Committee, the Bill will be passed into law, and the practice of medicine in North Carolina will be changed permanently.
Help us now, please, and come to the meeting on Tuesday if you can. It will be held at 12 noon in room 544 LOB, the Legislative Office Building, a six-story building on the corner of Salisbury and Lane Streets in downtown Raleigh. Full directions can be found here. Members of the committee can be found here. The actual Bill can be found here. The language is dense and a little tough to penetrate, which is exactly how the Culture of Death wants it. It hides behind language and euphemisms. Thus, passive euthanasia becomes "death with dignity," "allowing a natural death," and "allowing nature to take its course." Please.
There is an old saying: "If you don't take an interest in politics, sooner or later politics will take an interest in you." 45 million children since January 22, 1973 never got a chance to understand that saying. We need doctors especially to show up at the meeting. Thank you for your time and consideration, and please help us.
Sincerely,
Kenneth R. McElynn, M.D.
Board-Certified Family Physician
Vice-President, Catholic Medical Association, North Carolina
"Evil thrives when good people do nothing." - ascribed to Edmund Burke
Dear Dr. England,
It was nice to meet you in your office this past Tuesday.
HERE ARE MY CONCERNS WITH - S1046 - Advance Directives and Health Care Power of Attorney
S 1046 is a worrisome and dangerous bill. These types of bills inevitably curtail care and shorten lives, as patients and their families are pressured by hospital staff, nursing home employees, and hospice officials to forego treatment. In essence, S 1046 is "back-door euthanasia." I strongly implore you to reject this Bill and to uphold the present General Statutes.
Our healthcare system truly needs more caring and helpful conversations between doctors and patients regarding the dying process, NOT more bills. Patient health crises are notoriously unpredictable, and often fluctuate dynamically. Static advance directive forms are full of inertia, and often fail patients in times of crisis. Simply put, patients often change their minds. It is one thing to reflect upon severe illness in the future; it is quite another to experience it first-hand. Doctors are also concerned that a healthcare culture of severe time constraints, aggressive utilization review, and confusing end-of-life forms often places the elderly and mentally infirm at great risk. In this environment, the "right-to-die with dignity", often becomes "the duty-to-die outside an expensive hospital."
Here are the TOP 5 reasons why this Bill must be stopped:
#1. The Bill makes dangerous changes in language throughout its text. It changes every reference of "life-sustaining care" to "life-prolonging care." Such changes have psychological effects, and real-world consequences. To "prolong" something carries negative connotations, as if the action is bothersome and should be ended quickly. To "sustain" something, on the other hand, carries positive connotations of active advocacy. To think that such changes will not affect healthcare personnel and their influence on patient decision-making is naive.
#2 (Section 11 (c) (1.) (c)) The Bill cites "advanced dementia" as a reason to direct a physician to withdraw life-sustaining care. The Bill allows many possible parties, including those with only a trivial relationship to the patient, to make this declaration. Dementia as a trigger for an advance directive breaks new ground, and is particularly troubling. It is a clinical, subjective diagnosis open to wide interpretation. Elderly patients who are quite coherent at 8 a.m., often appear severely demented at 11 p.m. An acute or chronic infection may obtund any elderly patient.
Additionally, the potential arises for family abuse of an elderly patient when a dementia diagnosis triggers an advance directive. Family members eager to get their hands on inheritance money could pressure a hospitalist to make a dementia diagnosis, withdraw care, and thus hasten a patient's death. The elderly patient is thus quietly euthanized, with everyone going home happy, convincing themselves that she "died with dignity."
#3. (Section 11 (c) (1.) (b)) The Bill creates provisions to direct physicians to withdraw life-sustaining care if a patient "becomes unconscious and, to a high degree of medical certainty, will never regain unconsciousness." Again, the Bill allows many possible parties to make this declaration. All coma patients across the board are placed in serious jeopardy by this new, ground-breaking, language. The medical literature is replete with patients recovering unexpectedly after long periods of unconsciousness, despite medical predictions to the contrary. It is well-known that stroke patients are often unconscious for long periods before recovery.
#4 (Section 14 G.S. 90-21.17 rewritten) The Bill creates a dangerous new advance directive form called a "Medical Order for Scope of Treatment," also known as the "MOST" form. The form originates from Oregon's Right-to-Die movement, and its promotion is part of their national campaign. Oregon remains the only State in the Union that permits Physician-Assisted Suicide.
This form will curtail patient care much more than it will respect patient wishes, once it is placed in a harried healthcare environment with over-worked staff. It is human nature to cut corners when over-worked. This form provides plenty of opportunities to do exactly that, thus enabling de facto, "back-door" euthanasia of patients. Language in the Bill empowers the MOST form to trump other Advance Directives and Health Care Powers of Attorney, and does not even require a patient signature. It requests it only "if practicable." Even with a patient signature, the form remains open to severe abuse by staff biased to withdraw care. Under stress, patients can easily be manipulated by staff to agree, whether they sign it or not. Additionally, the form need not be signed by a physician, but allows nurse practitioners and physician assistants to sign the form as well.
#5 S 1046 will place those physicians opposed to end-of-life withdrawal of hydration and nutrition in an untenable position. Patients are often seen by multiple doctors during a hospitalization. Doctors "sign out" patients to one another. If one doctor signs a MOST form withdrawing treatment, a doctor in disagreement will be forced to resign from that patient's care, transfer the patient to another doctor, or even to another healthcare facility. Otherwise, that physician would have to violate his own conscience just to "get along" with colleagues, and to stay in business. Many doctors would thus watch patients die of thirst and starvation. This Bill will effectively drive many physicians from hospitals, nursing homes, and hospice work once and for all, magnifying an already severe shortage of healthcare professionals.
Dr. England, as Chairman of this Committee, you have the power to affect the lives of millions of North Carolina citizens right now by stopping this harmful, deadly Bill.
Please do not be party to the "back-door" euthanasia that this Bill represents. Evil hides behind language. Abortion is not called "murder;" instead it is called "a termination," "a choice," or even "a Constitutional right." Similarly, euthanasia is not called "murder;" instead, it is called "death with dignity," "allowing a natural death," or simply "Bill S 1046." Please help us with your leadership.
Respectfully Submitted,
Kenneth R. McElynn, M.D.
Board-Certified Family Physician
Vice President, Catholic Medical Association, North Carolina
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