Why Choice is an Illusion?

Friday, November 16, 2018

Proposed Federal Palliative Care Act Is a Springing Euthanasia Bill

By Margaret Dore, Esq., MBA

In 2012, an article in the New England Journal of Medicine reported that many doctors object to physician-assisted suicide.[1] The article's authors, Dr. Lisa Lehmann and Julian Prokopetz, argued back that assisted deaths need not be physician-assisted.[2] They said that a central government mechanism should provide the assistance instead:
We envision the development of a central state or federal mechanism to confirm the authenticity and eligibility of patients' requests, dispense medication [the lethal dose], and monitor demand and use.[3] 
Today, in the United States Congress, the "Palliative Care and Hospice Education and Training Act" has passed the House and is awaiting consideration in the Senate. (Bills H.R. 1676 and S. 693).

If enacted, the Act will create "Palliative Care and Hospice Education Centers," which will provide a central federal mechanism to provide students (including residents, trainees and fellows) with clinical training in palliative care in a broad range of settings, including long term care facilities, home care and hospices.[4] 

There is a twist, however, U.S. euthanasia advocates are actively promoting "medical aid in dying" (euthanasia) as "palliative care."[5] There is a similar situation in Canada, where "lobbies are trying to influence the government to include so-called Medical Aid in Dying ... in palliative care."[6]

If the proposed Act is enacted, and the above lobby efforts are then successful, medical aid in dying (euthanansia) will become a part of palliative care and therefore part of the Act. More to the point, the Act will then provide a central federal mechanism to promote euthanasia throughout the United States in long-term care facilities, home care, hospices, etc.

The Act passed the House on voice vote after a 40 minute debate. According to House staffers I spoke with, the members understood that they were voting for traditional palliative care and hospice, to help people, not a potentially springing euthanasia bill. 

The Act, regardless, is a closet euthanasia bill. More reasons to kill it are set forth in the materials below:
Margaret Dore, Final Bill Summary Sheet for the Act (S. 693 & H.R. 1676), available at https://choiceisanillusion.files.wordpress.com/2018/10/final-s-693-h-r-1676-summary-sheet.pdf
Margaret Dore, Legal/Policy Analysis of  S. 693, prepared for the U.S. Senate Committee on Health, Education, Labor and Pension, available at: https://choiceisanillusion.files.wordpress.com/2018/10/s-693-memo-appendix.pdf 
Footnotes:

[1]  Julian J.Z. Prokopetz, B.A., and Lisa Soleymani Lehmann, M.D., Ph.D., Perspective: "Redefining Physicians' Role in Assisted Dying," NEJM, July 12, 2012.
[2]  Id.
[3]  Id.
[4]  Bill S. 693, Sec. 3. 
[5]  "Aid in Dying" is a traditional euphemism for euthanasia. See https://repository.library.georgetown.edu/handle/10822/738671 In the US, Compassion & Choices (the former Hemlock Society) is running articles and providing other material describing "aid in dying" (euthanasia") as palliative care.  For examples, click this link:  https://choiceisanillusion.files.wordpress.com/2018/11/aid-palliative.pdf
[6]  See "Euthanasia, assisted suicide aren't palliative care," at  https://choiceisanillusion.files.wordpress.com/2018/11/ca-aid-palliative.pdf