End-of-Life Choice, Palliative Care and Counseling

Threat to End-of-Life Choice Heads to Georgia Governorby Blaine

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Bill Will Force Unnecessary Suffering at Life’s End

Portland, OR – Compassion & Choices, the nation’s oldest and largest nonprofit organization working to improve care and expand choice at the end of life, today expressed disappointment with a bill that undermines end-of-life choice in Georgia. The bill, sent today to Governor Nathan Deal’s desk, was initially aimed at preventing suicide coercion but will force unnecessary suffering on people near the end of their natural lives.

“Responsible medical practice at the end of life has no relationship to the crime of assisting a suicide,” said Barbara Coombs Lee, president of Compassion & Choices. “Treating the suffering of a terminally ill cancer patient is not similar to goading vulnerable young people to play Russian roulette.”

In drafting HB1114, the Georgia legislature tried to prevent assistance for people with mental illness to kill themselves, while also permitting rational end-of-life decisions and supportive medical care. They achieved the first goal, but fell far short in the second. Now doctors and patients are more vulnerable to accusations of murder and assisting a suicide for decisions and treatments to relieve end-of-life suffering.

HB1114 threatens compassionate implementation of advance directives, medical orders and responsible pain and symptom management. Doctors are at risk for criminal prosecution and civil litigation unless they can prove their decisions and actions were strictly “intended” and carefully “calculated” to treat pain.

The bill could have been even worse, said Coombs Lee. “Compassion & Choices fought to preserve the liberty and dignity of dying patients, and to protect the doctors, nurses and family members who care for them. Earlier versions gutted constitutionally protected rights and contained a dangerous provision that would have applied organized crime statutes to medical practice. This could have pulled dedicated doctors and nurses, families, loved ones, caregivers and even educators into unknowingly committing a crime.”

HB1114 creates uncertainty among medical providers and caregivers as to whether it is a crime when a licensed physician aids a mentally competent, terminally ill person in dying by:

• Providing palliative support to a patient who decides against dialysis, pacemakers, antibiotics or other medication, or who elects to stop eating and drinking;
• Administering palliative sedation upon the request of the patient;
• Prescribing medication to offer the comfort of knowing that a peaceful death is possible.

“We hope Governor Deal will veto HB1114,” said Coombs Lee, “and insist on a bill that protects private medical decisions between patients and doctors.”

Accusations of murder against those who provide palliative care are a growing national problem. Patients suffer when doctors are afraid to treat their pain. Patients who hope to end prolonged agony and advance the time of death are denied protection under the bill.

Confusion and disagreement about the reach of state assisted-suicide laws cause physicians to reject their patients’ end-of-life wishes and drive dying patients to endure prolonged, agonized deaths against their will, turn to violent means to end their suffering, or persuade loving family members to risk criminal prosecution.

“A law against assisted suicide,” said Coombs Lee, “should protect Georgians with disordered thinking from anyone who would facilitate attempts to harm themselves. But it should not interfere with options for comfort and support of terminally ill patients.”