An individual with a controllable medical condition could be considered to have a terminal illness, making him or her eligible for doctor-prescribed suicide.
To be eligible for a suicide prescription, a patient is considered to have a terminal illness if the condition “is an incurable and irreversible medical condition that an attending physician anticipates, within reasonable medical judgment, will produce a patient’s death within six months.”
There are many conditions (diabetes, certain types of leukemia, a disability requiring ventilator support, etc.) that, without medical treatment, would result in death within six months. However, with medical treatment, individuals with those conditions could live for many years. Yet those individuals would be eligible for doctor-prescribed suicide.
Why is the definition of “terminal illness” so broad?
If HB 7015 is approved, doctor-prescribed suicide would become a “medical treatment.”
This would give insurance programs the opportunity to cut costs by denying payment of more expensive treatments while approving payment of the less costly prescription for a lethal drug overdose.
This has already been documented in Oregon – the state with the law upon which the Connecticut proposal is based. The Oregon Health Plan (OHP) has notified some patients that medications prescribed to extend their lives or improve their comfort level would not be covered, but that the OHP would pay for a lethal drug prescription.
Referring to payment for assisted suicide, the Oregon Department of Human Services explains, “Individual insurers determine whether the procedure is covered under their policies, just as they do any other medical procedure.”
If the Connecticut bill is approved, will health insurance programs do the right thing – or the cheap thing?
A health care facility could not prevent deaths from doctor-prescribed suicide on its premises. Furthermore, a facility willing to permit assisted-suicide deaths could require nurses and certain other individuals to facilitate such deaths.
HB 7015 states that “a health care facility may adopt written policies prohibiting a health care provider associated with such health care facility from participating in the provision of medication to a patient for aid in dying.”
It also states that “a health care facility shall not require a health care provider to participate in the provision of medication to a qualified patient for aid in dying.”
However, the phrase “participate in the provision of medication” is very narrowly defined in the bill. It refers only to performing the duties of the attending or consulting physician, psychiatrist, psychologist, or pharmacist. It does not include nurses and other individuals.
Therefore, facilities would not be able to ban others from bringing a lethal drug prescription to a patient or resident to self-administer on the premises; would not be able to prevent the witnessing of the written requests for doctor-prescribed suicide; and would not be able to prohibit nurses or others from picking up the drugs from an outside pharmacy and providing them to a patient or resident.
Likewise, facilities permitting doctor-prescribed suicide could require nurses to bring the drugs to a patient since such activities would not constitute “participation” as defined in the proposal.
A person “familiar with the patient’s manner of communicating” could convey (translate) the patient’s requests for the lethal dose.
How would anyone know if the translation is accurate? How would it be possible to know if the patient is really requesting doctor-prescribed suicide?
The bill requires only two requests – both written. Nothing requires that those written requests be made in the presence of the physician who will write the prescription for the deadly overdose. As written, the bill would permit the written requests to be mailed or delivered by a third party to the prescribing physician.
There is no requirement of oral requests or that any requests be made in person. The only reference to an oral request is in reference to items to be filed in the patient’s medical record. However, this does not mean that oral requests are required since, the same section also notes that the report on counseling is to be included, yet counseling is not required for all patients who are deemed eligible for doctor-prescribed suicide.
Under the bill, a person who would benefit financially from the person’s death cannot serve as a witness to the written request. However, the request could be signed at the patient’s residence and witnessed by two of the heir’s “best friends” who claim that the signer is competent, acting voluntarily and not being coerced into signing it.
This places victims of elder abuse and domestic abuse in great danger since they are unlikely to share their fears with outsiders or to reveal that they are being pressured by family members to “choose” doctor-prescribed suicide.
The bill permits a person who would benefit financially from the person’s death to pick up and deliver the lethal prescription.
The drugs can be dispensed to “an expressly identified agent of the qualified patient.” The qualified patient could be encouraged to authorize another individual to pick up the drugs and deliver them to the patient’s residence.
All of the “safeguards” in the bill cease the moment the prescription is received.
The bill contains eight references to the fact that the prescription is to be “voluntarily” requested. However, nothing in the proposal states that the drugs, once prescribed, must be knowingly or voluntarily taken.
Why are there no safeguards at the most important part of the process – at the time the patient takes the drugs that will cause death?
 HB 7015, Sec. 1 (19).
 KATU Television, “Letter noting assisted suicide raises questions” (interview about one such case and the response of the Oregon Health Plan). Available at: http://www.katu.com/news/26119539.html (last accessed 1/29/15).
 Oregon Dept. of Human Services, “FAQs about the Death with Dignity Act.” Available at: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/faqs. aspx (last accessed 12/30/14).
 HB 7015, Sec. 13 (d). (Emphasis added.)
 HB 7015, Sec. 13 (b). (Emphasis added.)
 HB 7015, Sec. 13 (a).
 HB 7015, Sec.1 (4).
 HB 7015, Sec. 3 (a).
 HB 7015, Sec. 10 (2).
 HB 7015, Sec. 3 (b).
 For example, statistics indicate, “Only four percent of reported elder abuse cases come from the elder person; 96 percent of the reports come from somewhere else.” Gazette.net (Maryland), “A safe place for abused seniors,” February 9, 2015. Available at http://www.gazette.net/article/20150209/NEWS/150209456/1007&source=RSS &template=gazette (last accessed February 16, 2015).
 HB 7015, Sec. 9 (a) (6) (A).
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