SB 2016-022: Death With Dignity Act (Passed Senate)

[tmthforu94]

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Sponsor: Rep. NeverAgain (L-VA) in House

My apologies for just bringing this up. 72 hours for debate.

[NeverAgain]

Thanks for this, tmth.

For anyone who has questions, I would be more than happy to answer them.

[Senator Cris]

Wasn't this the version passed by the House?
https://uselectionatlas.org/FORUM/index.php?topic=240652.msg5198206#msg5198206

[NeverAgain]

Wasn't this the version passed by the House?
https://uselectionatlas.org/FORUM/index.php?topic=240652.msg5198206#msg5198206

Oh, goodness! Thanks so much Cris! I almost didn't see this wasn't the newer version.

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This is the voted on and passed version by the House.

Again, my apologies for my blindness and thanks much to Cris for that great catch!

[Senator Cris]

I strongly support the right of every Atlasian to die with dignity, without any form of pain and so I strongly support the bill.

[NeverAgain]

I strongly support the right of every Atlasian to die with dignity, without any form of pain and so I strongly support the bill.

I thank you for your support Mr. Senator.

This has been heavily worked on to safeguard any abuses of this system.

[tmthforu94]

I am hesitant to support this bill. I don't feel comfortable with allowing other parties to get involved with taking a life. That being said, if we are to proceed with this, it is essential we are careful with our wording and make sure that proper safeguards are in place. What we're talking about here is the government wading into the business of taking an individual's life. There are quite a few concerns I have with how this bill is written.

- In Section One, it says two doctors are required for consent. How do you define doctor? A veterinarian is a doctor, so could you get one of them to sign off? Additionally, what business does, say, a heart surgeon have in determining if a person is of the right mental state to make this decision? I'd prefer clarifying that at least one be a medical doctor and one be a psychiatric doctor.
- Again in Section One, how is it determined that someone has 6 months to live? If one doctor says a person has 4 months and another says 8 months, what happens?
- How is the first clause in Section 2 enforceable? How can we tell someone that their family can't have an impact on their decision? If I were ever put in this situation, how my family would be affected would be the first thing I think about. Are you going to tell a family they aren't allowed to give their opinion on whether or not the patient should end their life?
- On the second clause of Section Two, how do you define oral and written requests? How do you prove that an oral request was made? I would prefer just doing written requests and also requiring that they be notarized for each individual signing.
- For Section Three, it should be "afterwards", not "afterwords." Why do you believe we should allow hospitals to have free reign on what is used to end a life? Shouldn't there be some oversight from the FDA to ensure nothing is used that causes physical harm to the patient?
- Would you be opposed to requiring that at least one of the doctors who signed off on allowing the euthanasia to also be one of the administrators? I think it adds an extra safeguard to avoid confusion on what is being done and also helps ensure accountability.

Hope to hear thoughts from others before offering an amendment.

[tmthforu94]

Debate has stalled for nearly 72 hours. At this time, there is no way I can support this bill until the multiple concerns I have made are addressed.

[NeverAgain]

Debate has stalled for nearly 72 hours. At this time, there is no way I can support this bill until the multiple concerns I have made are addressed.

I'm sorry, I didn't see your concerns. Let me address them.

I will have responses to all, tomorrow afternoon.

[Senator Cris]

I'm looking forward to hear NeverAgain's thoughts on this and, if necessary, to work on an amendment.

[NeverAgain]

1. In Section One, it says two doctors are required for consent. How do you define doctor? A veterinarian is a doctor, so could you get one of them to sign off? Additionally, what business does, say, a heart surgeon have in determining if a person is of the right mental state to make this decision? I'd prefer clarifying that at least one be a medical doctor and one be a psychiatric doctor.
2. Again in Section One, how is it determined that someone has 6 months to live? If one doctor says a person has 4 months and another says 8 months, what happens?
3. How is the first clause in Section 2 enforceable? How can we tell someone that their family can't have an impact on their decision? If I were ever put in this situation, how my family would be affected would be the first thing I think about. Are you going to tell a family they aren't allowed to give their opinion on whether or not the patient should end their life?
4. On the second clause of Section Two, how do you define oral and written requests? How do you prove that an oral request was made? I would prefer just doing written requests and also requiring that they be notarized for each individual signing.
5. For Section Three, it should be "afterwards", not "afterwords." Why do you believe we should allow hospitals to have free reign on what is used to end a life? Shouldn't there be some oversight from the FDA to ensure nothing is used that causes physical harm to the patient?
6. Would you be opposed to requiring that at least one of the doctors who signed off on allowing the euthanasia to also be one of the administrators? I think it adds an extra safeguard to avoid confusion on what is being done and also helps ensure accountability.

Hope to hear thoughts from others before offering an amendment.

1. I think this could be an area that needs clarification. It, of course, means a human MD. I would be fine with amending it to specify that one doctor must be in the field of which the patient's illness is afflicting. On the issue of a heart surgeon, I think it could be argued that anyone with medical training enough to become an MD, should be able to help sign off on this practice.

2. Good question. I think it should go to the doctor with the shortest time, of course after a re-test to ensure the results are accurate. As this practice would be completely voluntary, it should defer to the patient's possible sense of urgency instead of continual retesting.

3. More clarification may be needed here. Families of patients cannot, under any circumstances undermine (unilaterally change the decision of the patient). With the guardian ad litem involved, I think it can be enforceable. I in no way suggesting families cannot consult on this decision with their loved ones. This is actually a safeguard (in my view) to stop any family member that could possibly gain from the death of the patient from forcing this decision to go through.

4. That seems fine, although I think an audio recording would help add another safeguard to stop coercion.

5. Well, in my original draft, the drug of use was only pentobarbital (the drug used by the woman from Oregon who used this procedure). It was changed due to other peoples' amendments... I would be fine with a change to mandate that pentobarbital be the drug cocktail of choice, not giving free reign over that choice.

6. That may be an option, although, I feel that it must be someone qualified to do the procedure and the two doctor's witnessing do not have to be in that specific field, just giving their medical consent. I would be fine with discussing this further though.

 

[The world will shine with light in our nightmare]

I'll offer an amendment tomorrow.

[The world will shine with light in our nightmare]

Here's a preliminary amendment that addresses some of Tmth's concerns.  I struck out section 2, subsection 2 because it doesn't qualify who a witness can be.  If a witness cannot be either a person employed by the medical profession or the patient's family member, then who can sign off on it?  Random strangers?

I also removed the mention of oral requests, which are difficult to keep record of, so that only a written request is necessary.

Let me know what you guys think and I'll make the necessary revisions.

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[NeverAgain]

The amendment is friendly. I thank the Senator for doing this.

Again any follow-ups would be fine to talk about.

[Senator Cris]

I'm ok with Scott's amendment.

[tmthforu94]

Scott's amendment is a step in the right direction. Another 24 hours for objections, and if none, it will be adopted.

[tmthforu94]

The amendment has been adopted.

[NeverAgain]

Bump?

[Prince of Salem]

I think I'll favor this bill. I'm usually for regional power in this kind of matter, but there are individual rights worth defending at the federal level here.

[Blair]

The fact that you have to wait until you have less than six months means that we're starting at a rather limited point- which is probably best for a bill of this importance.

One question- would the line about mental competence limit the availability to people with mental health problems?

[The world will shine with light in our nightmare]

The fact that you have to wait until you have less than six months means that we're starting at a rather limited point- which is probably best for a bill of this importance.

One question- would the line about mental competence limit the availability to people with mental health problems?

I would think the doctors are best equipped to determine if a person is of sound mind to make this decision, while taking their physical condition into account.

Obviously this is a very gray area with heavy ethical ramifications, but I think we can adopt some kind of parameter if you had one in mind.

[tmthforu94]

Amendment:

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[tmthforu94]

This amendment does 2 things:
1. It requires that at least two doctors prognose that the patient has less than 6 months to live.
2. It clarifies the last line in Section One to ensure that a psychiatrist makes the diagnose on the individual's mental state.

[Blair]

I'd like to thank everyone for the hard work on this bill; I'm happy to move on for a final vote

[tmthforu94]

I'll extend objections to my proposed amendment for another 12 hours. If there are none, we can consider it adopted and will move to a final vote in the morning.

While there still wasn't a lot of debate, this is a good example of what Senate should be doing - carefully examining each piece of legislation and ensuring that only the highest quality bills go through. While I remain uncertain on this bill in principle, I am glad we were able to clarify the language.