Source: http://www.patientsrightscouncil.org/site/h-5507-compassionate-care-act-analysis/
Timestamp: 2019-02-22 00:39:20
Document Index: 414470655

Matched Legal Cases: ['§23', '§23', '§23', '§23', '§23', '§23', '§23', '§23', '§23']

H 5507 “Compassionate Care Act” analysis | Patients Rights Council
H 5507 “Compassionate Care Act” analysis
Under the “Lila Manfield Sapinsley Compassionate Care Act” (H 5507):
This has already been documented in Oregon – the state with the law upon which the Rhode Island 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.[1]
If the Rhode Island bill is approved, will health insurance programs and government health programs do the right thing – or the cheap thing?
The bill states that witnesses to the written request must attest to the fact that the patient appeared to “be free from duress or undue influence at the time the request was signed.”[3] However, those words have a narrow legal meaning. The bill does not prohibit someone from suggesting, advising, or encouraging a patient to request doctor-prescribed suicide.
A patient is considered to have a terminal condition that makes him or her eligible for a prescription for suicide if the condition is incurable and irreversible and is expected to cause death within 6 months.[5]
However, many conditions that are incurable and irreversible and which would result in death within six months without treatment, can be controlled, resulting in a much longer life span. For example, some types of diabetes are incurable and irreversible and, without insulin, the patient would die within 6 months. But, with insulin, the patient could live for many years. Yet, under H 5507, an insulin-dependent patient would be considered eligible for doctor-prescribed suicide.
The written request for doctor-prescribed suicide could be witnessed by someone who would gain financially from the patient’s death.[7]
In the last official Oregon report, fear of becoming a burden on others was given as a reason for requesting lethal drugs by 40 % of those who died using that state’s assisted-suicide law.[8]
A person could move to Rhode Island and, within days, receive a prescription for a lethal drug overdose.
The patient is to be a resident of Rhode Island but no criteria is provided to make such a determination.[9] Merely giving a Rhode Island address would suffice.
Like the Oregon law, the bill only addresses activities taking place up until the prescription is filled. There are no provisions to insure that the patient is competent at the time the overdose is taken or that he or she knowingly and willingly takes the drugs.
Severely depressed or mentally ill patients can receive doctor-prescribed suicide, without having any form of counseling.[10]
Even if the patient is severely depressed or has a mental illness, a physician does not need to refer the patient for counseling unless the physician believes that the patient has “impaired judgment,” which is defined as inability to make an informed decisions.[11]
This provision is the similar to that contained in Oregon’s law where, in 2014, only three of the patients who received lethal prescriptions were referred for counseling.[12] A study about Oregon’s law found that it “may not adequately protect all mentally ill patients.”[13]
The proposed bill has an exceptionally narrow provision for facilities to protect patients from doctor-prescribed suicide.[14] A health care facility may only prohibit a physician from writing a prescription for a resident or patient if the prescription is intended to be used on the facility’s premises. In addition, nothing permits the facility to prohibit a caregiver or other individual from delivering a prescription for a patient to take on the premises.
Under the bill, before writing a prescription for death, a doctor must inform the patient of “the range of treatment options” and “all feasible end-of-life services including palliative care, comfort care, hospice care, and pain control.”[15] However, “informing” someone of all options does not mean the patient will have the ability to access those options. It only means the person must be told about them.
Patients may find that their insurance will not cover the “feasible alternatives” their doctors informed them about but, instead, will pay for doctor-prescribed suicide as has already happened in Oregon.[16]
Note: Supporters of H 5507 point to Oregon to claim that there are no problems with the law and that safeguards are meticulously followed and monitored. Yet, in closed-door sessions, they acknowledge that this is not true. For documented information about this contradiction, see “The Oregon Experience.”[17]
[3] §23-4.13-3 (a) (4).
[4] §23-4.13-2 (2), definition of “capable.”
[5] §23-4.13-2 (10).
[7] §23-4.13-3 (a) (4).
[9] §23-4.13-3 (a) (5) (v).
[10] §23-4.13-3 (a) (8).
[11] §23-4.13-2 (5).
[12] Official report for 2014 deaths under Oregon’s Death with Dignity Act, p. 5. Available at: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf (last accessed 4/6/15).
[13] Linda Ganzini, Elizabeth R. Goy, Steven K. Dobscha, “Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey,” British Medical Journal, Oct. 25, 2008, pp. 973-978.
[14] §23-4.13-6.
[15] §23-4.13-3 (a) (6) (iii & iv).
[16] 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).
[17] “The Oregon Experience.” Available at: http://www.patientsrightscouncil.org/site/the-oregon-experience (last accessed 1/30/15).