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Monday, December 1, 2014

Compassion & Choices has a New Campaign to Reduce Patient Choice: Be Careful What you Sign.

By Margaret Dore, Esq., MBA

Last week, the deceptively named euthanasia promotion group, Compassion & Choices (C & C), announced a new campaign to reduce patient choice in healthcare.*

C & C wants to increase the enforceability of health care directives, but only for those that refuse treatment. C & C wants a health care provider who doesn't follow the directive, to not get paid. The problem is that you could get stuck with what you thought that you wanted and not be allowed to change your mind. Consider this example:

You signed a health care directive stating that you do not want "artificially-provided" food and drink, for example, via an IV, nasal tube or stomach tube.

You're in an accident, which renders you unable to personally direct your health care and unable to eat and drink. The healthcare facility and the family member in charge of your care want to give you food and water through "artificial" means. The facility thinks that you will need it for a short time and then recover.

But, if the healthcare facility does this under C & C's proposal, it will not get paid.

A few years ago, the owner of an elder care facility told me about one of its residents. He was an older gentleman who was a slow eater, but he had never choked or aspirated on his food. His doctor arranged for a swallow test, which he failed. To prevent aspiration, the doctor said "Nothing by mouth." The man had previously signed a health care directive saying that he would not want artificially provided food or water. So this meant nothing at all. Moreover, the man's son sided with the doctor.

Over the next few days, the man said that he was hungry and that he wanted something to eat, until he got too weak to say anything at all.

He was not allowed to change his mind and it was a horrible awful death.

So much for compassion and choice.

Be careful what you sign.

Advance directives are dangerous when used to refuse treatment or care. It's better to leave that up to your trusted agent to make decisions in the moment.  Margaret Dore is an attorney in Washington State and President of Choice is an Illusion

* C & C's new campaign "to put a stop to unwanted medical treatment."