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Idaho Futile Care Law - Insufficient Due Process

Posted Mar 05 2009 5:12am
Yesterday, theIdaho Statesmandescribed state Senate Bill 1114, passed to the House on Tuesday. The article stated that the Senate bill will "allow medical treatment to be withheld from developmentally disabled people."  
But if enacted, the impact of this legislation will be broader and far more significant. First, the bill purports to amend the Idaho Medical Consent and Natural Death Actthat governs medical treatment for all patients in Idaho, not just for the developmentally disabled.  
Second, the bill would authorize health care providers to refuse treatment, including life-sustaining treatment, that is requested by the patient or her substitute decision maker. For example, providers could withhold or withdraw mechanical ventilation, dialysis, or artificial nutrition and hydration from a patient in a vegetative state, even though such treatment could keep the patient alive for many additional years and even though the patient (through her advance directive or spouse) requested such treatment under those circumstances.  
While there must be limits to the medical technology that is deployed at the end-of-life, the bill provides distressingly thin standards or oversight for such decisions. A physician can refuse life-sustaining medical treatment as "futile" or "inappropriate" so long as the healthcare facility ethics committee agrees. But the composition of this committee is left entirely to the facility, to which all or most of the ethics committee members are economically or otherwise beholden.  
Senate Bill 1114 is closely patterned after the controversial Texas Advance Directives Act, which has been widely-criticized as being unfair to patients. The Idaho bill suffers from almost all the same due process deficiencies. Indeed, while Texas gives surrogates 48 hours notice of the ethics committee, S.B. 1114 gives only 24 hours notice.
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