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Maryland House Bill 30: De-professionalizing the Care of People With Terminal Illnesses

Posted Jan 18 2009 2:41am

In addition to pushing assisted suicide, groups like Compassion and Choices yearn for respectability and desire to be seen as legitimate care givers for patients, at least in an informational context. That was part of the point last year when California passed AB 2747, requiring doctors to inform patients with one year or less to live of their terminal care options, such as refusing to eat or hospice. ( As originally written, it would have permitted patients to demand to be sedated and dehydrated to death --a back door method of assisted suicide.) If the doctor doesn't wish to so counsel, he or she is required to refer terminally ill patients to another doctor or to organizations that counsel the terminally ill in such matters. Not coincidentally, the bill was co-sponsored by Patty Berg, the good pal of Compassion and Choices (formerly Hemlock Society), that "counsels" the terminally ill, including about assisted suicide. So, while the original euthanasia purpose of the bill failed, assisted suicide groups took a big step forward by becoming approved conduits of information.

Two Maryland Delegates (Bobo and Manno) are now pushing this same line, with House Bill 30. If it passes, groups like C and C will be able to set up shop as an organization "specializing" in providing information for end-of-life care and receive referrals from doctors for patient counseling. No link yet, but here is the relevant language filed last year in preparation for the current legislative session:
E- Terminal Condition Care Counseling may include:...3) Information from organizations specializing in terminal condition care that provide information on fact sheets and Internet Websites to convey the information.
It is worth noting that there are no minimal credentials required for the counselors in the legislation, nor any minimal training for qualified "counselors." Isn't that odd? I mean, if this counseling is so important it must be legally required --then isn't its value diminished by setting such a low bar for qualifying to receive physician referrals? (Another clause of the legislation states that the organization need only be on that "specializes in terminal condition case management and consultation." ) Indeed, doesn't this open the door to what are, in essence, advocacy groups pushing their agendas in the guise of "counseling?" As such, doesn't this bill actually de-professionalize the field?

Of course patients and their doctors need to work through these important issues together. But proposals such as this are not only unnecessary and very loosely worded, they certainly seem to have agendas that go far beyond ensuring that patients receive appropriate information about proper end-of-life care.
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