The Missouri House of Representatives has approved a measure which would expand the circumstances in which passive euthanasia can occur in the state of Missouri. The bill would also grant specific authority to health care providers to ignore the wishes of family members regarding end-of-life care provided to their loved ones.
The legislation, House Committee Substitute for House Bill 144,
is known as the “Designated Health Care Decision-Maker Act.” The proposal is sponsored by Representative Joe Don McGaugh of Carrollton. The measure has been pushed by attorneys and agents for the hospital and elder care industry.
The underlying objective of the legislation is to establish a person to make end-of-life decisions for a patient when that person never executed a durable power of attorney (DPOA) for health care. Under a DPOA, a person designates someone to make health care decisions for them when they become incapacitated, and spells out the conditions under which they want medical care provided or withheld.
In the absence of a durable power of attorney for health care, House Bill 144 creates a tiered system of decision-making with regard to the health care needs of the person or patient in question. A priority system is etched into law under which a spouse would first have the right to make such decisions. In the absence of a spouse, an adult child of the patient would decide such matters.
The priority sequence continues with a parent of the patient, an adult sibling of the patient, a grandparent or adult grandchild of the patient, or “any other adult relative or nonrelative who can demonstrate that he or she has a close personal relationship with the patient and is familiar with the patient’s personal values.”
The grave harm in the bill is that the “designated health care decision-maker” is authorized to withhold basic life-saving and life-sustaining treatment, including nutrition and hydration, which would result in the death of a patient who is “incapacitated.” Thus, a person never chosen by the patient to make health care decisions for them would have the legal authority to starve them to death.
The definition of an “incapacitated” person is borrowed from Missouri’s guardianship statutes. It is defined as “a person who is unable by reason of any physical or mental condition to receive and evaluate information or to communicate decisions to such an extent that the person lacks capacity to meet essential requirements for food, clothing, shelter, safety, or other care….”
This extremely loose and reckless definition of who is incapacitated encompasses individuals with physical and mental disabilities, individuals who are suffering from Alzheimer’s disease or dementia, or other individuals with diminishing mental capacity or a confused mental state. The bill would make such persons vulnerable to passive euthanasia practices in the same way the durable power of attorney law did in 1989.
An even more alarming provision of the bill would grant express authority to hospitals and other health care providers to override the decisions of family members regarding care provided to their loved ones. Should a hospital disagree with a “designated health care decision-maker” that certain life-sustaining measures, including nutrition and hydration, are in the “best interests” of the patient, they can seek to suspend treatment by going to court. An expedited hearing would occur in probate court to appoint an outside individual or the hospital themselves as the temporary or permanent guardian of the patient.
This is very disturbing. There are more and more incidents occurring in the United States and around the world where health care providers have halted nutrition and hydration, and life-sustaining treatment, against the wishes of the family. Family members have watched their loved one die because of the overt actions of health care administrators to deny necessary health care or sustenance to a patient or resident they no longer want occupying a room or a bed.
House Committee Substitute for House Bill 144 was adopted by the Missouri House by a very disappointing vote of 127-5. We commend Representatives Jack Bondon, Tila Hubrecht, Tom Hurst, Mike Moon, and Jeff Pogue, for having the wisdom to oppose this bill.
The measure now moves to the Senate, where a companion bill has been sponsored by Senator Dan Hegeman. We encourage you to contact your state senator to urge them to vote against the “Designated Health Care Decision-Maker” bill.