Last year, the Idaho Legislature passed a “conscience bill” that granted health care professionals the right to abstain from doing their jobs if they morally objected to the course of treatment. The focus was on such politically charged issues as abortion, emergency contraceptives and embryonic stem-cell treatments. But along the way living wills and advanced care directives were added to the list, perhaps in a misguided response to the “death panel” fear that arose over national health care reform.
However, those end-of-life decisions were protected under a law the Legislature passed in 2005, and many people pointed out this conflict. Gov. Butch Otter didn’t sign the bill, but it became law when he failed to return it to the Legislature in time.
Don’t worry, proponents said, it can be fixed next year.
Early in this legislative session it looked like that would be the case, when the AARP made the issue a top priority. The solution could have been easy: Either strip end-of-life mentions from the law or explicitly state that health care professionals could not violate the 2005 law that protected patients’ wishes.
One bill did the latter, stating: “… no health care professional shall refuse to follow the patient’s or physician’s directions” as established by the 2005 law. But that bill went nowhere and was replaced by another that muddied the waters by substituting “physician” for “health care professional.”
Opponents rightfully point out that last year’s conscience law covers all health care workers and that many small communities don’t have physicians. The bill’s language unnecessarily complicates matters and raises a pertinent question: Why not make the easy fix? Idaho AARP remains outraged because it still isn’t clear whether advanced care directives can be legally ignored by some health care workers.
Frankly, we think the entire conscience law should be repealed because it causes patients to shop for health care providers when seeking legally available services. Short of that, we would appeal to the libertarian sensibilities of Otter, because the freedom of people to decide how they will be treated is in doubt.
To be clear, this issue isn’t about physician-assisted suicide. It represents limitations on how many heroic measures health care professionals will perform on patients who are gravely ill due to chronic conditions. People turn to living wills and advanced care directives to ensure that these deeply personal decisions are respected. Legislators should encourage their use, not look for reasons to substitute their own beliefs or create polarizing political dramas, such as the one that played out in Florida several years ago with Terri Schiavo, who was eventually removed from life support.
Otter should veto this bill and make it clear that a definitive version that respects patient freedoms is the only kind he’ll sign.