Legislative Action Alerts

OPPOSE AB 2747 - END-OF-LIFE CARE

AB 2747, End-of-life care, by Assembly Members Berg and Levine will be eligible for a floor vote in the Assembly on Thursday, May 8, 2008.

LEGISLATIVE ALERT!!!  May 3, 2008

Dear Friend of Life,

We need your help to stop AB 2747.

Undaunted by their earlier failure to advance a huge sweeping euthanasia law, Assemblymembers Patty Berg (D-Eureka) and Lloyd Levine (D-Van Nuys) are now attempting to take smaller step down the slippery euthanasia slope and we need your help to stop them.  Last Tuesday, on a straight party line vote Assembly Bill B 2747 was voted out of the Assembly Judiciary Committee and onto the Assembly floor.  We expect AB 2747 to be taken up by the full Assembly this week.  So we don’t have much time to act if we are to stop it there.

On the surface, AB 2747 seems like a simple bill benefiting the hospice care industry.  However, it contains a sneaky loophole that will permit doctors and health care providers to transform the rarely used practice of “palliative sedation” into a vehicle permitting assisted suicide. Palliative sedation is the sedation of a suffering and imminently dying patient to the point of unconsciousness. This bill changes the standards surrounding its use.

This is way around current law. So PLEASE call, write or fax your Assemblyman and Senator today and urge them to vote NO on AB 2747.  Feel free to re-write the sample letter below in your own words.  Assembly Capitol phone numbers are (916) 319-20 District Number and Assembly office fax numbers are (916) 319-21 District Number.  For example newly elected Speaker of the Assembly, Karen Bass is from the 47th Assembly District. Her phone number is (916) 319-2047 and her fax number is (916) 319-2147.

SAMPLE LETTER

Assemblyman or Senator _____:
State Capitol
Sacramento, CA 95814

RE: AB 2747 (by Assembly Members Berg & Levine) - OPPOSE

Dear Assemblyman or Senator ______:

My family and I are opposed to AB 2747, which attempts to make the legalization of voluntary euthanasia easier in California.

AB 2747 defines terminal illness as having one year or less to live.  We believe this is very arbitrary and subjective because predicting a patient’s time from death is merely a lifespan forecast.

AB 2747 transforms the rare medical practice of “palliative sedation” (sedation of a suffering and imminently dying patient to the point of unconsciousness) into a loophole by changing the legal definition of this practice.

AB 2747 would offer a “menu” of choices for end of life care that includes suicide via VSED (the voluntary stopping of eating and drinking), and palliative sedation.

AB 2747 would create situations where cost considerations could affect treatment options, as assisted suicide options are generally cheaper.

AB 2747 promotes practices which may hasten death, overlooking what should be the primary focus of counseling to a patient approaching the end of life, chiefly excellent palliative care and hospice referral.

Please oppose AB 2747.

Sincerely,

Your name

Read the entire text of AB 2747 below

AB 2747 Assembly Bill - AMENDED

BILL NUMBER: AB 2747    AMENDED     BILL TEXT   AMENDED IN

ASSEMBLY  APRIL 7, 2008 AMENDED IN ASSEMBLY  MARCH 25,

2008 INTRODUCED BY   Assembly Members Berg and Levine 

                     FEBRUARY 22, 2008   An act to add

Part 1.8 (commencing with Section 442) to Division 1of the Health and Safety Code, relating to end-of-life care. LEGISLATIVE COUNSEL'S DIGEST   AB 2747, as amended, Berg. End-of-life care.   Existing law provides for the licensure and regulation of health facilities and hospices by the State Department of Public Health. Existing law provides for the regulation and licensing of physicians and surgeons by the Medical Board of California.  This bill would provide that when an attending physician makes a diagnosis that a patient has a terminal illness or makes a prognosis that a patient has less than one year to live, the health care provider shall provide the patient with the opportunity to receive information and counseling regarding legal end-of-life options, as specified, and provide for the referral or transfer of a patient if the patient's physician does not wish to comply with the patient's choice of end-of-life options.   Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

SECTION 1.  The Legislature finds and declares all of the following:  (a) Palliative and hospice care are invaluable resources for terminally ill Californians in need of comfort and support at the end of life. (b)Palliative care and conventional medical treatment should be thoroughly integrated rather than viewed as separate entities.  (c) Even though Californians with a prognosis of six months or less to live are eligible for hospice care, nearly two-thirds of them receive hospice services for less than one month.  (d) Many patients benefit from being referred to hospice care earlier, where they receive better pain and symptom management and have an improved quality of life.  (e) Significant information gaps may exist between health care providers and their patients on end-of-life care options potentially leading to delays to, or lack of, referrals to hospice care for terminally ill patients. The sharing of important information regarding specific treatment options in a timely manner by healthcare providers is a key component of quality end-of-life care. Information that is helpful to patients and their families includes, but is not limited to, the availability of hospice care, the efficacy and potential side effects of continued curative treatment, and withholding or withdrawal of life sustaining treatments.  (f) Terminally ill and dying patients rely on their health care providers to give them timely and informative data. Research shows alack of communication between health care providers and their terminally ill patients can cause problems, including poor availability of, and lack of clarity regarding, advanced health care directives and patients' end-of-life care preferences. This lack of information and poor adherence to patient choices results  result  in "bad deaths" that cause needless physical and psychological suffering to patients and their families.  (g) Those problems are complicated by social issues, such as cultural and religious pressures for the providers, patients, and their family members. A recent survey found that providers that object to certain practices are less likely than others to believe they have an obligation to present all of the options to patients and refer patients to other providers, if necessary.   (h) Every medical school in California is required to include end-of-life care issues in its curriculum and every physician in California is required to complete continuing education courses in end-of-life care.  (i)Palliative care is not a one-size-fits-all approach. Patients have a range of diseases and respond differently to treatment options. A key benefit of palliative care is that it customizes treatment to meet the needs of each individual person.  (j) Informed patient choices will help terminally ill patients and their families cope with one of life's most challenging situations.  SEC. 2.  Part 1.8 (commencing with Section 442) is added to Division 1 of the Health and Safety Code, to read:     

PART 1.8.  End-Of-Life Care   442.  For the purposes of this part, the following definitions shall apply: (a) "Curative treatment" means treatment intended to cure or alleviate symptoms of a given disease or condition.  (b) "Hospice" means a specialized form of interdisciplinary healthcare that is designed to provide palliative care, alleviate the physical, emotional, social, and spiritual discomforts of an individual who is experiencing the last phases of life due to the existence of a terminal disease, and provide supportive care to the primary caregiver and the family of the hospice patient, and that meets all of the criteria specified in subdivision (b) of Section1746.   (c) "Palliative care" means medical treatment, interdisciplinary care, or consultation provided to a patient or family members, or both, that has as its primary purpose the prevention of, or relief from, suffering and the enhancement of the quality of life, rather than treatment aimed at investigation and intervention for the purpose of cure or prolongation of life as described in subdivision (b) of Section 1339.31.   (d) "Palliative sedation" means the use of sedative medications to relieve extreme suffering by making the patient unaware and unconscious, while artificial food and hydration are withheld, during the progression of the disease leading to the death of the patient.   (e) "Refusal or withdrawal of life sustaining treatment" means forgoing treatment or medical procedures that replace or support an essential bodily function, including, but not limited to, cardiopulmonary resuscitation, mechanical ventilation, artificial nutrition and hydration, dialysis, and any other treatment or discontinuing any or all of those treatments after they have been used for a reasonable time.   (f) "Voluntary stopping of eating and drinking" or "VSED" means the voluntary refusal of a patient to eat and drink in order to alleviate his or her suffering, and includes the withholding or withdrawal of life-sustaining treatment at the request of the patient.   442.5.  When an attending physician makes a diagnosis that a patient has a terminal illness or makes a prognosis that a patient has less than one year to live, the physician,  or in the case of a patient in a health facility, as defined in Section 1250,the health facility,  shall provide the patient with the opportunity to receive comprehensive information and counseling regarding legal end-of-life care options.  When a patient is in a health facility, as defined in Section 1250, the attending physician or medical director may refer the patient to a hospice provider or private or public agencies and community-based organizations that specialize in end-of-life care case   management and consultation to receive information and counseling regarding legal end-of-life care options.    (a) If the patient indicates a desire to receive the information and counseling, the information shall include, but not be limited to, the following:   (1) Hospice care at home or in a health care setting.   (2) A prognosis with and without the continuation of curative treatment.  (3) The patient's right to refusal  of  or withdrawal from life-sustaining treatment.   (4) The patient's right to continue to pursue curative treatment while receiving palliative care.   (5) The patient's right to comprehensive pain and symptom management at the end of life, including, but not limited to, adequate pain medication, treatment of nausea, palliative chemotherapy, relief of shortness of breath and fatigue, VSED, and palliative sedation.  (b) The information described in subdivision (a) may, but is not required to be, in writing.   (c) Counseling may include, but not be limited to, discussions about the outcomes on the patient and his or her family, based on the interest of the patient.   442.7.  If a physician does not wish to comply with his or her patient's choice of end-of-life options, the health care provider shall do both of the following:   (a) Refer or transfer a patient to an alternative health care provider.   (b) Provide the patient with information on procedures to transfer to an alternative health care provider.                      

California ProLife Council (CPLC) (www.californiaprolife.org.) is the largest statewide organization in California solely dedicated to pro-life issues. CPLC is a non-sectarian, non-partisan, non-profit grassroots organization of pro-life groups and individuals in California dedicated to protecting and fostering the most basic value of our society- respect for LIFE itself.  We seek to educate our community in regard to abortion, euthanasia, and infanticide, to identify and organize the pro-life population of the state into an effective team, and to restore respect for human life to public policy.  California ProLife Council is the California affiliate of the National Right to Life Committee, Inc. (www.nrlc.org)

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