Aid in Dying on Network TV.

Barbara Coombs Lee, Gary Blick and Stewart Lane will be on Anderson Cooper 360 tonight. The email from Compassion and Choices where Coombs Lee is president:

While still taboo for many families, increasingly our nation is engaging in a thoughtful, often difficult, dialogue about end-of-life choice. This shift is evidenced by the vigor and reach of public discussion surrounding this weekend's release of You Don't Know Jack, an HBO film about the life of Dr. Jack Kevorkian.

The truth is, many dying patients suffer, even with adequate care and pain management. Others fear that their pain will become unbearable. Unable to talk openly with their physicians about a range of legal, safe, peaceful options to ease a painful dying process, desperate patients look to guns and other violent options to end their lives. Or they ask physicians to work secretly outside the law.

Compassion & Choices advocates that all mentally competent, terminally ill patients should have a full range of end-of-life choices, including aggressive pain and symptom management, palliative sedation, voluntarily stopping eating and drinking, forgoing life-extending interventions and aid in dying.

You may be interested in watching CNN's Anderson Cooper 360 tonight where I was invited to be the voice of Compassion & Choices' supporters in a conversation about our landmark Blick v. Connecticut case. We represent two physicians, Gary Blick and Ron Levine, who are asking a Connecticut court to rule that the state's assisted-suicide statute does not reach their conduct in providing aid in dying to their terminally ill patients. Joined on Anderson Cooper 360 by Dr. Gary Blick and his patient Stewart Lane, I asserted that without a rational public discussion that includes aid in dying as a medical standard of care, covert aid in dying would continue.

Dr. Kevorkian recognized this need, and drew the national and international spotlight to the desperation of patients whose current legal choices are inadequate. His actions raised public awareness and highlighted major public policy problems. As in every movement for social change, there are provocateurs and persuaders.

Compassion & Choices works within the law, using education and advocacy to advance a vision where all Americans can live and die as free people, in dignity and according to their own values. We believe patients should be able to talk with their physicians about legal, safe, peaceful options for easing a painful dying process

Rita L. Marker, Lost Credibility.

In a recent article for the right-wing American Thinker, Rita L. Marker takes a very long time trashing health care for school students as provided by the new health care bill, to get to a simple and false point: students in Oregon and Washington will be instructed on and sent for "assisted suicide" when they should be in math class -- and all without parental notification.

If Marker, Executive Director of the increasingly wacky International Task Force on Assisted Suicide and Euthanasia and sometime-consort of ubiquitous, self-important Wesley J. Smith, had only read the Death with Dignity bills, which have been legal, and highly examined and reported since 1997 (Oregon) and 2008 (Washington) she would know that no one -- not a student, not a terminal patient - can get a prescription for lethal drugs in 2 weeks.

In addition to all the other regulations (two written requests, two doctor consultations, less than 6 months to live, etc.) there is a mandatory waiting period of 15 days.

Instead of making things up to imply that the government and Compassion & Choices and school doctors are all out to just kill your kids, she could have read the bills. But that's not how she makes her living.

Agree with the bills or not, there's no place for deceitful discussion regarding the care the way we care for all of our citizens.

The article, with so many other over-the-top insinuations, I'll leave you to find them:

Some years ago, I was speaking to a Nebraska state senator after testifying on a pending bill. I had explained that I wasn't saying that the billwould be interpreted in a certain way, only that it could be. Then he said something I've never forgotten. "Be assured that if a law can be interpreted in a certain way, it will be -- by someone. And it will all be perfectly legal."

In the week during which ObamaCare, euphemistically named the "Patient Protection and Affordable Care Act," was signed into law, I recalled that senator's words.

The catalyst was a story from a Seattle television station reporting a mother's outragethat a school-based health clinic (SBHC) had arranged for her 15-year-old daughter's abortion. The high school student was given a pass, put in a taxi, and sent for an abortion during school hours -- all without the parents' knowledge. To add insult to injury, the teen was told that there wouldn't be any charge for the abortion if she concealed it from her family.

Was this legal?

Yes.

According to Seattle School District spokeswoman Teresa Wippel, "From a legal/procedural standpoint, it's a non-issue."

But this article isn't about abortion and ObamaCare. That topic has been and will continue to be widely discussed. Rather, it is about school-based health clinics, parental consent, and assisted suicide. That aspect of the new law has, until now, been under the radar even though it is part and parcel.

Under ObamaCare, there will be a massive expansion of SBHCs (Sec. 4101), creating full-service clinics across the country.

SBHCs are not new.

Over the years, health-related services in schools have expanded from a part-time nurse who checked to see if little Johnny has a fever to clinics offering such broad services that they have become the primary source of health care for many children, particularly teens. So rapidly did they become entrenched in school across the country that by the mid-'80s, health services on school premises were the subject of national conferences of school-based clinic administrators and personnel. Caseloads in a school-based clinic located in or near high schools and junior high schools ranged from about 500 to 5,000 students per year.

Currently, thousands of such clinics are members of the National Assembly on School-Based Health Care (NASBHC), which has the stated mission "to improve the health status of children and youth by advancing and advocating for school-based health care." But until now, they had been funded by state and private funds. With passage of ObamaCare, the federal government has entered into the fray. According to the NASBHC, passage of ObamaCare was "an unprecedented victory for school-based health centers" which will enable other communities to open school clinics.

Kevin Jennings, the Obama administration's controversial Assistant Deputy Secretary of the Office of Safe and Drug-Free Schools, is slated to keynote the organization's June convention with an address titled "Partnering Education and Health for a Safer School Environment."

Hundreds of millions of federal dollars will be directed to SBHCs.

Since the stated rationale for passing ObamaCare was to provide health care coverage for the uninsured, it would be logical to expect that school-based clinics would become obsolete. It is therefore curious that the very law that was intended to provide health coverage for all allocates millions of dollars to school-based health clinics that will "be integrated into the school environment" and will provide, "at a minimum, comprehensive primary health services." The expanded clinics will provide on-site access during the academic year and 24-hour coverage through backup health providers to ensure access to services on a year-round basis when school is not in session. All of this will proceed with little or no parental involvement.

From the time that clinics began to expand services, parental consent has been requested for clinic services. The new law also gives lip service to parental consent. However, such consent is obtained by means of a general consent form signed at the beginning of the school year. Parents -- knowing that their children can receive immunizations, sports physicals, etc. through the SBHC-- rarely refuse such authorization for their children. They sign the consent form, naïvely assuming that it is just an inexpensive way to insure convenient, free physicals and care for minor medical problems.

But that's not the way it works.

According to the NASBHC, access to any service (sports physicals, for example) requiresparents to sign written consent for their children to receive the full scope of services provided at the SBHC.

As the Seattle area mom found out, the Ballard High School consent form that she signed gave permission for any and all services available that the clinic provides, either directly or by referral. In addition, it makes it crystal clear that all information is kept confidential, with few exceptions. One such exception is that if a student under 18 years old has a life-threatening health problem, parents will be informed of a child's condition. But that all changes once a child reaches her 18^thbirthday.

Consider the following.

A number of life-threatening (indeed, terminal) conditions can be diagnosed in a clinic or through a referral to a hospital on an outpatient basis. A student may be diagnosed through an SBHC's clinic with acute leukemia or melanoma -- all within school hours, when her parents believe she is in class or at band practice. And she could, under the state's law, be "qualified" for assisted suicide, since, in Washington (as well as in Oregon and Montana), the crime of assisted suicide has been transformed into a "medical treatment." That treatment is available to qualified patients who are at least 18 years old.

Within two weeks of her initial diagnosis, the student who had been looking forward to going to the prom could instead be referred to Compassion & Choices, the assisted suicide advocacy organization formerly called the Hemlock Society. (Compassion & Choices is the go-to group for assisted suicide services, responsible for facilitating most reported assisted suicide deaths in Washington and Oregon.)

Before her parents even knew she was ill, she could be given a prescription for a lethal drug overdose. She could take it. And die.

And her parents would be completely unaware of her condition -- until it's too late.

Will this happen? No one can know for sure.

Can it happen? Yes.

And if it does, the school district could say, "From a legal/procedural standpoint, it's a non-issue."

Welcome to full-service school-based health clinics -- ObamaCare style.

Thanks Compassion & Choices for Profiling Me!

I'm flattered and humbled this Sunday morning by receipt of the latest Compassion & Choices newsletter which has, among other fantastic news items, a profile of little old me! You can read the profile here.

And you can find great information about end of life care and C&C at their homepage.

Here's a clip from the article by Blaine Palmer:

Compassion & Choices’ President Barbara Coombs Lee first wrote in November about the directive from United States Conference of Catholic Bishops (USCCB) to Catholic health care facilities regarding feeding tubes. Compassion & Choices is concerned whenever patients’ choices for end-of-life treatment are blocked, whether it is by the government, by providers and certainly by a religious institution with control of nearly a quarter of American health care facilities.

Traditional media showed little initial interest in the change to Ethical and Religious Directive 58, and we feared we would be a voice crying alone in the wilderness. But the alternative journalists on blogs have been much better at reporting the story. One of the first, and most consistent is author and hospice volunteer Ann Neumann who, as she puts it, writes “primarily about the nexus of death and religion.” Her December blog at otherspoon explained the Bishops action:

The new guideline, instituted last month, determines that artificial nutrition and hydration (ANH, delivery of food and water via surgically applied feeding tubes) is "obligatory" care.

The USCCB has reached into an area of settled law in the US - it is now legal for patients or their proxies to deny ANH in all 50 states) - and created a scenario where patients lose autonomy over their own care.

Governments, churches and the medical profession, Ann says, have all worked to limit choices in end-of-life care because choice is a threat to their power. She cites a 2005 Garret Keizer article in Harpers to explain why these authorities are invested in protecting their control over pain:

. . . the belief that pain is fundamental to justice, which makes perfect sense if justice is conceived as nothing more than a system of punishments and rewards. The essence of punishment is pain. Whoever owns pain owns power.

“I would like to encourage various rights groups to work together to push a patient bill of rights. Many of the opponents pushing against end-of-life care rights are also opposed to women’s reproductive rights as well,” Ann said in a recent interview. “They are powerful and well-organized. The only way to counter that force would be for all groups working for patients’ rights to come together.” Her blog in January,What the Aid in Dying Movement Must Learn from Abortion Advocates, explains why.

Kathryn Tucker on Baxter v. Montana Decision

An interview with Kathryn Tucker of Compassion & Choices on the Montana decision on Baxter v. Montana. From Legal Broadcast Network.

Compassion & Choices Press Release on Legalization of Aid in Dying in Montana..

Montana physicians, terminally-ill patients and Compassion & Choices, the nation’s largest and oldest nonprofit organization working to improve care and expand choice at the end of life, today hailed the Montana Supreme Court’s ruling that terminally ill Montanans have the right to choose aid in dying under state law. There is no further appeal from this decision, as the Montana Supreme Court is the highest court available to decide State issues.

Compassion & Choices Legal Director Kathryn Tucker, co-counsel to the plaintiffs/respondents, said, “This case was about the right of mentally competent, terminally ill patients to request a prescription for medication from their doctors which they can ingest to bring about a peaceful death. The Montana Supreme Court has determined that this is a choice the public policy of Montana supports. Montanans trapped in an unbearable dying process deserve, and will now have, this end-of-life choice. This is the first state high court to find protection of this choice, and makes clear that in Montana, patients are able to make this choice and physicians can provide this care without risking sanction.”

Roberta King, of Missoula, the daughter of plaintiff Bob Baxter, said, “My father died without the peace and dignity he so dearly wanted for himself and others. He feared when he filed this lawsuit that he would not live long enough to benefit from it. I’m sure he would be deeply gratified that other terminally ill Montanans will have the choice and comfort that aid in dying affords them.”

Dr. Stephen Speckart, a Missoula cancer specialist and a plaintiff in the lawsuit, said, “This decision affirms that a terminal patient’s fundamental right to self-determination will guide end-of-life health decisions. I regularly treat patients dying from cancer, and many of these deaths are slow and painful. Terminal patients will no longer be forced to choose between unrelenting pain and an alert mental state as they approach the end of their lives from terminal diseases. The comfort this brings to their last days can have an immeasurable benefit.”Compassion & Choices news release, Montana Supreme Court ruling; page 2 Missoula attorney Mark Connell, who argued the case to the Supreme Court on behalf of the plaintiff physicians and patients, described the decision as "a victory for individual rights over government control." Connell added: "The Montana Supreme Court has now recognized that, where intensely personal and private choices regarding end-of-life care are involved, Montana law entrusts those decisions to the individuals whose lives are at stake, not the government. I know Bob Baxter would be very pleased that the court has now reaffirmed that these choices should be left to the terminally ill people in our state."

Steve Johnson, 71, of Helena, is terminally ill with brain cancer, hailed the decision and asked the Montana medical profession to provide patients like himself with aid in dying. “I approach the end of my life with a clear mind, and I would like to work with my doctor to minimize the pain and maximize the peacefulness in my dying. I would like my physician to be able to respect and honor my choice to die with dignity. Adults like myself should have the option, if terminally ill, to request physician aid in dying.

It’s only compassionate to minimize unnecessary suffering at the end of life, and to let me make the choice about how much suffering to endure, based on my own values and beliefs,” said Johnson.

Montana State Sen. Christine Kaufmann, Rep. Dick Barrett and twenty-nine other state legislators; the American Medical Women’s Association, the American Medical Students Association, and a coalition of Montana clinicians; the American College of Legal Medicine; the American Civil Liberties Union of Montana; the Montana Human Rights Network; the Northwest Women’s Law Center; terminal patients’ surviving family members; Montana religious leaders; and Montana’s leading constitutional law experts had urged the Court to find in favor of the terminal patient’s right to receive aid in dying from their physicians.

Compassion & Choices encourages terminally ill patients to call 800 247-7421 if they would like information about aid in dying, or suggestions on how to open a dialogue with their physician and loved ones.

For more information please visit www.compassionandchoices.org

From Compassion & Choices on Montana's Legalization of Aid in Dying.

via email. Their website is www.compassionandchoices.org:

Thrilling news from Montana Supreme Court today - I wanted you to be among the first to know. Dying patients in Montana now have the right to ask their doctors to provide aid in dying!

The Montana Supreme Court just issued a decision that public policy of Montana does not criminalize, and much in current public policy affirmatively supports, aid in dying. The court did not reach the question of whether the Montana constitution specifically protects aid in dying.

In a detailed review of Montana law on the "Rights of the Terminally Ill," the Court concluded that the legislature specifically defers to a patient's own decisions and affords patients the right to control their own bodies at the end of life. The decision to self-administer life-ending medication receives the same treatment as a decision to discontinue life sustaining therapies such as mechanical ventilation. This is a landmark victory!

This makes Montana the first state where a court has determined that patients may request, and physicians may legally provide, aid in dying. This is a historic ruling, which will change the landscape of end-of-life choice in Montana; in addition this decision will have persuasive influence in other states across the nation.

The decision applies to terminally ill, mentally competent Montanans, and its ripple effect will be felt in states across the nation.Compassion & Choices Legal Director Kathryn Tucker represented the patients and physicians in the lawsuit that produced the ruling, and I am extremely proud of the work of Kathryn and her colleagues, including her co-counsel, Missoula litigator Mark Connell, have done on this case.

I am also proud of you, because it is your enduring support for Compassion & Choices that gave us the financial strength and moral authority to wage this important legal battle.

What does this mean for Montanans? It means that patients like Steve Johnson of Helena, who is terminally ill with brain cancer, can request a prescription from his doctor for medication that he could consume to bring about a peaceful death without him or his doctor risking criminal prosecution. Steve said, "It's only compassionate to allow me to choose to minimize unnecessary suffering at the end of my life, to let me make the choice about how much suffering to endure, based on my own values and beliefs."

With today's ruling, Montanans like Steve now have a choice.

Click here to view Compassion & Choices' press statement.

Your support for Compassion & Choices helped win this landmark case. It paves the way to similar rulings to expand patients' rights in more states, and at the federal level, in years to come.

Dignity and Choices Symposium: Starting to Unpack.

On Tuesday and Wednesday, I was in Washington DC to attend the first Dignity & Choices Symposium, sponsored by Compassion & Choices, the nation's largest aid in dying and end of life care advocacy organization.

What I came away with - insights, education, materials, new acquaintances and understandings, topics for research, and project ideas - is impossible to capture in one post. So throughout the day (and beyond) I will be unpacking my experiences from the symposium, session by session, in posts interspersed with my usual blogging. (Next week, when I attend the Pennsylvania Pro-Life Conference in Scranton to hear Bobby Schindler, brother of Terri Schiavo, Phill Kline, former AG of Kansas, and Dr. David Prentice, of the Family Research Council speak, I hope to do the same thing.)

But to quickly summarize my overall impressions from DC:

*For a first symposium, the event was surprisingly well-organized and the speakers were of a particularly high caliber of ability to speak to aid in dying and surrounding issues

*All age groups were represented; the group, both attendees and speakers, was racially diverse; from C&C board members to hospice workers, from journalists to lawyers, from ethicists to pastors, from women's group members to advocates for the elderly, the group, though lacking statical depth, possessed breadth of occupation and interest in end of life issues

*For a symposium focused on how to compassionately end life, attendees were surprisingly positive, cheerful, life-loving, and affirming - much to any detractor's chagrin. Don't laugh at this comment; I anticipated some sort of over-exuberant political correctness - the issue demands sensitivity and maturity that uncountable societal entities, including the media at large, churches, our government and social service organizations, all fail to muster with consistency - and some overly-dramatic, maudlin reverence for death or those who face it that would be more acceptable than an obituary section of the newspaper but less so than a Hallmark card. The tone of the event was spot on: professional, action-oriented, information-filled and accessible.

Expect much more from me on the Dignity & Choices Symposium as the day and week carry on.