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Assisted Suicide Bill Passes California Assembly
Democrats voted for the bill, Rebublicans voted against it
http://www.lifesitenews.com/ldn/2008/may/08052901.html

By Tim Waggoner May 29, 2008 LIFESITENEWS.COM

SACRAMENTO, May 29, 2008 (LifeSiteNews.com) - An assisted-suicide bill
that allows doctors and nurses to suggest death by unconscious
dehydration has barely passed the California State Assembly.

AB 2747 would authorize total sedation without nutrition and hydration
for depressed and confused patients, whether or not their natural death
was imminent. The bill would also allow family members to order the
death of a mentally disabled person when a nurse opines they have less
than a year to live, similar to Terry Schindler Schiavo's death at the
hands of her husband.

AB 2747 passed the Democrat-controlled Assembly Wednesday afternoon on a
41-32 vote, a one-vote margin of victory in the 80-member lower house.
The vote was virtually party line, Democrats for, Republicans against.
AB 2747 is authored by the same Democrats who unsuccessfully carried
physician-assisted suicide bills for the last three years.

"This deceptive bill will cause death and shorten life, despite its
claims," said Randy Thomasson, president of Campaign for Children and
Families, a leading California-based pro-life, pro-family organization.
"Drying up and shriveling to death through dehydration is a fate worse
than lethal injection. By transforming palliative sedation into a
vehicle for assisted suicide, AB 2747 would transform doctors and nurses
from healers and comforters into killers like Dr. Jack Kevorkian."

AB 2747 would allow a doctor or a nurse to opine that a patient has
"less than one year to live," and then ask depressed patients if they
would like to be totally sedated into unconsciousness. Total sedation is
usually an irreversible procedure that does not include nutrition and
hydration. If patients or decision-making family members fall prey to
suggestions of total sedation, death from dehydration will usually occur
within five days.

This is the fourth time that the assisted suicide bill has been pushed
by Assembly Democrats Patty Berg and Lloyd Levine. But this year,
instead of proposing to have doctors administer lethal injections, AB
2747 aims to produce death by sedation abuse, a clear violation of
life-affirming medical ethics. Until now, total sedation has been used
only when death was imminent - within hours or days - and when strong
pain medication was not enough. Medical ethics require that food and
water (nutrition and hydration) not be removed when sleep-inducing drugs
are used, since doing so would cause unnatural, as opposed to natural,
death. Yet AB 2747 pushes total sedation even if patients have not
rejected food and water.

"Just as the assisted-suicide bills of the last three years have been
rejected, so should the California Legislature reject AB 2747," said
Thomasson. "Assisted suicide by total sedation ignores the sanctity of
human life and violates life-affirming medical ethics. People who are
ill need support, spiritual care, and counseling if they're depressed.
But AB 2747 would ensure the death of innocent Californians at the hands
of an increasingly unscrupulous insurance industry that regards people
cheaper dead than alive."

Dr. Howard M. Ducharme is past chair of the philosophy department at the
University of Akron. On January 24, 2002, Dr. Ducharme participated in
"The Debate over Total/Terminal/Palliative Sedation," sponsored by The
Center for Bioethics and Human Dignity
(http://www.cbhd.org/resources/endoflife/kingsbury-ducharme_2...), where
he detailed how total sedation prematurely kills people:

Total sedation (TS) -- called by some "terminal sedation," "palliative
sedation," or "slow euthanasia" -- is a protocol recently added to the
lexicon of contemporary medical interventions and is a construct
actively promulgated by the National Hospice and Palliative Care
Organization (NHPCO). It is defined as "the application of
pharmacotherapy to induce a state of decreased or absent awareness
(unconsciousness) in order to relieve the burden of otherwise
intractable suffering." With only this much said, there may seem to be
no ethical objection to TS -- a patient who is terminally ill,
imminently dying, and suffering overwhelming physical pain may simply
request temporary TS to get some sleep today with the hope that the pain
will be endurable tomorrow. However, any quick acceptance of TS would be
ill-advised because of the many "devils in the details."

TS is not limited to patients with terminal illness who are imminently
dying. The NHPCO's policy explains that TS can be used "in the last day
or two of life," but it can also be used "at multiple points" in a
"patient's trajectory toward death," when the patient is not imminently
dying. Thus, TS is not limited by standard clinical criteria as put
forth in the AMA's policy on forgoing life-sustaining treatment (FLST)
-- i.e., that the patient be terminally ill and imminently dying.

TS protocol allows that the sedation may be "partial or complete," and
that it can be initiated as a temporary and reversible sedation. There
is no problem with this application of sedation; however, TS policy does
not limit the time frame, or require reversibility, of sedation. Though
the NHPCO states that "[TS] need not be considered irreversible," TS can
be titrated to produce a "complete unresponsiveness of patients" with
the "intent" to provide "deep sedation until death occurs, without
concern for reversibility." When a permanent TS treatment is
administered upon the patient's directive, it cannot be revoked; no
totally unconscious patient will ever have the opportunity to reverse
her directive, say, to look at the face of a loved one just one last
time. By contrast, when a DNR order is in effect, it can be revoked by
the patient at any time. Absolute final farewells must precede permanent
TS -- just as in an act of euthanasia.

TS protocol also allows that any concomitant therapies may be added to
the TS patient's protocol, each "based on their own merits." Thus, a
terminally ill patient (e.g., an HIV+ or early-stage ALS patient) who is
not imminently dying can be given TS concomitant with a decision to
forego (withhold or withdraw) life-sustaining treatment (FLST). When the
patient's life does depend upon the continuation of life-sustaining
treatment, the cause of his death may be ambiguous. Would the immediate
cause be regarded as FLST and not at all dependent upon the active
interventions of TS policy? What if such a patient refuses to forego
life-sustaining treatment without first undergoing TS? In such a
scenario, TS is necessarily implicated in the immediate cause of the
death of the patient. Such a context carries TS into the frontiers of
euthanasia. Furthermore, TS plus concomitant patient decisions can place
TS squarely in the arena of euthanasia, e.g., when a TS patient elects
to have her organs harvested per the Non-Heart-Beating Cadaver Donor
Protocol. Here the result is an act, elsewhere argued, of
"thrift-euthanasia."

Another troubling aspect of TS is that strict respect for patient
autonomy is compromised on several fronts.

According to the NHPCO, "When patients do not have [autonomous]
capacity, their designated decision-makers may make the decision on
their behalf." This element of TS policy dissolves two fundamental
boundaries set up to protect patients. When irreversible TS is deemed
appropriate by family members (third-party, outside observers) of a
non-competent patient, TS is then administered as non-voluntary or
involuntary TS -- on a parallel with non-voluntary and involuntary
euthanasia. Additionally, TS decisions made by substituted
decision-makers will not be based on first-hand descriptions of the
level of suffering experienced by the patient. Rather, they will be mere
inferences based on observations and value-laden evaluations of
onlookers -- who may have low pain thresholds and/or high sensitivity to
the perceived suffering of others. Family members may (or may not) have
the best of intentions, but they are nonetheless incapable of knowing
for certain whether or not the patient has crossed over from tolerable
to intolerable distress, the supposed symptom required for TS.

The ugly reality is that irreversible TS may too often be treatment
given to a patient for the comfort of the family.

If the patient does want to die, then TS will be readily accepted. If
she does not want to die, then simply being approached to consider TS
will communicate to her that she must be a burden on others and/or that
her life just cannot be worth living any longer. Such reflections by the
patient may be exactly enough to shift an individual's suffering from
bearable to unbearable.

The psychological distress added to the patient's life by others
initiating this conversation may be the existential push that takes them
over the TS cliff. Furthermore, when TS becomes hospice and hospital
policy, it will be incumbent on the agency to inform all patients of
their TS options at admission. Therefore TS policy adds significantly to
the so-called "culture of death" mentality already inundating society.

Lastly, given the details unpacked above, a health care team can
initiate the discussion of TS of an incompetent patient with family
members and carry it out all without any patient involvement. This is a
dire and shadowy way to end the lives of others via paternalistic,
non-voluntary, existential euthanasia.

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for more info:

Euthanasia & Assisted Suicide Information
http://www.californiaprolife.org/euthanasia/euthanasia.html

AB 2747 BARELY PASSES
IN THE ASSEMBLY

AB 2747 barely passed the Assembly 41-32. The bill now moves, likely to
the Senate Judiciary Committee


HELP STOP ASSISTED SUICIDE IN CALIFORNIA
http://www.californiaprolife.org/update/materials.html