New Law May Complicate Enforcing Living Wills
Written by Jacque Mingle
Arizona lawmakers may have just complicated your Living Will.
Gov. Doug Ducey signed Senate Bill 1439, which protects health care entities, which includes doctors and other health care workers, from discrimination if they choose not to participate in medical treatments or procedures that could end a patient’s life.
Proponents of the measure say providers should be free to opt out of these treatments based on their beliefs without any adverse consequences. On the other hand, those who opposed the bill believe patients (or their agents) should be allowed to make treatment decisions at the end of life and that health-care directives like Living Wills should be followed regardless of a provider’s personal views.
In Arizona, health-care providers are already shielded from criminal or civil liability for declining to follow a Living Will and a provider’s professional license can’t be revoked, denied, or suspended for acting according to religious beliefs. (A.R.S. § 36-3205(C), A.R.S. § 41-1493.04). The new law goes further by protecting care workers’ jobs by prohibiting “discrimination,” defined as taking or threatening any adverse action including, but not limited to, termination of employment, transfer, or demotion, and adverse administrative action.
Sen. Katie Hobbs, D-Phoenix, who opposed the bill, told the Arizona Republic that an entire hospital could opt out of providing certain services, which could leave a patient with no alternatives to receive the care they desire. For instance, she said, “a hospital could say it’s the policy of this institution that we are not going to provide morphine doses to alleviate pain if the morphine dose could shorten the life of the individual in our care.”
Supporters say that’s pretty much true. Cathi Herrod, president of the conservative Center for Arizona Policy, which championed the measure, has said the bill recognizes that there are medical treatments and medications that might be given near the end of life that providers might object to on religious grounds, and the decision to provide them rests with their conscience.
As Ron Johnson, executive director of the Arizona Catholic Conference, told the Republic: “If [health-care providers] are asked to give extra morphine and they believe the dose is given more to end the life of the person as opposed to easing pain, that’s what we’re talking about.”
This development may be alarming to those who have Living Wills. Your Living Will (aka Advance Directive) provides guidance for your Agent acting under your Health-Care Power of Attorney and health-care providers regarding the treatment you want – or don’t want – if you have a terminal condition and cannot make your own decisions. Documents often permit the administration of drugs or the withholding of food and fluids even if doing so might hasten the moment of death.
Many of us don’t consider the fact that, in Arizona, those wishes legally do not have to be followed if a provider’s beliefs conflict with them. The solution? It may be easier said than done, but know your providers, discuss your Living Will and your wishes, and ask specifically whether anyone on the care team would have religious objections to following them. Also, consider adding language to your Health Care Power of Attorney that permits your Agent to move you to another facility or even to a different state. As you may know, six states have gone the opposite direction and have legalized assisted suicide, and more than 20 states are considering legalization bills this session. (The six that have it: Washington, Vermont, Oregon, Colorado, California, and Montana.)
A “death with dignity” bill (House Bill 2336) was introduced in Arizona this session, too, but it went nowhere.