Assisted Suicide in California: Would Catholic Hospitals and Nursing Homes Have to Participate?

First Things blogger and Discovery Institute fellow Wesley Smith reports:

If the new bill to legalize assisted suicide in California (A.B. 374) becomes law, Catholic nursing homes will be legally required to permit assisted suicide to be committed within their premises, even though doing so would be a profound violation of Catholic moral teaching. In-patient hospice facilities would be similarly coerced, despite assisted suicide being a direct affront to the hospice philosophy and the medical standards under which programs operate. Other California medical facilities and group homes could also be forced to comply. Only acute-care hospitals escape the proposed tyrannical duty to cooperate in ending patients’ lives.

Smith then launches into a convoluted reading of AB 374 to justify his interpretation. In doing so, however, Smith overlooks a key provision of the proposed legislation, which states in Section 7198 (d):

No health care provider shall be under any duty, whether by contract, by statute, or by any other legal requirement to participate in the provision to a qualified patient of medication.

The phrase "provision to a qualified patient of medication" is the bill's euphemism for assisted suicide. The phrase "health care provider" any "licensed health care facility." On its face, this section would allow a Catholic nursing home to refuse to participate in an assisted suicide.

There are legitimate arguments to be made against assisted suicide. Unfounded scare tactics like this one, however, discredit the entire pro-life movement.

While I don't buy Smith's reading of the statute, there is one wrinkle in AB 374 that is potentially troubling. Section 7198 (b) states:

No professional organization or association, or heath care provider, may subject a person to censure, discipline, suspension, loss of license, loss of privileges, loss of membership, or other penalty for participating or refusing to participate in good faith compliance with this chapter.

Arguably, this provision could undermine the exemption provided by 7198 (d). Suppose a Catholic nursing home or hospice adopted an institutional policy against providing assisted suicide. An employee of that nursing home violated the policy and assisted in a patient's suicide. On its face, subsection (b) appears to prohibit the nursing home from imposing any penalty on such an employee. As such, the exemption provided by subsection (d) is rendered nugatory.

If it is to be adopted at all, an issue on which I am not currently expressing an opinion, AB 374 should be amended to include (1) a clear exemption for religiously affiliated health care providers and (2) allow religiously affiliated health care providers to sanction employees who violate an institutional policy against participating in assisted suicide.

The principal sponsors of AB 374 are Patty Berg, Lloyd Levine, and Fabian Nunez. I've sent them each a copy of this blog post, FWIW.

Posted on Monday, February 26 2007 | Permalink

Not scare tactics.  You nailed it in this paragraph: “Arguably, this provision could undermine the exemption provided by 7198 (d). Suppose a Catholic nursing home or hospice adopted an institutional policy against providing assisted suicide. An employee of that nursing home violated the policy and assisted in a patient’s suicide. On its face, subsection (b) appears to prohibit the nursing home from imposing any penalty on such an employee. As such, the exemption provided by subsection (d) is rendered nugatory.” Add in the explicit section which only permits acute care hospitals to direct that no assisted suicides happen in their facilities, and my interperetation is clearly correct.

This is how it would be: A nursing home and personnel could not be forced to do the deed or participate. But, at the same time, they could not prevent the deed from being done on site.  Hence, they could be forced to permit assisted suicide on premeses.

Add in the strict construction clause and the deal is sealed.  Moreover, under your view, the permission for acute care hospitals to opt out becomes superfluous.  By identifying one category of health care provider that can refuse consent for assisted suicides on premises and excluding all others, it means--based on the section you quoted--faclities that opposed the act would be powerless to prevent it in their faclities.

Posted by Wesley J. Smith  on  02/27  at  02:08 PM

Two additional points:
- The various provisions relating to health insurance could require Catholic institutions to pay for suicides.
- As written, the wide provision of 7918 (b) could arguably be significantly more constraining on Catholic health providers than the example provided: for example, if someone had participated in providing suicide, Catholic health providers could not refuse to offer employment to them on those grounds, nor at any point refuse admitting privileges to such a physician, nor could Catholic health associations refuse membership to such people.

Posted by Paul  on  02/27  at  02:56 PM

Did I miss something or is there no place either in the physician interviews or in the statement a “dying” patient signs that confirms either experiencing “unbearable suffering” or to being coerced? Granted, suffering is somewhat subjective but it is never personal - that in itself would be inhumane. “Unbearable suffering” is the stated motivation for the existence of the bill (Digest paragraph 3; sec. 7195.1j) but is not required to be documented.
Coercion is not safeguarded because there is no requirement that the patient be queried nor documentation of such query. 7195.1h Informed decision refers to “an appreciation of the relevant facts” which is quite vague and again says nothing about unbearable suffering. Relevant facts could include financial issues which are medically irrelevant and could lead a patient to be silently coerced.
The form that is to be signed by the patient refers to neither of these critical issues, nor is there an “opt-out” that says “You can say no to this”. People with poor language skills understand that even if they don’t know the word “coerce”. Research shows that the elderly pretty much do whatever the Dr. tells them; this bill gives physicians power to legally effect death with huge implications for abuse by any number of people who have access to vulnerable patients.

Posted by  on  03/03  at  12:43 PM

Hi! I thought you and your readers might be interested in some post-Easter news about Pope Benedict XVI…
The Pope’s car is being auctioned off to raise money for Habitat for Humanity:
http://www.buyacarvideos.com/popecar.htm
The bidding is already more than $200,000! Personally, I think this is a really fun and creative way to raise
money. The auction goes until April 14th if you and your readers want to check it out.

Posted by BJ  on  04/10  at  05:45 AM
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