US Euthanasia Bill All But Dead - For Now

Margaret Dore &
Dawn Eskew

This year, the US Congress considered the "Palliative Care and Hospice Education and Training Act," bills H.R. 1676 and S. 693. The Act seeks to provide financial support for palliative care and hospice education centers, including direct patient care.

The Act was viewed as noncontroversial. Indeed, H.R. 1676 passed the House on a voice vote without opposition.

There is, however, a catch.

This is because US euthanasia advocates are currently promoting "medical aid in dying" (euthanasia) as "palliative care."[1] There is a similar situation in Canada, where "lobbies are trying to influence the government to include so-called Medical Aid in Dying ... in palliative care."[2]

The significance is this: If the Act is passed into law and the above advocacy efforts are successful, medical aid in dying (euthanasia) will become part of palliative care and therefore part of the Act. More to the point, the Act will legalize and also finance euthanasia in government funded centers throughout the US. The Act is a closet or "springing" euthanasia bill.

Proposed U.S. Palliative Care Act Is a Potentialy Springing Euthanasia Bill

By MARGARET dORE, Esq., MBA

In 2012, an article in the New England Journal of Medicine noted that many doctors object to physician-assisted suicide.[1] The article's authors, Dr. Lisa Lehmann and Julian Prokopetz, added that assisted deaths need not be physician-assisted.[2] They argued that a central government mechanism should provide the assistance instead:

We envision the development of a central state or federal mechanism to confirm the authenticity and eligibility of patients' requests, dispense medication [the lethal dose], and monitor demand and use.[3] 

Press Release: "Proposed Federal Hospice Act Must Be Defeated to 'Stop the Waste, Bleeding and Heartache'

https://www.einnews.com/pr_news/465588180/proposed-federal-hospice-act-must-be-defeated-to-stop-the-waste-bleeding-and-heartache

Washington DC

Dore: "Existing federal hospice programs, such as the Medicare hospice benefit, are plagued by fraud, poor quality care, rampant abuse, arguably murder, and a gross waste of taxpayer dollars. Enacting another federal hospice program, when existing programs are far from being under control, makes no sense and will only cause more of the same."

Dore Memo to US Senate HELP Committee: Vote No on Bill S. 693

By Margaret Dore, Esq., MBA

For a summary sheet including a similar House bill (H.R. 1676), click here. For a pdf version of this memo, click here.

I.  INTRODUCTION

I am an elder law attorney and president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia.[1] Formed in 2010, Choice is an Illusion fights against assisted suicide and euthanasia throughout the U.S. and in other countries.[2] We also fight against hospice and palliative care abuse.

S. 693, the Palliative Care and Hospice Education & Training Act," amends the existing Public Health Service Act to require financial support for “Palliative Care and Hospice Education Centers.”[3] This is a new program, which will include direct patient care.[4]

Existing federal palliative care programs, such as the Medicare hospice benefit, are plagued by fraud, poor quality care and a gross waste of taxpayer money.[5] S. 693 must be rejected unless problems with existing programs are resolved; Congress must not throw good money after bad. The bill must also be rejected for the reasons set forth below. 

Margaret Dore and Dawn Eskew Take the Lead Against Flawed Hospice Act

The "Palliative Care and Hospice Education and Training Act," bills H.R. 1676 and S. 693, were proposed in 2017 and viewed as noncontroversial.  In July 2018, H.R. 1676 passed the House. The bill was then received in the Senate and transferred to the Health, Education, Labor and Pensions Committee, which was also considering S. 693.

A week later, the Office of the Inspector General for the U.S. Department of Health and Human Services (OIG) issued a portfolio highly critical of the Medicare hospice benefit. This alerted Dore to some of the bills' problems.

Problems with the proposed bills include:

• They do not require patients to be “terminally ill,” which is an eligibility requirement for hospice under Medicare. If the bills are enacted, this omission will create confusion in the law and/or undermine laws designed to prevent patient harm and fraud in the Medicare program.

• The bills describe hospice and palliative care as a benefit for patients and their families, who can have divergent interests. Patients may want to get well, while their families may want inheritances. This is a fundamental problem with the bills, that as written, they serve two masters. 

* In early October 2018, Dore, assisted by Dawn Eskew of New York Against Assisted Suicide, went to the US Capitol with a formal analysis of the bills' problems. The staff person at their first appointment told them that no other visitor had expressed opposition to the bills.

Margaret Dore and Dawn Eskew Take the Lead Against Flawed Hospice Act

Margaret Dore and
Dawn Eskew

The "Palliative Care and Hospice Education and Training Act," bills H.R. 1676 and S. 693, were proposed in 2017 and viewed as noncontroversial. 

In July 2018, H.R. 1676 passed the House. The bill was then received in the Senate and transferred to the Health, Education, Labor and Pensions Committee, which was also considering S. 693.

A week later, the Office of the Inspector General for the U.S. Department of Health and Human Services (OIG) issued a portfolio highly critical of the Medicare hospice benefit. This alerted Dore to some of the bills' problems.

Inspector General Slams Hospice

https://oig.hhs.gov/newsroom/media-materials/2018/hospice/anr-transcript.pdf

(Washington D.C., Tuesday, July 30, 2018) - Hospice use has grown steadily over recent years, with Medicare paying $16.7 billion for 1.4 million beneficiaries in hospice care in 2016. A decade before, in 2006, those numbers were $9.2 billion for fewer than 1 million beneficiaries....

In a new hospice portfolio released by the Inspector General for the U.S. Department of Health and Human Services (OIG), the agency found that hospices do not always provide needed services to patients and sometimes provide poor quality care.

OIG also found that patients and their families and caregivers do not receive crucial information to make informed decisions about their care. And taxpayers are bankrolling much of this poor care and fraud through the Medicare hospice benefit....