Arizona Capitol Reports Staff//March 25, 2005//[read_meter]
Arizona Capitol Reports Staff//March 25, 2005//[read_meter]
While state legislators are divided along party lines over whether government should have intervened in the Terri Schiavo case, many have one thing in common when it comes to making their medical wishes known should they ever become incapacitated.
“I hate to admit that no one in my family has health directives,” said Rep. Cheryl Chase, R-23.
Ms. Chase and other legislators responded to an Arizona Capitol Times informal e-mail survey about issues surrounding the Schiavo case, including the question: “Do you have advanced health directives?
“No, but I know I should,” said Rep. Nancy McLain, R-3.
Rep. Laura Knaperek, R-17, answered, “No, but I will soon.”
At press time, Ms. Schiavo’s parents had lost their appeal to the U.S. Supreme Court to have their daughter’s feeding tube reinserted.
A Florida Circuit Court Judge on March 24 denied a petition of the state Department of Children and Families — and Governor Jeb Bush — to take Schiavo into state custody.
The recent appeals were made possible when Congress on March 20 passed a bill sending the case to the federal court in Tampa, Fla.
Ms. Shiavo suffered cardiac arrest in 1990 and since has been in what physicians testified is a “persistent vegetative state.” Legal battles between her husband and her parents over whether nutrition should be withheld have continued for more than a decade, including interventions by Governor Bush and the Florida Legislature and, most recently, the U.S. Congress.
Arizona legislators also were asked: “Had there existed an identical case in Arizona, would you have favored legislative intervention . . .” and “Do you support or oppose Congress’s actions in the case…?”
Republicans who responded said they agree with actions of the Florida Legislature and Congress to forestall Ms. Schiavo’s death through further court proceedings.
“This is a heartbreaking situation,” said Ms. Chase, a nurse. “I agree that government should not be involved, but in this case, I would have to support giving her nutrients.”
Sen. Ron Gould, R-3, said, “The main purpose of government is the protection of individuals’ rights. To starve Mrs. Schiavo is inhuman. Who among us would not feed a starving person?”
Ms. McLain said, “I would have favored intervention by the Arizona Legislature” had there been an identical case in the state.
Legislative Democrats, including Rep. Kyrsten Sinema, whose pregnant stepsister was in a vegetative state before her death, oppose government intervention in the Schiavo matter. The decision whether to keep the Florida woman alive with a feeding tube belongs only to Ms. Schiavo’s husband, Ms. Sinema, D-15, said.
“The [Florida] Legislature has no business interfering with it,” she said, and “Congress has no right to interfere.”
Ms. Sinema said, “This incident is being used as a political sword by special interest groups around the country to push their agendas, which I frankly find offensive and crass.”
She said her stepsister, Holly, was six months pregnant with twin girls when she suffered two strokes, and doctors pronounced her brain dead.
“The doctors were able to perform surgery and save the lives of her two daughters,” Ms. Sinema said. “We honored Holly’s life by letting her body go when the rest of her was already gone.”
Ms. Sinema, Sen. Robert Cannell, D-24, and Reps. Linda Lopez, D-29, and Ann Kirkpatrick, R-2, were the only survey respondents who said they had made their advanced medical directives known.
Governor Napolitano told reporters March 23 she has advanced medical directives, and she was critical of Congress’s action.
“The rush of Congress and everybody else to jump into what has been obviously a very difficult family situation, I think, is unseemly at best,” she said. “If one lesson is learned out of this it is the importance of having a written advanced directive.
Ms. Lopez, sponsor of a resolution to encourage people to talk with loved ones about their wishes for medical care, said Florida court decisions in the Schiavo case should have stood, and Congress “overstepped” [its authority] as regards separation of powers.”
HCR 2021: Health Care Decisions Week
Along with HCR 2021, which establishes “Health Care Decisions Week” Nov. 6 and is ready for a final vote, Ms. Lopez is the sponsor of several measures dealing with terminally ill patients, H2311 and H2313, which have not been heard in committee, and pain management (HM2002), which failed 4-4 in the House Human Services Committee.
Mr. Cannell said, “State and federal legislative bodies and the executive branch should stay out of the relationship between a husband and wife and stay out of the doctor-patient relationship.”
“It’s perplexing,” said Rep. David Lujan, D-15, that Congress goes to great lengths to save this one life when so often they fail to do anything to help those in this country who are dying because of a lack of health care, poverty, abuse and many other causes.”
Ms. Kirkpatrick urged people to have a living will.
“As a mother, I find this to be an extremely difficult and emotional issue,” she said. “Terri Schiavo’s ordeal is and has been a heart-wrenching tragedy for her family. I do have advanced health directives and encourage people to consider signing a living will as recognized by Arizona law.”
Health Care Directives Registry
The Legislature last year created the Arizona Health Care Directives Registry, a free online service for people to register their health care directives with the Secretary of State’s Office. The system, which became operational this month, had registered 15 directives as of March 21, and staff was processing 150 to 200 filings, said Kevin Tyne, deputy secretary of state.
“It’s been popular from the get-go,” he said, adding that publicity about the Schiavo case was expected to result in a steady flow of inquires about the service.
The registry, created by H2172 and funded by contributions from Hospice of the Valley and other health care organizations, gives health care providers access to patients’ living wills and powers of attorney — written instructions about medical care should they be incapable of making such decisions. “This new program will assist doctors and hospitals immensely to gain appropriate access to this critical health care documentation,” said Secretary of State Jan Brewer, and it “provides a secure location to keep vital records…”
Under H2172, which was sponsored by then-Rep. Deb Gullett, the registry must be privately funded. Setup costs were estimated at between $100,000 to $150,000, and annual costs thereafter at $50,000. Hospice of the Valley has provided $60,000.
Testifying last year for the bill, Susan Goldwater Levine, the hospice organization’s executive director, said, “So often we encounter individuals who enter the emergency room or hospital unable to speak for themselves and without a copy of their advanced directives.” Ms. Levine told the House Health Committee that Arizona leads the nation in hospice care, but there remains “a lack of clarity” when it comes to people’s end-of-life wishes.
Arizonans may register living wills and powers of attorney for health care and mental health care, although opting not to use the registry does not invalidate existing directives.
Under state law, health care directives may include instructions regarding everything from how much to how little care should be provided to an incapacitated person, to whether organs are to be do
nated or an autopsy performed. When the documents are received by the state and verified as accurate, they are copied into the database, then returned to the owner with a wallet-size card that contains a file number and password. The information may only be accessed by using the individual ID number and password. The number and password will be used by health care officials to access the directives, if need be, or by the patient to change or revoke the directives.
Where To Get Forms
Living will, power of attorney and other advance directive forms can be downloaded from the attorney general’s Web site: www.attorneygeneral.state.az. us/seniors/life_care/LifeCarePlanning.
The following statutes all contain examples of various forms of an advance directive: ARS 36-3224; ARS 36-3262, and ARS 36-3286. —
For further information: www.azsos. gov/adv_dir/.
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