Help us protect Georgia Citizens - Please Support These Bills:
24 - Georgia Advance Directive for Health Care Act; enact
HB 394 Disabled adults and elder persons; protective services; discharge and transfer from facilities
and SB 181 Nursing Home Accountability Act; add definition; notice of deaths; penalties
The Four Laws We Workig Hard To Pass In Georgia
Endeavor Freedom, the Georgia Advocacy Office and Georgia ADAPT have been working together to organize, implement, and promote the passing of 4 pieces of legislation which would better protect people with disabilities from ever having to endure the nightmare scenario of forced starvation/dehydration. The four laws are:
1) The Georgia Directive - Health Agent Law
" The current State living will form is confusing.
" The current State living will form only gives choices people want least-no food or water.
" The new bill is much easier to understand and was written to be consumer friendly.
" The new bill may set a new national standard for a simple, comprehensive and understandable method to deal with health choices.
" The new bill was prepared by a legislative committee bringing together all sectors of interested parties.
" The disability community supports the new bill as a vast improvement over the current Georgia law.
" The new bill emphasizes selection of a health agent which is preferable due to wide variety of medical circumstances, instead of static living will.
2) Food and Water for Persons with Disabilities Law
" There is great deal of confusion surrounding the provision of treatment
for persons with disabilities as the case of = Terri Schiavo case showed.
" A painful and unnecessary death by dehydration is inhumane and should not be permitted for any human being except for someone who purposely chooses to do so.
" The provision of water and food is simple and can be done by non-medical personnel. In fact, some nursing homes improperly place feeding tubes in people who can swallow for their own convenience. There are many reasons people might die, but starving or dehydrating to death should not be one.
" Georgia law protects animals from the inhumane care of being deprived of food and water O.C.G.A. § 16-12-4; see O.C.G.A. § 4-11-2(1), (4).
" The proposed bill simply presumes that most people do not want to undergo this inhumane practice that results in an unnecessary death within days.
" The bill includes exceptions for all of the circumstances where a reasonable person might not want or need to take food or water.
" The proposed bill allows people to make choices to abstain from food or water if they prefer.
" The bill includes exceptions for all circumstances where not providing food and water might be medically appropriate.
" The disability community firmly supports the bill as a safeguard to unwanted premature death.
3) Presumption that Good Decisions Support Life and Health
" Many individuals with disabilities are not competent to make decisions
while in a hospital and others must make healthcare decisions for them.
" Too often, decisions are made not to treat persons with disabilities for treatable conditions out of the personal views or conflicting motives of the relative making the decision under O.C.G.A. § 31-9-2 and not out of concern for the medical well-being of the individual in the hospital.
" The proposed bill is a minor change in the current law to ensure that good medical practice is being provided to all people, even if some relative has an ulterior motive or does not appreciate the life of an individual with a disability.
4) Life-Sustaining Treatment Must be Continued During Transfer
" Some hospitals refuse to treat an individual for a variety of reasons
from a legitimate disagreement on the best medical course to a failure to receive
reimbursement. It may take a number of days before relatives can find a facility
willing to provide the treatment. The proposed bill simply requires life-sustaining
measures to continue in the interim.
" A second opinion or an alternative treatment option mean nothing if a hospital is not required to maintain life-sustaining measures in the interim until transfer.
" The proposal is a minor change to an existing law.
" Alabama has a similar provision protecting the lives of people who need to be transferred.
We need your support to help turn these bills into reality. Please inform yourself with these issues by studying the talking points below. You must understand the issues before you can educate your representative. These issues are some of the most important issues affecting our community. People everyday are loosing their lives because of the lack of protections in these areas. Your life is at risk even now and that is why it is absolutely imperative that you act to make this legislation happen.
SIMPLIFIED TALKING POINTS
Health Agent Law
1. Current State living will is confusing and presents options people least want.
2. Proposed law is consumer-friendly document that permits people to make real choices.
Food and Water for Persons with Disabilities Law
1. People with disabilities can face the inhumane and fatal consequences of starvation and dehydration and the case of Terri Schiavo shows the confusion of some people surrounding this issue.
2. The proposed law disfavors the deadly and unnecessary practice unless the individual chooses it or it is medically appropriate.
Presumption that Good Decisions Support Life and Health
1. Under current law, relatives with all sorts of conflicts of interests can cause someone in a hospital to unnecessarily die.
2. Most people want, and the law should presume they choose, treatment that reasonably supports life.
Life-Sustaining Treatment Must Be Continued During Transfer
1. Sometimes hospitals for medical or financial reasons do not want to treat a patient who could survive for some time.
2. Georgia needs a law, like Alabama's, which requires life-sustaining treatment to continue while a transfer to a facility that will treat the patient.
PARAGRAPH FORM TALKING POINTS
Health Choices Bill
A committee of experts has developed a consumer-friendly document for making health choices that is far superior to the confusing and unpopular standard Georgia living will.
The current standard Georgia living will set out in statute is a confusing document. It describes only three choices and the least popular ones at that, not to be artificially fed, not to be artificially hydrated, or not to be fed or hydrated. The confusing language and the limited unpopular choices may be reasons the living will is often not filled out.
The new form has a simple and logical design where people can select someone
to make health choices for them when incapacitated and/or give them guidance.
All of the choices have been designed, with the help of marketing experts, to
be easily understood. Moreover, the most popular, life affirming choices are
The committee that designed the bill had representatives of all sectors of the community. The disability community was represented and it strongly supports the bills as a significant improvement over current Georgia law. The proposed health choices document starts with the selection of a health care agent which is preferable to a static living will in consideration of the constant advances in medicine and the multiplicity of conditions that people can have. The document then has a living will section that can provide guidance or can provide real choices for people, unlike the current statutory form. The proposed document also allows some easy selections for other end-of-life decisions.
The clarity of and simplicity of the proposed form's design and language will not only be a great improvement, make it used more, and underline that Georgians first value human life, but the form can be a model for other states that have difficulties with their statutory health choice forms.
Food And Water For People Bill
Food and water are basic human needs that no civilized society would deprive any person. There is a great deal of confusion surrounding the provision of nutrition and hydration to people who cannot swallow as the case of Terri Schiavo illustrated. Without a clear standard pronounced in law, the inhumane practice of putting people to death through thirst and starvation may unnecessarily occur. Georgia needs a law to protect people and to prevent their being starved to death unless a competent individual has chosen to do so or unless a medical condition does not allow for providing food or water. With the new consumer-friendly health choices form, anyone who prefers to die this way under certain conditions can more readily make that choice.
In Georgia, animals are protected from the inhumane care of being deprived of food and water. O.C.G.A. § 16-12-4; see O.C.G.A. § 4-11-2(1), (4). People with disabilities should have no less right unless the person makes a voluntary choice not to take food or water.
A variety of medical conditions prevent people from being able to take food or water by mouth. For these people, the provision of water and food is simple and can be done by non-medical personnel after a routine brief medical procedure to insert a tube. Some nursing homes improperly place feeding tubes in people who can swallow for the convenience of nursing home staff since feeding by tubes is easier and faster than helping many individuals eat and drink by mouth. Death by starvation and dehydration is completely unnecessary for any individual in any American health facility.
The proposed bill simply legitimizes a presumption that most people do not want to undergo the inhumane practices of being denied food and water that will result in an unnecessarily early death within days. If Georgia considers deprivation of food and water cruelty to animals, the practice should not be tolerated for people who have not chosen to die in this manner.
The proposed bill respects the health choices of people to choose to die by
starvation or dehydration when faced with certain health conditions. The new
health choices bill discussed above allows competent people who believe that
they prefer dying to living with certain conditions can make those choices more
The proposed food and water for people bill also provides exceptions for those situations where providing food or water is not helpful to the health or well-being of an individual. Some medical conditions are worsened for a period by the introduction of food or water, or food and water simply does no good. These are humane exceptions to having food and water forced into someone when it makes no sense. The proposed bill, therefore, is a measured and balanced response for the protection of lives of people with disabilities and others in medical settings.
Presumption Of Life Bill
Most people choose medical treatment that will reasonably promote life and health. However, when Georgia law allows others to substitute their judgment on healthcare choices for a person in a hospital, conflicts of interest may cause them to make a choice that the individual would be unlikely to make. A minor change in the law could protect individual rights and choices.
Individuals with disabilities are sometimes not competent to make decisions for themselves, either because or a cognitive disability or because of a medical condition or treatment that causes them temporarily unable to make health care choices. Georgia law allows other people, generally relatives, to make health care decisions for the individual under a disability. An estranged spouse, a beleaguered parent, or an indifferent distant relative can all be tempted to make a decision that would not be the choice of the individual nor in the individual's best interest. As anyone who has studied family dynamics knows, relatives can made decisions that are not in another's best interest and there needs to be a standard against which to measure substitute decisions.
The proposed bill makes a minor change in an existing Georgia law, O.C.G.A. § 31-9-2, to presume that most people want medical treatment that reasonably promotes life or health. Substitute decision-makers who do not make reasonable judgments in favor of life and health are not acting in good faith and their decisions cannot prevent another person from agreeing to reasonable medical treatment or a doctor from providing emergency treatment. If some relative has an ulterior motive or if the relative does not appreciate the life of an individual with a disability, the presumption will permit good medical judgment, always in favor of prolonging life or restoring health where reasonable, to override any conflicting motives. Of course, if the individual needing medical treatment would not want the treatment or if the proposed medical treatment is not reasonable in consideration of the overall health of the individual, the presumption is overcome. But most people want treatment that will help them live longer and restore their health and those choices should be the standard response.
Maintaining Life-Sustaining Measures Through Transfer
Some hospitals refuse to treat an individual for a variety of reasons. The refusal could be from a legitimate disagreement on the best medical course or it could be from a failure to receive reimbursement. Relatives might then seek a facility willing to provide the treatment or to give a second opinion, but the search might take several days. The proposed bill simply requires life-sustaining measures to continue in the interim until the transfer is completed.
People and their families have a right to seek second opinions or to choose medical facilities that can give alternative treatments. However, the right to make these choices means nothing if, before the transfer is completed, the first facility allows the individual to die from the interruption or denial of life-sustaining measures. Life-sustaining measures must continue during transfer.
Adding one sentence to an existing law, O.C.G.A. § 31-32-8, will allow life-sustaining measures to be provided until and during transfer. Alabama has a similar provision protecting the lives of people are transferred. Lives should not be jeopardized simply because the first facility may be unwilling to provide life-sustaining measures awaiting transfer to a facility that will provide care.