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Keep the courts out of hospital rooms

Last modified: 3/12/2012 12:00:00 AM
Advanced-care directives are instructions about end-of-life care made by an individual to determine the course of treatment in the event that he or she is near death and unconscious or mentally incapacitated, or in a persistent vegetative state with no hope for improvement. In an age when medical science can keep comatose people alive for years, such directives allow people to end life as closely as possible in accordance with their wishes.

Two bills sponsored by Republican Rep. Dan Itse of Fremont would make the use of advanced-care directives more difficult. In some situations, they could potentially countermand the wishes of a dying individual. They both deserve defeat.

The use of advanced-care directives has increased slowly and steadily over the two-plus decades they've been in use. Having a directive on file makes decision-making far easier for loved ones and medical providers. Everyone would be wise to fill one out, have it witnessed, copied and filed with important papers and medical providers. But the reality is, people procrastinate. House Bill 1216 would punish them for it by taking power away from their loved ones and needlessly giving it to the courts.

Traditionally, when a person is incapacitated and receiving life-sustaining medical care, his or her family members work with health-care providers to discuss when or if that care should be changed or stopped. Itse's bill would require both doctors and family members to go to probate court for approval of any change. That would put a big psychological burden on family members, slow decision-making enormously and prove costly for the health-care and judicial systems.

Even when the incapacitated person had the foresight to have an advanced-care directive, House Bill 1217 would force health-care providers and family members to seek probate court approval if the directive differed from the form prescribed by New Hampshire law. Forms used by another state or filled out incorrectly, for example, and those created by an individual or family to meet their own needs could be declared invalid.

The bill's sponsors have offered no evidence that incapacitated people are being put to death against their will and demonstrated no need for either bill. It's odd that Itse and the bill's other sponsors are among the Legislature's most conservative members, yet they want to take power away from individuals and their family members and give it to a judicial system that knows nothing of the individual involved and has no medical expertise.

Care at the end of life should reflect a person's values and wishes, not the beliefs of a given judge. People with advance directives, the Journal of the American Medical Association reported, are far less likely to die in a hospital and end life instead where they wanted to be, at home or in a hospice. Itse's bills would make it harder for them to do that. They should not become law.


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