'Right-to-die' bill aims for clarity


December 01, 1992|By Norris West | Norris West,Staff Writer

You've been in an accident and you're unconscious, attached to a life-preserving respirator. You're being kept alive artificially; doctors give you virtually no chance of recovery.

Would you want to be kept alive while trying to beat the odds? Or would you want the life-support system withdrawn? Because you can't communicate your decision now, how does anyone know what you want? Should someone choose for you?

Baltimore Circuit Judge John Carroll Byrnes says a bill he helped write for consideration in the 1993 General Assembly would allow Marylanders to choose surrogates who would be able to decide whether they should be kept alive on life-support systems.

This so-called "right-to-die" issue is one of the more hotly discussed topics in the country today.

QUESTION: You were one of five members of a committee appointed by the Maryland Conference of Circuit Court Judges that drafted changes in Maryland law pertaining to the right to die. Why this committee, and is it responding to public pressure for law that permits a person to have control over his or her death, even if incapacitated?

ANSWER: Yes. You can see public concern reflected in the various constituent organizations that have consulted with our committee. We have a list that's up to 50.

There are grass-roots individuals, and there are organizations that represent individuals. There are senior citizens groups, such as the Alzheimer's Association, and the American Association of Retired Persons. People felt that the current law was very, very unclear. Does a judge, for example, have authority to authorize life-support withdrawal, or could family members make decisions like that? The law is not clear.

Q.: From your committee's research and discussions, why is this right-to-die issue so much in the public's mind right now?

A.: I think people have become deeply concerned by the dying process. That happens, specifically, with diseases such as Alzheimer's, Lou Gehrig's disease and AIDS.

There's been a lot more publicity recently attending the dying process. While for some people it might seem to be a beautiful sunset, for others it is a raging inferno. There is an obvious concern about controlling the process as best they can.

Q.: In Maryland, what right does a person have in deciding whether to refuse life-sustaining medical treatment or to have it withdrawn?

A.: Individuals now have a right to make their own medical decisions -- that their body is not to be invaded or touched by any other human being, including doctors or hospitals, without their consent.

Q.: What's the difference between a living will, which is available in Maryland now, and the legislation you're proposing? Wouldn't both permit an individual to decide in advance whether to receive life support?

A.: Under current law, a living will is confined to conditions where 1) someone is unconscious; 2) is suffering from a terminal illness; where death is imminent; and 4) extraordinary life-support technology is involved. All four of these factors have to be in effect under a living will.

Under this bill, a person's health-care authority would be more extensive than that. You would be able to write your own life-ending agenda when permanently comatose -- not just when there is terminal illness and death is imminent. The bill would urge citizens to execute powers-of-attorney [a legal document designating someone to act on your behalf]. They could designate virtually anyone to make a decision for them in their health care.

Q.: Where would this legislation, if it passes, put Maryland on the right-to-die issue, compared with other states?

A.: This would be the most comprehensive approach to health-care decisions in the United States -- period. Living-will statutes are uniform throughout the country, but this would have a wider scope.

Q.: Surely there would be people who won't sign such a power of attorney and who would not have expressed a clear directive. What would happen to them if they were to become comatose?

A.: It's fair to say that even in the long term a large majority of non-elderly will not have advanced directives because human nature is human nature.

But if such a person suffers a traumatic accident at some time, even if young, or hospitalized while suffering from a serious disease, [the legal options] could be brought to their attention. However, the bill would provide that the patient's family could become the decision-maker -- even if a person has not done a living will, does not have an advanced directive at any time or does not have a power of attorney executed.

Q.: This bill would make it more difficult for parents of minor children to have life support withdrawn from themselves than for others? Isn't this an unfair restriction on them?

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