E Pluribus

July 8, 2005

            Earlier this year, the world suffered during the Terry Schiavo case.  It was tragic for many people for many different reasons.  At the core of that case, though, was a single issue…under what circumstances should a person with disabilities be denied food and water?  It is a concern for people with disabilities, accident victims, those that are aging, family members, medical professionals and society.  In an effort to see that no Iowan has a similar legal battle over that issue, I introduced House Study Bill 302 near the end of last session.  It tries to answer that fundamental question.

            House Study Bill 302 (HSB 302) states that a person with a disability who cannot speak for himself or herself is presumed to want food and water unless certain exceptions apply.  (Exceptions are required by prior US Supreme Court decisions.)  Those exceptions include:  one, the person signed a written directive, like a power of attorney for health care, when they could speak for themselves and specifically said they didn’t want food and water under the circumstances; two, the person verbally stated in a clear and convincing manner that they didn’t want food and water under the circumstances; and three, under certain medical situations, such as where the person can’t digest food and water, or it hastens death, etc… 

            The current Iowa law treats artificial feeding of food and water (for example, by a tube) as a medical treatment.  This was the result of a national legislative effort in the early 1980s.  That meant food and water was placed on the same level as ventilators, respirators and other serious medical treatments.  As a result, when a person stated in their power of attorney form that they didn’t want extraordinary medical treatments, they could be interpreted to mean they didn’t want food and water either.  Or, as in the Terry Schiavo case, when Terry said to her husband, her brother-in-law and sister-in-law that she wouldn’t want to live like the character playing Karen Ann Quinlan on TV, the judge could find that Terry did not want food and water.  (Quinlan was a twenty-one year old woman who lapsed into a coma.  There was a legal battle to remover her from a respirator.)

            I’ve heard that national surveys show that 50% of the people don’t think that artificial feeding and hydration should be considered a medical treatment.  They think of food and water - regardless if by tube, spoon-fed or whatever means - is normal human compassion.  As they point out, society doesn’t let animals die of hunger or thirst without consequences, so why should society permit humans to die in that manner.  My impression is that much more than 50% of Iowans believe it is appropriate to treat food and water differently than other, more invasive medical treatments.  And I thought HSB 302 would allow us to have that discussion.

            I had the bill drafted as an Oversight Committee bill so we could work on it between sessions.  We started having sub-committee meetings on it and I am the Chairman of the sub-committee.  Our next sub-committee meeting is July 18 where we intend to hear from people with disabilities, their family members and advocates.

            The disabled, as well as the elderly, have special concerns.  They don’t want to be burdens on their loved ones.  Studies show they often suffer from depression that makes their decision making even more difficult.  And often, they are more susceptible to influence on these critical decisions. 

It is my hopes that HSB 302 clarifies that society values all members of our society.  We should approach disability and aging with compassion and understanding.  Society should not want to hasten any death, unless the circumstances are very clear.  And it is hoped that no Iowan will suffer through a Schiavo case. 

            I appreciate your comments.  I can be reached at PO Box 140, Stratford, IA 50249, eichhorn@globalccs.net or george.eichhorn@legis.state.ia.us. 

George Eichhorn, State Representative