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Apparently legislation in Missouri is controversial among the bioethics set because it requires written consent to stop ICU care for a child. From Thaddeus Mason Pope’s valuable Medical Futility blog:

Ordained Christian minister and Missouri state representative Bill Kidd has introduced H.B. 113. It contains two main provisions…

More controversially, the bill also follows Idaho and Oklahoma in always requiring consent to stop life-sustaining treatment. But in contrast to those other states, the Missouri bill is focused on only treatment of children.

Hmm. I am not sure what the legislator being a pastor has to do with the merits of the legislation. I would say, nothing. 

But I am puzzled why this proposal is “controversial.” So, I went to the legislation. From, H.B. 113:

4. No health care facility, nursing home, physician, nurse, or medical staff shall withhold life-sustaining procedures, food, medication, or nutrition, nor place any restrictions on life-sustaining procedures including, but not limited to, food, medication, or nutrition for any minor patient, resident, or ward without the written permission of at least one parent or legal guardian of the minor patient or ward.

5. No do-not-resuscitate order or similar physician’s order shall be instituted either orally or in writing without the written permission of at least one parent or legal guardian of the minor patient or resident or prospective minor patient or resident.

I honestly don’t see the problem, and indeed, believe it should also apply to adults.

Getting consent in writing would better ensure that parents made a truly informed decision to stop ICU care or put a DNR on the chart. The doctors might have to work harder to educate the parents, but isn’t that a good thing?

Getting consent in writing would also protect doctors later if parents, in their grief, claimed they had not consented to stopping treatment. Call it a lawsuit stopper.

I suppose it would impede unilateral futile care decisions to take a child off treatment without consent. If that is what makes it controversial–it is very telling. The more we stop futile care impositions, the more trusted and ethical our health care system will be.

Reprinted with permission from National Review Online.