Virginia Patient Autonomy Protection Act Takes Effect

The potential for involuntary euthanasia no longer threatens vulnerable Virginians. Gov. James Gilmore signed the Patient Autonomy Protection Act last April and this important pro-life victory went into effect July 1.

A massive lobbying effort by the Virginia Society for Human Life (VSHL), combined with strong support from Gov. Gilmore, culminated in passage of the Patient Autonomy Protection Act without a single negative vote in either house of the Virginia General Assembly.

While appearing easy, the victory, in fact, was a tremendous struggle that took years of patient work to accomplish.

The new bill amends the 1992 Health Care Decisions Act, an act which allowed for the denial of lifesaving medical treatment if a physician considered it "medically or ethically inappropriate" against the will of the patient or the patient's family.

But under the Patient Autonomy Protection Act, before a physician can discontinue life-sustaining treatment, he must notify the patient or family and allow time for transfer to another physician who is willing to continue treatment. "Life- sustaining care" is defined as "any ongoing medical treatment that utilizes mechanical or other artificial means to sustain, restore or supplant a spontaneous vital function, including hydration, nutrition, maintenance medication, and cardiopulmonary resuscitation."

The original 1992 Health Care Decision Act was the first in the nation to actually authorize involuntary euthanasia (i.e., denying lifesaving treatment against the explicit wishes of a patient or his family). Yet most Virginians were unaware of this "technicality" buried in the bill's wording. Even a great many legislators did not know of the impact.

Now, eight years later, this threat has been removed.

To rectify the 1992 law, VSHL State Legislation Chairman Fiona Givens, VSHL President Louise Hartz, and Geline Williams, state delegate to the National Right to Life Board of Directors and its chairwoman - - with the assistance of NRLC's Department of Medical Ethics--visited 110 General Assembly members to explain the necessity of passing the Patient Autonomy Protection Act.

Dr. John A. Jane, Sr., chairman of the Department of Neurological Surgery at the University of Virginia Health System, wrote a letter to committee members urging support of the bill. He said that it

...imposes a minimal obligation on a physician or facility unwilling to respect their patient's choice for life. It merely requires that they continue life-sustaining care for two weeks so the patients or their representatives can seek a more congenial health care provider. Surely this is not too much to ask when the patient's very life is at stake.

Yet in spite of all the preparatory effort, the protective bill garnered a bevy of powerful opponents. The Medical Society of Virginia, the Virginia Health Care Association, the Virginia Hospital Association, and the Virginia Bar Association all worked against its passage.

Gov. Gilmore, however, was a strong supporter. Along with Secretary of Health and Human Resources Claude Allen, Gilmore took a leading role in initiating meetings to negotiate differences with dissenting groups. The outstanding leadership skills of the patrons of the bills, Senator Randy Forbes and Delegate Morgan Griffith, were also critical in this process.

The resulting bills with identical wording were reported unanimously out of their committees and passed in floor action by votes of 39-0 in the Senate and 99-0 in the House. The outcome represented a huge victory for VSHL.

Burke Balch, director of NRLC's Department of Medical Ethics, said, "Tragically, too many doctors today, pushed both by ideological commitments to the quality of life ethic and pressures from managed care providers to ration medical treatment, are denying lifesaving treatment against the wishes of patients and their families. Virginia's new Patient Autonomy Protection Act provides vital protection against this very scary trend."

"Passage of this legislation is a major pro-life victory, not only in Virginia, but in the United States as well," Balch said. " Protective measures similar to Virginia's have been included in legislation passed in Maryland, Minnesota, Ohio, Oklahoma, South Dakota, and Texas."

The protective measure passed in Texas, Balch added, "was adopted with the strong backing of Gov. George W. Bush."

Virginia is the first state to pass such a measure as a freestanding bill, which could be an important precedent for other states to follow.