Patient autonomy is fast becoming a one-way street. Choose to die by refusing life-sustaining treatment–sacrosanct! Want to live with life-sustaining treatment? Not your call.
I recently helped successfully fight an attempt in Texas (SB 303) to legalize no consent DNRs. But they have been passed in VT and MD. From Thaddeus Pope’s Medical Futility blog:
In both Maryland and Vermont, a clinician can write a POLST [Physician Orders for Life-Sustaining Treatment] order indicating “no CPR” even without patient or surrogate consent. Regulations in both states authorize the entry of a “do not attempt resuscitation” order on a POLST on the basis that CPR would be “futile” or “medically ineffective.” This “no consent” option is clearly printed right on the POLST form.
POLST stands for Physician Order for Life-Sustaining Treatment. Laws that regulate POLSTs are increasingly authorizing doctors to unilaterally overturn surrogate wishes and patient advance directives with POLST orders. (This varies widely from state-to-state). It would be tragic if a form designed to improve the care of patients became a tool for overturning autonomy.
Not coincidentally, Vermont has a single payer healthcare plan it can’t pay for. Some have called for the cost savings to come from assisted suicide legalization–now done–and healthcare rationing. This abuse of POLSTs fits that “show me the money” paradigm.