In a previous post about the new House version of Obamacare, I concluded that the end of life counseling provisions had been improved but could still use further clarification.  But I have a concern about assisted suicide in an area not connected to end of life counseling or advance directives.

There is a section deep in the bill that would appear to pay for “advocacy services,” provided to beneficiaries receiving “home or community based services,” starting at page 1593.  I wonder whether this section could permit back door assisted suicide advocacy in states where it is legal. The key question comes up on page 1594. From the bill:

(e) ADVICE AND ASSISTANCE COUNSELING.—An agreement entered into under subsection (a)(2)(A)(iii) shall require the entity to assign, as requested by an eligible beneficiary that is covered by such agreement, an advice and assistance counselor who shall provide an eligible  beneficiary with information regarding—(1) accessing and coordinating long-term services and supports in the most integrated setting;  (2) possible eligibility for other benefits and services; (3) development of a service and support plan; (4) information about programs established under the Assistive Technology Act of 1998 and the services offered under such programs; (5) available assistance with decision making concerning medical care, including the right to accept or refuse medical or surgical treatment and the  right to formulate advance directives or other written instructions recognized under State law, such as a living will or durable power of attorney for health care, in the case that an injury or illness causes the  individual to be unable to make health care decisions; and (6) such other services as the Secretary, by regulation, may require.

It seems to me that this could be construed as permitting an advocacy group like Compassion and Choices to be paid to help eligible people who want assisted suicide to fill out the required forms and advise about assisted suicide services.  Note, there is no prohibition on this section for “promoting” assisted suicide as there is in the advance directive section.  Moreover, relevant to both this and the previous post,  Compassion and Choices says that assisted suicide of the terminally ill by physicians isn’t assisted suicide, but “aid in dying.”  It is even facilitating a lawsuit in CT to have a judge legalize assisted suicide by redefinition.

The ridiculous “aid in dying” scheme aside, I certainly don’t know that this was the intent of the drafters or, indeed, whether my concern is warranted. But I don’t see anything in this section of the bill that would preclude payment for assisted suicide advocacy services in states where it is legal.  The devil would be in the regulatory details.  Indeed, with Compassion and Choices is striving to become the Planned Parenthood of death, I have little doubt that it and other such groups would seek payment for assisted suicide advocacy services they now offer for free if Obamacare passes.

Articles by Wesley J. Smith

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