A bill that would create a process by which a physician can cease treatment they deem to be medically unnecessary or inappropriate for a patient passed its first committee hurdle Tuesday.
The bill, sponsored by Sen. John Edwards, D-Roanoke, establishes safeguards that are not currently in the state code for situations in which a conflict arises between a patient or their family and the physician providing care. Oftentimes these situations arise over end-of-life treatment, when a physician determines the treatment is medically or ethically inappropriate, contrary to the request of the patient or their family.
“Right now, the Virginia (code) is silent in the case of what to do in an unresolved disagreement between families on the one hand and health care providers on the other hand,” Edwards told Senate Education and Health’s Health Professions Subcommittee on Tuesday.
Currently, the state requires that, in a case when a conflict cannot be resolved within the hospital, the physician must make a reasonable effort to identify another physician or facility that is willing to provide the desired treatment. Edwards’ bill states that after that, if the conflict is still unresolved and another physician hasn’t been identified, “the physician may cease to provide the treatment” that he or she has already deemed medically unnecessary.
The issue of what to do in such unresolved conflicts has been a topic of discussion for the state’s Joint Commission on Health Care for about two years. The commission has held several work groups with stakeholders to determine the best way to resolve these conflicts.
Several organizations that were involved in the work group spoke in favor of the bill during Tuesday’s meeting, including the Family Foundation, the Virginia Society for Human Life, the Virginia Catholic Conference and the Virginia Hospital & Healthcare Association.
Dr. Kelly Stuart, a health care ethicist with Bon Secours Richmond Health System, spoke Tuesday about the trouble physicians go through when faced with providing treatment they consider unethical.
She said she sees about 25 cases each year relating to medically inappropriate treatment at the end of life, and said sometimes physicians and nurses are forced to provide treatment they consider “tantamount to torture.”
“At present, if a family member insists, providers are required by law to apply interventions that they know are medically inappropriate, regardless of their professional judgment that the intervention is harmful,” she said. “That that intervention just keeps a heart beating. And the law provides no remedy.”
The subcommittee voted unanimously for the full Senate Education and Health Committee to report Edwards’ bill. Del. Christopher Stolle, R-Virginia Beach, has a companion bill that the House’s Committee on Health, Welfare and Institutions recommended referring to the Committee for Courts of Justice.