washingtonpost.com  > Metro > Virginia

End-of-Life Legislation Planned by Va. Delegates

By Bob Lewis
Associated Press Writer
Thursday, April 14, 2005; Page VA19

RICHMOND -- Legislation addressing the sort of end-of-life struggles that surrounded Terri Schiavo's death in Florida will confront the General Assembly next year, conservative lawmakers said.

"At a minimum, we need to say that you can't just starve someone to death if there is no written declaration by the person in question," said Del. Robert G. Marshall (R-Prince William).

_____Related Article_____
Easing the Final Days (The Washington Post, Apr 14, 2005)
Where to Learn More

The following Web sites offer information about hospices and related issues:

• Hospice Net. All about hospices for patients and families, www.hospicenet.org.

• National Hospice and Palliative Care Organization. Information and a database of hospices in each state, www.caringinfo.org or 800-658-8898.

• AARP Web site on caregiving and end-of-life issues, www.aarp.org/life/caregiving.

• American Hospice Foundation, www.americanhospice.org.

• Hospice Patients Alliance, www.hospicepatients.org.

• Growth House. For people with terminal illnesses, www.growthhouse.org.

• Webhealing.com. A Web site run by a D.C. psychotherapist for people dealing with grief and related issues, www.webhealing.com.

• Advance directive. Form for use in Virginia, the District and Maryland that allows you to appoint someone to make health care decisions for you and to indicate what treatment you do or do not want if you are unable to make those decisions yourself, www.capitalhospice.org; click on "Advance Directive-Living Will."

Schiavo's death two weeks ago, 13 days after the severely brain-damaged woman's feeding tube was removed, has angered religious conservatives and generated demands for action by the states and possibly by Congress.

"What we just went through was one of the most ghastly events in American history," said Del. Richard H. Black (R-Loudoun), one of the House's most outspoken conservatives.

Marshall said he is devising legislation similar to bills that he introduced but were defeated in 1999, the year after he orchestrated protests in Virginia in a case with strong similarities to Schiavo's. The legislation would preclude withholding water and nourishment to severely brain-damaged patients without clear, written directives left by the patient.

On Oct. 9, 1998, former Louisville television anchor Hugh Finn died in a Manassas nursing home, eight days after the feeding tube that had sustained him for 3 1/2 years was removed on orders of his wife, Michele.

Finn had been unable to eat, communicate or care for himself since a March 1995 car crash in Kentucky ruptured his aorta, depriving his brain of oxygen.

A few months after Finn's death, Marshall introduced legislation to make it almost impossible to withdraw nutrition from people in a vegetative condition unless it's authorized in writing by the patient. Where there is no explicit, written directive, other relatives could veto a next-of-kin decision to remove a feeding tube under Marshall's legislation.

His bills failed, and there is no guarantee they would be cleared this time given the wide range of opinions on the subject. Still, Marshall and other lawmakers say it's time for new legislation. "At least we should avoid a situation where there is all this he-said, she-said, and nothing is written down," Marshall said.

Black added: "It would probably be good to clarify the issue of living wills. My guess is that very few people who make those out anticipate that they will be made to die of thirst."

Del. John A. Cosgrove (R-Chesapeake) said nutrition and water put into the stomach of an incapacitated patient through a surgically implanted tube is different from more drastic means of life support.

"Most people think of life support as a way to keep someone breathing or a heart beating. Providing nutrition is not an artificial means of keeping someone alive," Cosgrove said. Virginia, however, can't address the issue until next year without a special session. The 2005 General Assembly adjourned in February and can only address bills the governor has amended or vetoed.

Congress, however, might act again this year, a prospect that bothers some conservatives who believe it's a matter reserved for the states.

Last month, Congress swiftly passed -- and President Bush signed -- legislation to remove the Schiavo case from Florida's courts and place it before federal judges. Federal courts refused to order the tube reinserted, and the Supreme Court declined to intervene.

"Congress tried to get involved, and while I understand the intent, it's a cumbersome way of doing things," Cosgrove said. "But what troubles us more is the forced taking of a helpless life, and that's what this was."

Caught in the middle are doctors, who assess patients like Finn and Schiavo, who advise their loved ones and, ultimately, who carry out wrenching and sometimes disputed decisions to terminate life support.

Health care industry lobbyist W. Scott Johnson said Virginia's end-of-life law, updated in 2000, already clearly delineates, in descending order, who can make decisions about withholding life support.

"One of the operational things the physicians try to do, even though this pecking order is in play, is include as many people as they can with the family and answer all their questions. If you do that, you eliminate much of the battle we saw in Florida," Johnson said.

© 2005 The Washington Post Company