Policy Advocacy Project Part B.

Identify and Describe the Legislator

One of the Kentucky’s remarkable legislator is Mary Lou Marzian, a Democratic member of the Kentucky House of Representatives representing District 34. Mary has represented her District since January 1995, running several elections unopposed.Policy Advocacy Project Part B.

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Her contribution in sponsoring house bills, more so in the area of healthcare is largely noticeable, a process which has continued to strengthen the health care system within the Kentucky region and keeping up with the pace of the other states to better the citizens’ health well-being. Her experience in healthcare Legislation is supported by her familiarization in the world of nursing, having earned her Bachelor of Science in Nursing from the University of Louisville.The 25 years of service at the Kentucky House of Representatives has earned her legislative experience, thus making her easily identify the areas of concerns that may require legislative backing for quality improvement and performance. This has been a remarkable career which will definitely leave an unforgettable mark, especially within the Kentucky healthcare sector.Policy Advocacy Project Part B.

The Review of the Elected Official

Mary Lou Marzian had in the past sponsored numerous health bills within the Kentucky House of Representatives. Nevertheless, she recently sponsored a bill, House Bill 224 of 2020 or what is widely referred to as the Kentucky Act Relating to Patient-Directed Care at the End of Life (HB224) (Kentucky General Assembly, 2020). This bill touches on the controversial area of medically assisted death, where only a few states have taken a step to legislate on this matter. Having been a qualified and registered nurse professional, Mary Lou Marzian is well familiar with the legislation in this area, having widely consulted from Acts relating to this matter in the states of Oregon, Hawaii, Maine, New Jersey, Washington, Vermont, and Montana.Policy Advocacy Project Part B. Largely, she consulted closely on Oregon’s Death with Dignity Act, which is a detailed Act with specific provisions that protect the misuse of the law, both by the patient, as well as the involved physicians. Her strive to make the Kentucky healthcare system as one of the best in the US has not gone unnoticed and this bill regarding medically assisted suicide is a proof that she is determined even where matters are of ethical concerns.Policy Advocacy Project Part B.

Review of the Legislator’s Position on the Topic

Ms. Mary House Bill 224 of 2020 provides that terminally ill patients above the 18 years of age can make decisions to end their life willingly through a request of medication to self-administer to cause death. This has been supported by the fact that terminally ill patients sometimes undergo through an unimaginable pain and suffering, which will eventually end in death, which is seen as a deny of chance for the patient to die in dignity.Policy Advocacy Project Part B. As opposed to several other states with a similar legislation on medically assisted death, the House Bill 224 of 2020 categorically prohibits the administration of the legal prescription by a physician or a relative and only permits the patients in their own capacity to legally obtain a prescription from their respective physician and to administer it by themselves, at a place and time of their own choosing(Kentucky General Assembly, 2020). The proposed Act does not authorize physician assisted death either through lethal injection, mercy killing or active euthanasia.Policy Advocacy Project Part B.

Ms. Mary position on the medically assisted death is largely based on patient safety and therefore, eliminates misuse of the provisions of the Act by the physicians or patient relatives without a clear and informed consent from the patient. The requirements of making a request, timeline, documentation, as well as provision for rescinding request at any time, makes the misuse a bit difficult as the patient must fully consent with the request procedures and duration.Policy Advocacy Project Part B. As such, theHouse Bill 224 of 2020 has largely been viewed as largely borrowing from the Oregon’s Death with Dignity Act, which provides similar legal backing on the voluntary self-administration of a lethal dose of medication, strictly prescribed by a physician for the purpose of ending life with dignity(Kentucky General Assembly, 2020). Ms. Mary’s position attracts legal backing from other various acts from different states, thus also elevating the House Bill 224 of 2020 to a national level standard by complying with other legal provisions that touch on the patient’s privacy, rights for healthcare access, palliative care and dignity in death. However, Ms. Mary is cordial and carefully listened to my views during my visit to her office and as such, she promised to consider my proposals and propose provisional amendments during the bill discussions in the House of Representatives.Policy Advocacy Project Part B.

Personal Perspective of the Topic

Assisted death remains one of the ethical controversies in the medical world and its acceptance within the larger society has been hesitant and where the legal provisions have been introduced, there has also been a noticeable legal challenge emanating from interest groups within the healthcare system. As such, as Oregon embarks to pass a bill in regard to assisted death, I hold a personal perspective on this matter based on several aspects and reservations as I will express herein.Policy Advocacy Project Part B.

First, every life counts no matter what and medically assisted death in my view cannot be justified over the moral values. However, terminally ill patients sometimes undergo a lot of pain and suffering which eventually leads to death. Through a proper physician examination with a consultation of a second opinion, it may be determined that the patient may not live for long due to the complications that they pose. As such, it may be advisable if the patient is willing to end their lives, they can make a request (Burlone& Richmond, 2018).Policy Advocacy Project Part B.

Nevertheless, most of the terminally ill patients face a great challenge during their diagnosis and treatment processes. Some may be in great pain which sometimes may make them unconscious. Although the proposed House Bill 224 of 2020 provides that the physician must fully advise the patient upon request on the matter of medically assisted death, the patient must consent in verbal and in writing, which sometimes may not be possible to most of the terminally ill patients whom may consent willingly when conscious. On the other hand, a patient may qualify for request, undergo the whole process, but fail to be in a position to administer the lethal dose by themselves.Policy Advocacy Project Part B.

From this perspective, the existing bill may not fully remedy the patients from pain and suffering or neither provide a chance to die with dignity, as the provisions only may favor a few considering the challenges of unconscious status as posed by most terminally ill patients.  While the argument for the strictness is based on the patient protection, the law must also be non-discriminative in its application, thus requiring amendments to introduce exceptions that will also be guided by existing laws and ethical standards within the medical sector for maximum benefit and betterment of the end of life patient care delivery (Daskal, 2018).Policy Advocacy Project Part B.

Recommendation

House Bill 224 of 2020 seeks to introduce a legal backing for the terminally ill patients whom voluntarily requests a chance to end their life(Kentucky General Assembly, 2020). Kentucky is one of the many states where Assisted death is prohibited, but due to the growing need and acceptance of the Assisted death across the US, the legislature through the House of Representative is proposing a bill to permit this medical procedure to save thousands of suffering terminally ill patients to die in dignity upon voluntary request through a physician.Policy Advocacy Project Part B.

Although the bill by Ms. Mary is well detailed and much focuses on a patient centeredprocess when it comes to the medically assisted suicide, I would propose several amendments that the bill misses to fully assist the vulnerable group as it is aimed. First, I recommend that the bill introduces a provision that in case the patient passes all the request procedures, but becomes unconscious during the administration time, then their physician is authorized to execute the procedure. On the other hand, if a patient is not able to administer the lethal dose by themselves, then the physician or a close relative can assist in doing so without legal implications.Policy Advocacy Project Part B.

On the other hand, the verbal and writing consent should be eliminated in cases where the patient is not in a position to make such requests, but through a representative, the request is made to the Cabinet for Health and Family Services upon whichif the request gets approval, then the physician is authorized to execute the procedure without the consent of the patient. This will save many patients with which physician examination shows that they will not live for long from suffering and pain, even without their consent due to the unconscious state that they are in. To be cautious, however, the Cabinet for Health and Family Services must establish ethical guidelines that must be used to reach their decisions to fill the gap for misuse of the provision.Policy Advocacy Project Part B.

Proposed Thank You Letter

(Enter your name and address)

December 11, 2020

To:

Mary Lou Marzian

House of Representative

Louisville, Kentucky

Dear Ms. Mary

Hope you are doing fine. Following the visit to your office last Friday, I am deeply humbled to express my gratitude for your warm welcome and cooperation regarding the matter on House Bill 224 of 2020 that you are sponsoring. Having dedicated your time to listen to my presentation in regard to medically assisted death matter was an honor and a show of confidence for the public participation in this debate.Policy Advocacy Project Part B.

In a controversial matter such as the medically assisted death, it was my humble submission that your bill may have missed on key patient rights provisions, which with the proper application of various legal articles, it will benefit many terminally ill patients who may be willing to end their life in a dignified way.Policy Advocacy Project Part B.

Your promise to take my submissions into consideration did not only show your willingness to make the Kentucky health system better, but as well, this will go a long way in making the bill benefit a lot more for this vulnerable group, having eliminated the barriers through amendments to better the end of life care for thousands of Kentuckians who may be terminally ill and willing to take the Medically assisted death process. Your actions will never go unnoticed and thank you for giving me the chance to participate in this noble process.Policy Advocacy Project Part B.