| By Mary Summa, J.D.Through the efforts of many, who want the state to be known as “progressive,” the North Carolina General Assembly, in 2007, authorized “Medical Order for Scope of Treatment” or a “MOST” document. This action by lawmakers may be the most dangerous assault on the right to life and dignity of the human person since Roe v. Wade.Patterned after the POLST (Physician Orders for Life-Sustaining Treatment) Paradigm, a “right to die” Oregon program, MOST is a two-page document which may supercede the wishes of a patient. In addition to Do Not Resuscitate Orders (DNR’s), it can be used to limit a sick patient’s medical treatment, including life-sustaining food and hydration provided by a feeding tube and medications. Medically, it carries the weight of a doctor’s order, and legally, it protects a doctor from criminal or civil liability. It is attached to the patient’s medical records.The MOST document threatens a patient’s right to informed consent about the withdrawal of food and water given by a feeding tube and life-sustaining medicines. It is said that “the devil is in the details,” and that is certainly the case here:The MOST may suspend previously executed Advance Medical Directives, including Living Wills, Medical Health Care Powers of Attorney, or Protective Medical Directive Documents. If a patient has specifically stated that he wants food/water and medicines, those wishes may be ignored.Unlike other Advance Medical Directives, which require the signature of the patient, with the MOST document, a “patient representative” can sign it. A family member will suffice, but if a family member is not “reasonably available,” the right to signing falls on “an individual with an established relationship with the patient who is acting in good faith and can reliably convey the wishes of the patient.” The terms “established relationship,” “good faith,” and “reliably convey” are left undefined. Furthermore, if these individuals are not “reasonably available,” a doctor can make the deadly decision to withhold medicines or artificial food and water on his or her own.
Unlike other Advance Medical Directives, which require that the patient sign the original document in the presence of notary, a copy of the MOST can be signed by a “patient representative” and faxed in to the hospital or health care facility. The authenticity of the signature cannot be verified because the signature does not need to be notarized. The MOST form does not require any witness signatures at all. In contrast, other Advance Medical Directives must be signed by two witnesses in the presence of a notary. Those witnesses attest to the mental competence of the patient and cannot be related to the patient by blood or by marriage, cannot be the patient’s physician or health care provider and cannot have anything monetarily to gain from the patient or his estate. Mistakenly, the Euthanasia Movement has equated liberty with autonomy. The North Carolina legislature has already legalized voluntary euthanasia by giving patients the legal right to direct the withholding of their own artificial food and hydration and life-sustaining medicines. MOST legislation catapults the State’s position to a whole new level. By ignoring long-standing procedures to ensure a patient’s right to consent, MOST provides opportunities for North Carolina doctors to involuntarily euthanize sick patients with impunity. The “First in Flight” state is fast becoming “First in Death.” Mary Summa is an attorney in Charlotte, North Carolina. Copyright © 2010. North Carolina Family Policy Council. All rights reserved. Re-printed with permission from the NORTH CAROLINA FAMILY COUNCIL MAGAZINE PUBLICATION. Originally appeared: “Babies for Sale — Buying and Selling Human Life in Surrogacy Agreements.” Family NC. Fall 2009.
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