Santiago bill seeks terminally ill person’s right to die

Senator Miriam Defensor-Santiago. INQUIRER FILE PHOTO

MANILA, Philippines—Senator Miriam Defensor-Santiago has filed a bill that will allow  a patient with a terminal condition or “permanent unconscious condition” to refuse medical treatment and allow the “natural process of dying.”

Senate Bill 1887 also known as the “Natural Death Act” filed by Santiago provides that  any person of legal age and sound mind may execute a written instruction, “directing the witholding or withdrawal of life-sustaining treatment in a terminal condition or permanent unconscious condition.”

The directive should be signed by the patient in the presence of two witnesses.

But the witnesses, the bill said, should not be related to the declarer, should not  be entitled to any portion of the estate of the declarer upon his or her demise, and should not be the attending physician of the declarer or an employee of the physician or  a hospital in which the declarer is a patient.

In the “health care directive,” the patient may “wilfully” and “voluntarily make known” his  desire that his  dying should not be “artificially prolonged” if he was diagnosed for example to be in a terminal condition by the attending physician or in a permanent unconscious condition.

“If at anytime I should be diagnosed in writing to be in a terminal condition by the attending physician or in a permanent unconscious condition by two physicians, and the where the application of life-sustaining treatment would serve only to artificially prolong the process of my dying, I direct that such treatment be withheld or withdrawn, and that I be permitted to die naturally…” said the proposed directive.

The directive may also state that in the absence of the patient’s  ability to give directions regarding the use of such life-sustaining treatment, “It is my intention that this directive shall be honored by my family and physician (s) as the final expression of my legal right to refuse medical or surgical treatment and I accept the consequences of such refusal.”

The directive, under the bill, should be notarized and should be made part of the patient’s medical records.

“If a qualified patient capable of making health care decision indicates his or her desire to die at home, the patient shall be discharged as soon as reasonably possible,” it also said.

Section 10 of the proposed measure though clarified  that “Nothing in this Act shall be construed to condone, authorize, or approve mercy killing or physician-assisted suicide or to permit any affirmative or deliberate act or omission to end life other than to permit the natural process of dying.”

The bill also exempts any physician or health care provider from any legal liability.

“Any physician or health care provider acting under the direction of a physician or health facility and its personnel, who participate in good faith in the withholding or withdrawal of life-sustaining treatment from a qualified patient in accordance with the requirements of this chapter, shall be immune from legal liability, including civil, criminal or professional conduct sanctions unless otherwise negligent,” the bill said.

In filing the bill, Santiago acknowledged the fundamental right of adult persons to decide their own health care, including the decision to have life-sustaining treatment withheld or withdrawn in instances of a terminal condition or permanent unconscious decision.

“Modern medical technology has made possible the artificial prolongation of human life beyond natural limits. Such prolongation of the process of dying for persons with a terminal condition or permanent unconscious condition may cause loss of patient dignity, and unnecessary pain and suffering, while providing nothing medically necessary or beneficial to the patient,” she said in her explanatory note of the bill.

“In the interest of protecting individual autonomy, and in recognition of the dignity and privacy which patients have a right to expect, our laws should recognize the right of an adult person to make a written directive instructing such  person’s physician to withhold or withdraw life-sustaining treatment in the event of a terminal condition or permanent unconscious condition,” Santiago added.

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