Alia Beard Rau

The Republic | azcentral.com

The Arizona Legislature has given final approval to a controversial bill that would protect a health-care provider who refuses for religious or moral reasons to participate in medical care that may lead to a patient's death.

The bill passed 32-24, with Republicans supporting it and Democrats opposing it. Four members were absent.

Gov. Doug Ducey now has five days to sign the bill, veto it or do nothing and allow it to become law.

Senate Bill 1439, sponsored by Sen. Nancy Barto, R-Phoenix, and pushed by the conservative Center for Arizona Policy, would protect from discrimination individuals, such as doctors or nurses, and entire medical facilities that refuse to participate in any service or to provide any item that results in the death of an individual.

Unlike in several other states, assisted suicide is not legal in Arizona and thus health-care workers don't participate in that action. The bill's lack of specificity has raised concerns that doctors or nurses may refuse to carry out an individual's end-of-life instructions, which could include not inserting a breathing tube, ceasing food or water, or increasing pain medications.

Barto and bill supporter Rep. Eddie Farnsworth, R-Gilbert, have said the protections in the bill already exist with no problems in Arizona as part of the federal Affordable Care Act. This bill is needed, Barto has said, because Congress is working to eliminate the ACA.

However, unlike the federal law, the Arizona bill does not state instances where the protection wouldn't apply, including federal exceptions for withholding medical care; withdrawing food or water; abortion; or providing an item or service for the purpose of alleviating pain, even if the action may increase the risk of death.

Surgeon: 'This bill is unnecessary'

Rep. Randy Friese, D-Tucson, a trauma surgeon, opposed the bill.

"Life is associated with a 100 percent mortality rate," he said. "What we aim to do when providing care to those who are dying is at some point help a family understand when we are no longer prolonging life, but we are in fact prolonging death and suffering."

He said health-care professionals' goal at that point is to provide comfort prior to death, possibly including withholding significant treatments like kidney dialysis or putting the patient on a respirator, or by making them more comfortable with pain medications.

Friese said supporters gave no specific examples of individuals who experienced discrimination from an employer for refusing to assist with end-of-life medical care during the two public committee hearings for the bill.

The bill defines discrimination in this case to include firing, demoting, cutting wages or "any other penalty or disciplinary or retaliatory action."

"I've never seen an example of this, and this is what I do," Friese said. "This bill is unnecessary."

Supporter: Protection for medical professionals

Farnsworth disagreed.

"We base policy upon the potential for harm. That's what we're doing here," he said. "I can't think of a single circumstance where we ought to punish somebody ... who decides they don't want to kill another human being."

He said he believes the bill is "very narrowly crafted ... very direct."

"We continue to talk about the rights of the patient ... but we ignore the other side of the equation," he said. "There are people who have personal, moral and religious beliefs that they should not assist somebody in death."