Sorry for the driveby, folks, I’m multitasking. This may have been mentioned already, if so apologies.

In reference to “orders” for life sustaining treatment, what needs to be looked at is sec 5 of 1233 where they are defined. An “order” refers to the orders left by an individual about their preferences regarding treatment. These orders are the product of the end of life counselling, assuming that the individual wants it at all. Their entire purpose is to ensure that the individual’s wishes about his treatment be respected, should he become incapacitated. The section also outlines who can sign off on (‘witness’, basically) those orders: doctors, etc.

‘‘(5)(A) For purposes of this section, the term ‘order regarding life sustaining treatment’ means, with respect to an individual, an actionable medical order relating to the treatment of that individual that—

‘‘(i) is signed and dated by a physician (as defined in subsection (r)(1)) or another health care professional (as specified by the Secretary and who is acting within the scope of the professional’s authority under State law in signing such an order, including a nurse practitioner or physician assistant) and is in a form that permits it to stay with the individual and be followed by health care professionals and providers across the continuum of care;

‘‘(ii) effectively communicates the individual’s preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;

‘‘(iii) is uniquely identifiable and standardized within a given locality, region, or State (as identified by the Secretary); and

‘‘(iv) may incorporate any advance directive (as defined in section 1866(f)(3)) if executed by the individual.

This issue has been shamelessly distorted and manipulated by the Republicans. The entire purpose of 1233 was to ensure that end of life counselling would be available to everyone. The AARP wanted this provision.

Now, thanks to the GOP and the general state of our political discourse today, this provision is out. Some “victory”.