Veto likely for measure mandating medical treatment at birth

PHOENIX — Gov. Katie Hobbs says she intends to veto legislation approved Thursday that would require doctors to provide “medically appropriate and reasonable care and treatment” to any infant born alive, regardless of whether it is likely to survive.

“It overrides patient and clinician decision-making in complex and highly personal circumstances,” Murphy Hebert, the governor’s chief of communications told Capitol Media Services.

The move is not a surprise. Only one House Democrat, Rep. Lydia Hernandez of Phoenix, voted for the measure.

Thursday’s 32-28 House vote for SB 1600, which followed party-line approval in the Senate last month, was highlighted by lawmakers detailing not only their beliefs about when life begins but also, in some cases, personal stories about their experiences with extremely premature infants or those with medical problems, like being born with only half a brain.

And there were several mentions of God.

But much of it came down to what some people say happens now in these cases and what the law would — and would not — have required doctors to do.

“This bill comes down to a simple question: If a baby is born alive, even if it is sick or troubled, do we make efforts to try to save that person and treat them with the same dignity we would any other human being in our hospitals, or do we leave them on a table to die?’” asked Rep. Justin Heap, R-Mesa. “It is repellent. It is evil.”

House Majority Leader Leo Biasiucci, R-Lake Havasu City, said all this does is conform the treatment of newborns with what is expected elsewhere.

“In what world do we live in if you ever went to the emergency room for any reason, heart attack, stroke, car accident … would we be OK with the doctor saying, ‘You know what? This doesn’t look good. We’re going to let you die,’” he said. “This is exactly the same thing.”

But Rep. Athena Salman, D-Tempe, said there’s a crucial difference.

She said it can often be clear that a baby is so premature or so medically handicapped that survival beyond perhaps a few hours is not medically possible.

“In those instances where medical intervention will be futile, health care providers can help families by providing comfort care for the baby and providing the family an opportunity to hold their baby, spending those precious few moments of life with their loved ones and spiritual services as requested,” Salman said.

The legislation did have an exception.

It would have allowed a parent or guardian to refuse to consent to medical treatment or surgical care that is not necessary to save the life of the infant, where the risk outweighs the potential benefit, or “will do not more than temporarily prolong the act of dying when death is imminent.”

“It doesn’t require the draconian efforts that some in this chamber have claimed, nor does it put ethical doctors at risk,” said Rep. Steve Montenegro, R-Goodyear. “It requires medically appropriate and reasonable care to all newborns.”

And that, he said, depends on the circumstances.

“It’s not medically appropriate or reasonable to whisk a baby away from that baby’s mother’s arms at 15 weeks’ gestation,” he said. “Because we know that that baby is probably not going to survive at 15 weeks.”

But Salman said none of that means anything if parents are unaware of those rights.

Rep. Amish Shah, D-Phoenix, who is an emergency room physician, said the situations doctors face is not as simple as proponents of the legislation claim. And that’s because SB 1600 would have imposed potential prison terms for those who are found to have not complied with the law.

“When the threat of criminal penalties applies in a very subjective, harrowing situation like this, people are going to say, ‘I’m going to have to do something that I wouldn’t otherwise do with regard to medical judgment,’” he said.

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For example, Shah said, at 18 weeks of pregnancy the chances are “almost zero” the baby will survive. And he reads the law to require doctors to do all they can to preserve the life.

“But when would a medical code ever end?” Shah said.

“It would never end because it ends when I subjectively decide that the medical code ends and we stop the CPR process,” he said. “So anybody can disagree with that and say, ‘Dr. Shaw, you’re guilty of a criminal violation.’”

That area of possible dispute over when a newborn could be saved was underlined by Hernandez who told colleagues about the experiences of her sister-in-law who she said pleaded with a doctor to save her baby after the doctor explained the “slight chance” of the newborn surviving.

“I held her in the palm of my hand,” Hernandez said. “She survived and is now 18 years old and is a student at Phoenix Union High School,” said the representative as she joined with Republicans in support.

At least some of the debate about the issue became religious.

“With God, all things are possible,” said Rep. Rachel Jones, R-Tucson. “And if God wants that human being to live and have life, that human being will survive.”

Rep. Lupe Diaz, R-Benson, pastor at Grace Chapel in his home town, had his own take.

“Life is sacred,” he said. “And we are told that life is sacred because we are created in the image of God.”

Diaz said the issue goes beyond his belief that life begins at conception.

“How we treat life in the beginning, and how we view life, will also determine how we view life at the end,” he said.

But Rep. Stacey Travers, D-Phoenix, said this isn’t an academic issue for some.

“I have been through something like this,” she said tearfully. “And while I respect the comments of my learned colleagues from the other side, I think part of the biggest problem is we are not being heard.”

Travers said proponents also are making the assumption that parents would be able to deal with a severely handicapped child, like the one cited by Rep. Mae Peshlakai who the Cameron Democrat said was born with just half a brain, even if it was able to survive more than a few hours outside the womb.

“Who do we think we are?” Travers said.

“We are legislators,” she said. “And as my fellow colleagues talk about God, we are not God.”

And Rep. Stephanie Stahl-Hamilton, D-Tucson, said this is not a legislative issue.

“At the end of the day, the people who are in the room, when it comes to pregnancy outcomes, are the people who need to be able to make their decisions as a team,” she said.