After not holding meetings since mid-February, the Arizona House’s Health and Human Services Committee met on Tuesday to discuss five Senate bills. While three bills passed swiftly with unanimous approval, two bills concerning born-alive infants and prescription opioid container caps were met with more discussion.
SB 1600 passed out of the Senate’s Health and Human Services Committee on Feb. 14th by a vote of 5-4, and made its way to the House. The bill entitles infants that are born alive to be treated as a legal person under Arizona law, and receive the same medical rights as a legal person. The bill also states that medical professionals are to take all actions necessary to preserve the health of infants born alive.
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Dr. Lance Holeman, a board-certified OB/GYN, showed his support for the bill during testimony by sharing the story of his patient from back in 1987.
“Her pregnancy was completely normal until approximately 24 to 25 weeks, at which time she developed increasingly severe pregnancy induced hypertension,” Holeman said. “She eventually required hospitalization as her condition continued to worsen.”
Holeman’s patient developed kidney failure and blood clotting abnormalities, and he said her only cure was to deliver the baby. He brought up how after the baby was born, the nursery staff immediately took care of it, as the mother and child alike both beat all odds at survival by fully recovering. He said that care for preterm babies in 1987 was state-of-the-art at the time, but in this modern day and age, care for preterm babies has only improved.
Rep. Amish Shah (D – Gilbert) brought up concerns surrounding Holeman’s testimony. Shah highlighted his experience as a physician and mentioned that when a delivery is occurring, the medical professional is placed in a difficult position if a preterm infant is involved.
“We’re at a place where we’re trying to take that situation, and trying to honor the wishes of the family at the time when a very difficult situation is happening,” Shah said. “But the bill at hand ties the hands of physicians at the time that they are in such a harrowing spot, and takes away clinical judgment—that’s the part of the bill I can’t agree with.”
Shah brought up that having an overarching state statute that states doctors must do everything in their power, even during a medically futile position, does not make sense.
“I guess my point is, unless we are trained to know what is futile, can’t we just give the baby [the] benefit of the doubt?” Holeman asked.
Holeman said that if a baby is truly going to die and that there is nothing doctors can do to save it, they should do the best under the circumstances to give the baby a chance at life—whether it be for 15 extra minutes, one hour, or one day. Holeman also brought up how he feels like it’s his duty and responsibility to do as much as possible for babies, regardless of its chances of survival.
Shah said that while there are no Do Not Resuscitate orders (DNRs) in place for babies and family members are consulted and engage in open dialogue about actions that will be taken, but when that’s put into a state statute, a legal issue hangs over everyone’s heads. He also said that when end of life decisions take place, doctors ensure family members are involved in the process, but using the force of the law for this process is where the issue with this bill lies. SB 1600 narrowly passed by a vote of 5-4.
SB 1254 was another bill that committee members were split on. It would repeal the requirement that prescription opioid containers dispersed by pharmacies for personal use do not have a red cap. The original reasoning for opioid prescription containers having red caps is for the patient to easily identify opioids versus other prescribed medications.
Rick Hazelton of the Arizona Pharmacy Association provided testimony, saying the organization is concerned about potential HIPAA violations and the ability to easily identify opioids amidst a nationwide opioid epidemic. He also expressed concern about potential thefts in pharmacies; if individuals see a patient leaving a pharmacy with a medication container that has a red cap, that may put a target on their backs, implying that patients may be mugged for their opioid prescriptions while exiting pharmacies.
Committee Vice Chair Barbara Parker (R – Maricopa) brought up the fact that when medications are dispensed at pharmacies, they are placed in white paper bags that conceal the medications and therefore avoid HIPAA violations. The committee failed to pass SB 1254 by a vote of 3-4, with two members not voting.