Millions of people die every year in the United States most in hospitals in most of these cases don't get to court and most of the cases are resolved. If not easily. At least I resolved between the physician in the family in the patient and that's good, but I don't think it's acceptable that these families had to go through what they went through and I don't think it's acceptable for us as a society to continue giving you their experiences and what we've learned this type of abuse on these families.I'm Mr. Bob is an attorney and he has an attorney has many many rights and access the court courtrooms United States and he is certainly use that are in his presentation today though. I give him credit for coming here cuz he has to know that hardly anyone shares his views here use the word Trek. You know, where is all know if the facts are against you argue, the law are the laws against you argue the facts in this case both the facts and so he had to talk about something else and you made it very clear quartz have done to it. I'll talk about that.That the model he wants to use ears parents who are Jehovah's Witnesses wanted to know if blood transfusion to their child. That's what he sees. The equipment is doing the Lauren sister wearing Julia DeLeo and people so lucky to live a perfectly happy healthy life. And he says what we have to do as a society is not let families have the right to choose death.How far off can you be? The quillons want their daughter did to the craziest want their daughters at any of these families want their loved ones that they will be the happiest people in the world. Is there a relative could live a life with all the sudden come out of there, and come back? To them no one would be happier than them, but they have realized that that was not possible. No one's choosing death hear the Supreme Court was absolutely wrong to say these are choices between life and death. That's an easy choice will all take like how you're going to die death is not optional. We might like to think of you as we like to deny it or if the capitals right? We're not going to sign living wills. We're not going to side durable cars with her. We're not going to talk about what we are going to die. We are going to die in the fact that we don't talk about it is going to make the decision making about the end of our Lives more difficult. But recognize this is the main question Steve set for this panel. What role should the family have in that decision making process? What should our presumptions be should our presumptions be as Mr. Bob said that family is a killer. They're all to do in their loved ones and that we have to be especially suspicious about families in America or should our presumption be that families after the best interests of their loved ones and we should presume that that they are the ones to make decisions when the individual themselves have not made that decision. Call home hold you in suspense. But you just to get a feel for the for the audience. We all know what are biases. Let me ask how many of you would want to be me and king would want your life maintained if you are in a private call. That once we have one person here. All right, how many of you are if you were unable to make Healthcare decisions yourself would want your family to make those decisions? How many of you would want the judge to make decisions for you? I'm even want your doctor to make decisions for it. How many we want the state to make decisions for it? So your body shouldn't even talk anymore then I want you to cuz I think she's a lawyer. Some of you know Arthur's from Massachusetts and I grew up and say cloud and I Massachusetts and switch them out of this. Don't know. What's what are the two chapters with arts and those two exceptions are New York in Missouri. And unfortunately, she is caught in Missouri but New York really started this mess with the Mary O'Connor case and I quit looking at that case is briefly Merrell Connor was a woman with two strokes and wound up in a nursing home severely debilitated in both. Her daughter said she definitely would not want to be treated under those circumstances are and that Court decided that no, even though she said this over and over again. They were hypothetical statement. They weren't you didn't really mean it and besides all of her relatives that died of cancer and she had a stroke. I thought you really quitting. It wasn't specific enough. You couldn't take it seriously though, and there is really just been a disaster like in New York and still hasn't been overruled legislatively. I love New York cast from Life of law has has recommended that a Visa New York last one. Very good reason. He's at his water issues statement on the day. He resigned and if statements are published on the front page of New York Times said that judge Walker's family is looking for a resolution of this that enables him to live out his life in peace. I'm sure he wanted for himself what he was unwilling to give the other citizens of New York. Where was very I think he was absolutely right that that's what most of us what we want to live our lives in peace with our families. We don't want the state to make decisions for us. We don't want other people to make decisions for us even worse than New York is the L Baum case when I'm real bomb work there for years. They have a his wife his wife's treatment terminated something. She wanted something she documented. I don't lie to him children and her friends and find clear and convincing evidence of she wanted the feeding to remove they remove the feeding tube. And then the nursing home came after Mario bomb for $110,000 for taking care of her during the. Of time when he refused treatment. And the cork Laura Court, threw it out the appeals court. However, he said that the nursing home has a right to be paid and the reasoning is what is what is so disturbing in the Quinlan case Mary call that the court said the doctors were fearful of malpractice suit, and that's why we needed to grant them legal immunity. So they do the right thing without worrying about being sued. Samba liability language is still in this case. But more important in this case of Court says you sent me that if we didn't pay doctor to take care of people whose families don't want them treated then Doctors Without corn additional Financial incentive to obey without question the orders of those conservatories Guardians who might prematurely despair of their Conservatory recovery the potential evil. We see resulting from this that is a possibility of death of even one patient whose life might have been saved is infinitely greater then continued on wanted treatment. They said they're going to kill patients are going to stop treating everybody of the next of Ken isn't that what the New Jersey what the New York courts think of physician all they care about is money, and if you don't pay them, they won't treat. Patient therefore therefore the bottom line is in the ark of this court to intermediate appeals court hopefully will be overturned on appeal court said that can you treat my even in the face of clear and convincing evidence of the first would not want it until the person's family goes to court and get the court order for them to cease and every right to be paid for that treatment until that court order is obtained just an outrageous case. It's a case one, but that still that's still alive in New York. And and so you should know that not everything has has been sawed up. Well, mr. Bob talks about the other disabled and how he is on a crusade to help the disabled and God bless a disabled Community Deeds watch more help from society that it's gotten the Americans with Disabilities Act. Was it a major step forward there that we should all plot bright. To say that were talking about indications that we looked at so far. I hate this is totally accurate, but it's like your relevant to the discussion. It's a useless piece of information. These patients are far beyond being disabled and no reasonable accommodation will ever permit them to a not only enjoy life, but even to experience life When are mr. Bob filed a brief? In the book The Walking case you didn't argue about this ability as a primary thing what he said was that the families are not good. He's a family do not consist of Angel and then use the case that the state of what his view of this case was the case was people versus fly heart to hear the tragic example of a family abusing its own the husband and wife were convicted criminal negligent homicide in the starvation death of a husband is 36 year old brother who lived with them the brother was mentally retarded and Afflicted with cerebral palsy epilepsy and other related maladies you had resided in defendant's home for 9 years and the evidence establish the brother had Nazi been seen by a doctor for 2 years and not received adequate nutrition have been lock without a tension for up to three weeks at a time and that the brother where I was to get $122,000 trust upon the death of the disabled drug. That's a horrible case is that the case of people go out with her while she is that the case were talking about? What planet are we living on when we equate those to the point to the only Point as well as our presumptions that families are criminal that they're all trying to kill their loved ones to make money or should I presumption be that families are basically two people to make these decisions supreme court appearance. Now, it says in the Palm vs. Jr. That some parents May at times be acting against the best interests of their children and this creates a precaution but it is hardly a reason to discard wholesale those pages of human experience at each that parents generally do act in the best interest of children. Of course the Supreme Court affirmed quite ironically as a joke about yesterday the same day. They decide the Cruzan case says your they decided that it was okay for a state to make the parents make a decision about abortion for their minor children. Why because the court said this again the US Supreme Court decision decide the day of the Cruise vacations both rational and fair that in most instances the family will strive to give a lonely and even terrified minor advice that is both compassionate and mature the family as societies with intimate Association and Breaking Dawn hirotaka, Paul Armstrong said I couldn't forget to mention the job's case what she thinks is the strongest case of the United States for families and it probably is in New Jersey the Supreme Court New Jersey said quote family members are best qualified to make substitute. The judgments were incompetent patient. This is not only because of their peculiar grass for the patient approach to life. But also because Human Experience informs us at family members are generally most concerned with the welfare of the patient and that all seems so obviously you could be right speech reminded me of Illusion may be reminded me of this is suicide pact on the back says you first It's that kind of suspicious. I think that other people's motives that undergirds his entire view of life. The good news is good news. The good news is that the world is changing Jim Bob has a legal center for the disabled and they have argued in newspapers and other places that is perfectly appropriate for them to have a political agenda right to life right wing political agenda. Right? But the good news is that we have a change of administration is also perfectly appropriate to change that agenda and they have an agenda that is consistent with the with the new Administration has Al Gore put it so well, I think it's time for them to go it's time for that that Center to be replaced by someone more in the mainstream of American life and values and I'm very pleased when President Clinton decided to begin his inauguration at Monticello. I'm taking a bus tour from the home of Thomas Jefferson Thomas Jefferson talk about equality. All men are created equal. Let me know all the same and we can all do everything. What do you mean by that was that we all have the same moral sense? All human beings have a moral sense. Who know? What's right and what's wrong know what what they should do and what they shouldn't do the state exists the permit us to make our decision sure there have to be some confinements on the outside. Yes. We have criminals in our society. Yes. We have a dysfunctional family, but the question That is what the presumption should be. Probably leave you with with five things to consider quickly and I'll do it quickly. The first is that that we should affirm and know that medical treatment is optional patients have a right to refuse anything and primarily want to make decision that brought the patient make their own decisions and honor those decisions and when others make decisions for them, they should be as much as possible decisions of patient should make themselves. I like Pete's idea to have someone the hospital helping families. I'd call that a patient rights Advocate and I do think that that's necessary people cannot negotiate hospitals all by himself the right to refuse any tree what does not mean the right to demand any treatment. Secondly, we should encourage the health care proxy. I absolutely believe everybody should write a healthcare proxy everybody. Why because people will make decisions for them. It's not as if you know that if you don't have this proxy then everything out, then you will never have a horrible illness or people will never have to make decisions for you will make decisions for you. I think you all your relatives a moral duty to pick one up or friend to make those decisions because if you don't they're going to have to struggle through this issue who gets to make these decisions who can speak for you, but I know you won't so so I think every state should pass that you're well if you could should have a whale but if you don't here's where your money goes half your spouse the rest of all of your children or whatever should have a statute that says that too if you don't have a healthcare proxy here for a few. Children Cedric said, it doesn't mean that list is always going to be the most ideal. But that list is going to avoid this idea of was Jim Bob says we should have to go to court. Go to get State authority to make decisions family shouldn't have to go to get State authority to make decisions family should have the authority to make decisions. If someone wants to challenge that Authority, I think it'd have to be someone with an interest in the case. They should have the burden of going to court and they should I buy clear and convincing the patient. I also would have one more presumption not only a presumption that Molly naming the person to make a decision in a presumption that they are making the right decision that could only be challenged are based on clear and convincing evidence such a presumption maybe more controversial. The presumption would be there the people in the permanent, do not want treatment. In the absence of clear and convincing evidence that they did and I think is right surely this crowd agrees to that my 99.9% and many quarts of said the vast majority of people do not want to be treated like that. What why don't we have done that? Why do we continue to act as if they do we get rid of this legal debate about abortion in United States and get it back to me set it on a moral issue. I think it's very important abortion has an infected all of these cases. I believe really was an abortion case in the sky and see if we obviously need a national health plan to start concentrate on spending money on life on children and healthy people and people who can who can benefit from care and stop spending so much money on Death Cure. Thank you very much.