Wisconsin bill lets advance directives be ignored

"Conscience clause" bill passes over medical society objections, but governor expected to veto it.

By Andis Robeznieks — Posted April 5, 2004

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Legislative approval of a Wisconsin "conscience clause" bill opposed by the state medical association actually could turn out to strengthen the organization's efforts to promote advance directives for end-of-life care.

"The bill raised awareness of advance directives and it's caused some proactive measures among some folks," said Wisconsin Medical Society Vice President of Government Relations Mark Grapentine. "Our involvement raised an issue that no one expected to get that much attention."

While the WMS is encouraging doctors to discuss advance directives with patients, the conscience clause bill would allow health care workers to ignore advance directives without referring the patient to a physician who would honor requests for limited end-of-life treatment, Grapentine said.

The bill took a year to be approved. Gov. Jim Doyle, however, is expected to veto it.

Grapentine said some improvements had been made to the bill, including a requirement that doctors make a "good faith attempt" to transfer a patient to a doctor who would abide by the advance directive, but he said the bill was still flawed. WMS concerns were outlined in a letter from society President Paul Wertsch, MD, that was hand-delivered to Doyle.

"Still remaining is the possible situation of an incapacitated patient who lacks an advance directive having a physician refuse to follow a family's wishes regarding end-of-life care, while also refusing to transfer the patient to another physician," Dr. Wertsch wrote. "While this physician would not be 'abandoning' a patient -- indeed, that physician would still oversee care maintaining the patient's life -- there is debate as to whether that physician might be causing the patient undue harm."

State health care workers already can refuse to participate in abortions or sterilizations, but the new bill also would let them opt out of withholding nutrition or hydration, assisted suicide and procedures involving material obtained from embryos.

Back to top

External links

Text of Wisconsin Conscience Clause bill, in pdf (link)

Wisconsin State Medical Society's state Senate testimony opposing AB 67 (link)

"Wisconsin Governor Asked to Sign Pro-Life Conscience Clause Bill,", Feb. 27 (link)

Editorial, "Wise veto of medical bill," The Capital Times, March 19 (link)

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn