The legislative term of Representative Bill Kidd (R-Buckner) is coming to a close. As his final session as a member of the House wound down, Kidd bid his colleagues farewell.
“You will be a picture on the wall, the desk will be given back to someone else, it will be time for you to give it all back. My time has arrived and now it’s time to give it back and go home … it’s been an honor.”
Missouri is set to become the fourth state to enact a law to keep do-not-resuscitate orders from being issued for children without a parent’s knowledge.
The House and Senate both unanimously voted to pass House Bill 138, “Simon’s Law.” It would prohibit a health care facility, nursing home, physician, nurse, or medical staff from putting such an order in a child’s file without permission from a parent or legal guardian. That permission could be written, or given orally in the presence of at least two witnesses.
The bill is named for Simon Crosier who died at three months old. His parents say a DNR order was put on his chart without their knowledge. His parents say when the monitors in his room went off as he died, no medical staff responded and they were left wondering why.
The vote to send the bill to Governor Mike Parson (R) was taken as Simon’s mother, Sheryl Crosier, watched from the side gallery.
“I have three other children [in Missouri] and they’re finally safe,” Crosier said tearfully after its passage.
“I seriously had been thinking what would I do if one of them would end up in the ICU. You don’t know what could happen. I mean, it could be something as simple as falling off a bicycle. It could be a 16 year-old getting into a car accident,” said Crosier. “In the back of my mind I’m like, ‘I’m going to have to probably get them to Kansas because they have Simon’s Law,’ and I felt like they were more protected, but I don’t have to worry about that now.”
The bill was sponsored by Buckner Republican Bill Kidd.
Earlier versions of legislation with the same aim met with opposition, including from doctors, nurses, and even other parents, who had concerns about the position those versions would have put them in. Kidd found himself agreeing with many of their perspectives, and worked with all those groups over five years to arrive at this language.
“We had to come up with a solution that would be acceptable to say okay, how can we make sure the doctor can’t do this, and yet have the parents involved, because what I really wanted was I wanted a conversation between the doctor and the parents, and I wanted the parents to make the decision,” said Kidd. “It’s easy to say when you talk about it. It’s difficult when you put it into words for law.”
Kidd said this bill might not prevent every situation that would be similar to Simon’s, but now if that plays out again, parents will be able to hold doctors accountable.
Kidd says he anticipates Governor Parson will sign HB 138 into law. It would then take effect August 28.
Both Kidd and Crosier say divine intervention played a role in bringing them together five years ago before Kidd had been elected, and in Simon’s law becoming law. They note that the first version of the legislation was pre-filed on December 3, 2014, at 10:45 a.m., the date and time that Simon had died five years earlier.
Missouri would be joining Kansas, South Dakota, and Arizona in having a Simon’s Law, and several other states’ legislatures are considering versions of it.
With HB 138 likely on its way to becoming law, Crosier said she will continue to push for passage in other states and at the federal level.
As the final vote on Simon’s Law was taken, Kidd addressed Crosier, saying, “Even though Simon lived a short life, he did not die in vain, and he did not live in vain.”
Crosier agreed, saying “Just look at how many more lives are going to be saved because of him.”
The House is close to voting to prevent do-not-resuscitate orders from being issued for Missouri children without a parent being aware.
House Bill 138 is commonly known as “Simon’s Law.” It would prohibit a health care facility, nursing home, physician, nurse, or medical staff from putting such an order in a child’s file without a parent’s permission. That permission may be written, or given orally in the presence of at least two witnesses.
“This is a parental rights bill that says only you can determine the outcome for your child,” said bill sponsor Bill Kidd (R-Buckner).
The bill is named for Simon Crosier, who died at three months old after, his parents say, a DNR order was put on his chart without their knowledge. His parents testified to a House Committee last year that when the monitors in his room went off as he died, they didn’t understand why no medical staff responded to try to save him.
Kidd said under “Simon’s Law,” doctors will have to have a conversation with parents about the care of their child, “so that the conversation happens. So that when the buzzers go off and your child codes, no one stands there like the Crosiers did wondering why no one shows up.”
Kidd has offered Simon’s Law in some form for four years. Last year’s version would have required written permission from a parent or legal guardian of a patient under 18 years old before a DNR or similar order could be issued. It was opposed by some parents and medical practitioners, some of whom said forcing a parent to sign off on such a document was “really inhumane.”
Since then, Kidd said he met with hospitals, parents, and doctors to refine the legislation.
“What I discovered in sitting across the table and talking to parents who had been through this was that for many of them it was as if they had signed their child’s death warrant,” said Kidd. “As I listened to their emotional pain, still reliving that very action, I realized that there had to be a different way.”
By including the ability for two witnesses to attest to a doctor having discussed the situation with parents, Kidd says that onus has been taken off of parents, and that has alleviated some opponents’ concerns. No one testified against HB 138 when it went was heard by a House committee.
Independence Democrat Rory Rowland, who has spoken many times during debates about his son JP who has Down syndrome, spoke emotionally in favor of Kidd’s legislation.
“There will be few times when I will take the microphone and beseech all of you to vote for a bill because it is, beyond a shadow of a doubt, the right thing to do,” said Rowland. “There is no question in my mind or my soul that what we are doing today is profoundly correct for parents who have children with disabilities.”
The House gave initial approval to HB 138. Another favorable vote would send it to the Senate.
Legislation in the Missouri House would lift the requirement, under certain circumstances, that the death of a person under hospice care be investigated.
Backers of House Bill 242 and an amendment added to House Bill 447 say that Missouri law requiring coroners and medical examiners to investigate a death in a home doesn’t account for the increase in the use of hospice care for terminal patients.
“The coroner does not have to come out and see that person who we all know is dead from cancer or a well-documented terminal illness,” said the proposal’s sponsor, Cameron Republican Jim Neely.
The legislation would allow the physician treating a patient or the hospice director to certify when a patient has died due to natural causes relating to a disease or known illness. A coroner or medical examiner must be notified within 24 hours of such a death.
The legislation is personal for at least a couple of representatives. Republican Bill Kidd (Buckner) told his colleagues his wife died after about three weeks in hospice care. He said hospice care allows a terminally ill person and his or her family a great deal of comfort and assistance
Kansas City Democrat Richard Brown said his wife battled cancer for 12-years. She was in hospice for two weeks before she died in 2018.
“The one thing that she wanted was death with dignity. That’s what this amendment does, is it allows those person that are in hospice to die with a sense of dignity,” said Brown. “My wife did not want to go to a coroner and be subjected to an autopsy when we knew what the cause of death would be.”
“In a hospice situation hospice is there on doctor orders, hospice has their own doctors and physicians that come in and access the patient. They already know – everybody has come to the conclusion that this is a terminal case, and it is not necessary for the coroner to intrude into your private home at such a fragile time,” said Kidd.
Neely’s stand-alone bill, HB 242, has been approved by two House committees and could soon be brought to the floor for debate. HB 447, to which the language of 242 has been amended, has received initial approval in the House and could soon be sent to the Senate.
State lawmakers have heard passionate testimony while being asked to decide what steps should be taken before life-sustaining treatment of a child is ended.
Some are telling state lawmakers state law should require parents’ consent before such treatments can end. Others are urging the opposite. Both say the humane, compassionate, and complete care of children hangs in the balance.
House Bill 1361, known as Simon’s Law, would require written permission from a parent or legal guardian of a patient under 18 years old before a do-not-resuscitate order can be issued for that patient.
The House Committee on Children and Families heard from the parents of Simon Crosier that he died at three months old in a hospital that had a “futility policy,” and after doctors put a DNR order on him without their knowledge.
“Then we got the medical records after he died and the DNR was still there even though we were told it had been removed,” said Scott Crosier, Simon’s father. “We had told them … my crying words to my doctors and to the medical staff and to anybody that would hear me is, ‘We will not expedite his demise. I want you to treat him like he is a healthy child and has conditions, so you get him healthy so that we can try and get him better and if nothing else extend his life so we can have a Christmas together.’ He died December 3, 2010.”
The committee also heard from Kim and Paul Kosednar, whose 2-year-old son Elias died of interstitial lung disease. They say they were involved with doctors in every decision about the care for their son, and they oppose Simon’s law.
“All this journey was done without any form of us ever knowing a futility clause or staring at a DNR. We used our knowledge to present our goals and wishes for Elias with our specialty team and this would change daily; sometimes hourly,” said Kim Kosednar. “Again, parents of terminally ill children have to keep evaluating the stance of, ‘How far are you willing to go to keep trying?’ Love is very strong and it is very binding and it is so much more complicated than just a piece of paper.”
Several medical professionals told the committee the story of Simon’s family is not common and urged lawmakers not to base state policy on it.
Doctor Sarah Younger, a Columbia neonatologist and leader of a palliative care team, said, “I’m so just unbelievably shaken by the testimony from Simon’s father because no parent should ever go through that, ever. That was abhorrent to me.”
Younger said requiring a parent’s written permission for a cessation of their child’s life-sustaining care would take away her ability to ease parents’ burden of making such a decision.
“When you put the onus on a parent of having to sign a piece of paper, basically the child’s death warrant is how they often see it,” said Younger. “Forcing them to sign that piece of paper is just really inhumane when someone’s at that point.”
Alissa Johnson with Concerned Women for America told lawmakers about children with mental and physical disabilities who were adopted by her husband’s parents. She said doctors told her in-laws life-sustaining care shouldn’t be given to those children, but those children are now in their teens and twenties.
The sponsor of HB 1361, Independence Republican Bill Kidd, told the committee what happened to Simon and his family was not a unique case. He said Simon’s Law is written to give a voice to children who are not terminally ill.
Under HB 1361, in cases in which parents do not agree on whether to give permission for a termination of care one parent can petition a court to consider the matter. HB 1361’s requirements would not apply if life-sustaining care is deemed “medically inappropriate.”
The committee has not voted on HB 1361. Last year the House voted 117-22 to amend Simon’s Law to Senate Bill 50, but the language was removed by the Senate.