Friday, August 18, 2017

In Oregon, Other Suicides Have Increased with the Legalization of Physician-Assisted Suicide

By Margaret K. Dore, Esq.

Since the passage of Oregon’s law allowing physician-assisted suicide, other suicides in Oregon have steadily increased. This is consistent with a suicide contagion in which the legalization of physician-assisted suicides has encouraged other suicides. In Oregon, the financial and emotional impacts of suicide on family members and the broader community are devastating and long-lasting.[1]

A.  Suicide is Contagious 

It is well known that suicide is contagious. A famous example is Marilyn Monroe.[2] Her widely reported suicide was followed by “a spate of suicides.”[3]

With the understanding that suicide is contagious, groups such as the National Institute of Mental Health and the World Health Organization have developed guidelines for the responsible reporting of suicide, to prevent contagion. Key points include that the risk of additional suicides increases:
[W]hen the story explicitly describes the suicide method, uses dramatic/graphic headlines or images, and repeated/extensive coverage sensationalizes or glamorizes a death.[4] 
B. Physician-Assisted Suicide in Oregon

In Oregon, prominent cases of physician-assisted suicide include Lovelle Svart and Brittany Maynard.

Lovelle Svart died in 2007.[5] The Oregonian, which is Oregon’s largest paper, violated the recommended guidelines for the responsible reporting of suicide by explicitly describing her suicide method and by employing “dramatic/graphic images.” Indeed, visitors to the paper’s website were invited “to hear and see when Lovelle swallowed the fatal dose.”[6] Today, ten years later, there are still photos of her online, lying in bed, dying.[7]

Brittany Maynard reportedly died from physician-assisted suicide in Oregon, on November 1, 2014. Contrary to the recommended guidelines, there was “repeated/extensive coverage” in multiple media, worldwide.[8] This coverage is ongoing, albeit on a smaller and less intense scale.

C. The Young Man Wanted to Die Like Brittany Maynard

A month after Ms. Maynard’s death, Dr. Will Johnston was presented with a twenty year old patient during an emergency appointment.[9] The young man, who had been brought in by his mother, was physically healthy, but had been acting oddly and talking about death.[10]

Dr. Johnston asked the young man if he had a plan.[11] The young man said "yes," that he had watched a video about Ms. Maynard.[12] He said that he was very impressed with her and that he identified with her and that he thought it was a good idea for him to die like her.[13] He also told Dr. Johnston that after watching the video he had been surfing the internet looking for suicide drugs.[14] Dr. Johnston’s declaration states:
He was actively suicidal and agreed to go to the hospital, where he stayed for five weeks until it was determined that he was sufficiently safe from self-harm to go home.[15]
The young man had wanted to die like Brittany Maynard.

D. In Oregon, Other Suicides Have Increased with Legalization of Physician-Assisted Suicide

Oregon government reports show the following positive correlation between the legalization of physician-assisted suicide and an increase in other suicides.  Per the reports:
  • Oregon legalized physician-assisted suicide “in late 1997.”[16]
  • By 2000, Oregon’s conventional suicide rate was "increasing significantly."[17]
  • By 2007, Oregon's conventional suicide rate was 35% above the national average.[18]
  • By 2010, Oregon's conventional suicide rate was 41% above the national average.[19]
  • By 2012, Oregon's conventional suicide rate was 42% above the national average.[20]
  • By 2014, Oregon's conventional suicide rate was 43.1% higher than the national average.[21]
E. The Financial and Emotional Cost of Suicide in Oregon 

Oregon’s report for 2012 describes the cost of suicide as “enormous.” The report states:
Suicide is the second leading cause of death among Oregonians aged 15 to 34 years, and the eighth leading cause of death among all ages in Oregon. The cost of suicide is enormous. In 201[2] alone, self-inflicted injury hospitalization charges in Oregon exceeded $54 million; and the estimate of total lifetime cost of suicide in Oregon was over $677 million. The loss to families and communities broadens the impact of each death. (footnotes omitted).[22]
F. The Significance for Montana

In Montana, the law on assisted suicide is governed by   the Montana Supreme Court decision, Baxter v. State, 354 Mont. 234 (2009). Baxter gives doctors who assist a suicide a potential defense to criminal prosecution.[23] Baxter does not legalize assisted suicide by giving doctors or anyone else immunity.[24]

The decision, however, is also confusing so that it can be read different ways. More importantly, some doctors are claiming to have assisted suicides in Montana. If nothing is done to clarify the law, there will at some point be de facto legality.

Montana already has a higher suicide rate than Oregon.[25] If Baxter is not overturned and/or the law clarified that assisted suicide is not legal, the suicide problem in Montana will only get worse. Montana does not need the Oregon experience.

Footnotes:

[1]  Shen X., Millet L., Suicides in Oregon: Trends and Associated Factors. 2003-2012, Oregon Health Authority, Portland Oregon, p.3, Executive Summary. 
[2]  Margot Sanger-Katz, “The Science Behind Suicide Contagion,” The New York Times, August 13, 2014.
[3]  Id.
[4]  "Recommendations for Reporting on Suicide,” The National Institute of Mental Health. See also “Preventing Suicide: A Resource for Media Professionals,” World Health Organization, at http://www.who.int/mental_health/prevention/suicide/resource_media.pdf.
[5]  Ed Madrid, “Lovelle Svart, 1945 - 2007, The Oregonian, September 28, 2007. 
[6]  Id.
[7]  The still shots at this link, are still up today, July 7, 2017.
[8]  The worldwide coverage of Ms. Maynard in multiple media started with an exclusive cover story in People Magazine. Other coverage has included TV, radio, print, web and social media.
[9]  Declaration of Williard Johnston, MD, May 24, 2015. 
[10]  Id.
[11]  Id.
[12]  Id.
[13]  Id.
[14]  Id.
[15]  Id.
[16]  Oregon's Death with Dignity report for 2016, p. 4, first line. 
[17]  Oregon Health Authority News Release, September 9, 2010, at https://choiceisanillusion.files.wordpress.com/2017/07/news-release-09-09-10.pdf ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000").  
[18]  Suicides in Oregon: Trend and Risk Factors, issued September 2010 (data through 2007). 
[19]  Suicides in Oregon: Trends and Risk Factors, 2012 Report (data through 2010). 
[20]  Suicides in Oregon: Trends and Associated Factors, 2003-2012 (data through 2012). 
[21] Oregon Vital Statistics Report 2015 (data through 2014;
at page 6-26, third full paragraph)
[23]  Greg Jackson, Esq. & Matt Bowman, Esq., "Analysis of Implications of the Baxter Case on Potential Criminal Liability," April 2010.
[24]  State Senator Jim Shockley and Margaret Dore, Esq., "No, physician-assisted suicide is not legal in Montana: It's a recipe for elder abuse and more," The Montana Lawyer," The State Bar of Montana, November 2011.
[25]  CDC Centers For Disease Control and Prevention, "QuickStats: Age Adjusted Suicide Rates by State, United States, 2012," published on November 14, 2014.
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