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)

[22]  See https://choiceisanillusion.files.wordpress.com/2017/07/suicides-in-oregon-2003-2012-p-6.pdf  

[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.

Brittany Maynard's Story Sends the Wrong Message to Young People

Will Johnston, MD

Dear Editor:

I agree with the Gazette editorial board that legal assisted suicide sends the wrong message to young people. ("Vote 'no' on more suicide," 09/26/16). I also write to describe the damaging impact of the highly publicized case of Brittany Maynard, on my young adult patient who became actively suicidal after watching her video. I understand that her story is now being used to promote assisted suicide legalization in Colorado.

Ms. Maynard died in November 2014. A month later, I was presented with my young adult patient during an emergency appointment. He was physically healthy. His mother told me that he had been acting oddly and talking about death.

Montana: Say "No" to the Oregon Experience

By Margaret Dore, Esq., MBA

To view pdf version with footnotes, click here.

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.

Whose Choice Will It Be? Telling the truth about assisted suicide. Excerpts from an NRO Interview

http://www.nationalreview.com/article/392444/whose-choice-will-it-be-interview  . . . .

Margaret Dore is a lawyer in Washington State, where assisted suicide is also legal. Dore is a former law clerk to the Washington state supreme court and president of Choice Is an Illusion, a 501(c)(4) nonprofit corporation opposed to assisted suicide and euthanasia. She talks with National Review Online about assisted suicide as it exists now and how we might make a change. — Kathryn Jean Lopez 

. . . .
Lopez: What is the absolute first thing that you would like anyone who was moved by Brittany Maynard’s life and death to know?

Dore: I would want them to know that “eligibility” for legal assisted suicide is not limited to people who are near death. This is true for the following reasons:

Under the Oregon and Washington assisted-suicide laws, assisted suicide is legal for “terminal” patients, meaning those predicted to have less than six months to live. But such predictions can be wrong. Moreover, treatment can lead to recovery. Consider Jeanette Hall, who was diagnosed with cancer in Oregon in 2000 and was adamant that she would “do” Oregon’s law. Her doctor, who didn’t believe in assisted suicide, stalled her and convinced her to be treated instead. Today, 14 years later, she is thrilled to be alive. You can see her doctor’s affidavit here.

Once assisted suicide is legal, there is pressure to expand. For example, here in Washington State, we have already had “trial balloon” proposals to expand our law to euthanasia for non-terminal people. For me, the most disturbing proposal was a discussion in our largest paper suggesting euthanasia for people who didn’t have enough money for their old age. So, if you worked hard all your life, paid taxes, and then your pension plan went broke, this is how society will pay you back? With non-voluntary or involuntary euthanasia? (The newspaper column can be read here.)

In other words, with legal assisted suicide, people with years to live are encouraged to throw away their lives. Moreover, and contrary to the media hype, legal assisted suicide (or euthanasia) may not be voluntary. . . .

Lopez: Why is the “death with dignity” language misleading?

Dore: Because it’s a euphemism, which doesn’t readily disclose that we are talking about assisted suicide and euthanasia for people who may or may not be dying anytime soon, and that such death may not be voluntary.

Lopez: Who is Compassion & Choices? Is its name misleading?

Dore: Compassion & Choices is a successor organization to the Hemlock Society, originally formed by Derek Humphry. In March 2011, Humphry was in the news as a promoter of mail-order suicide kits from a company now shut down by the FBI. This was after a 29-year-old man had used one of the kits to commit suicide. Seven months later, on October 22, 2011, Humphry was the keynote speaker at Compassion & Choices’ annual meeting here in Washington State.

Compassion & Choices’ name is misleading because it does not disclose its true nature as a suicide/euthanasia advocacy group. The name is also misleading because Compassion & Choices’ true mission is to reduce choice in health care and to change public policy so as to reduce patient cures.

Lopez: Speaking of names: How did your group arrive at Choice Is an Illusion?   

Dore: The name, Choice Is an Illusion, is a commentary on Compassion & Choices because the laws it promotes do not assure patient choice. . . .

Lopez: What might you want to leave readers with in closing?

Dore: Problems with legal assisted suicide include:

• The encouragement of people with years to live to throw away their lives.
• New paths of elder abuse, for example, in the context of inheritance.
• A push to expand euthanasia to non-terminal individuals.

Don’t make Washington State’s mistake.

To read the entire article, please go here:  http://www.nationalreview.com/article/392444/whose-choice-will-it-be-interview