Persons Living with HIV/AIDS: Is This What You Want?

By Margaret Dore, Esq

This is an updated version of an article I wrote three years ago in response to HIV/AIDS groups that had endorsed Ballot Question 2, seeking to legalize assisted suicide in Massachusetts. The ballot question failed, but there is now a similar proposal pending in the Massachusetts legislature (H.1991). I suggest that these groups and persons living with HIV/AIDS give the new proposal a close look. 

1.  "Terminal" does not mean dying. 

H.1991 applies to persons with a "terminal illness," defined in terms of less than six months to live with or without treatment.[1] 

In the 1980's, HIV/AIDS was a death sentence. Today, we have people living with HIV/AIDS, who do well, but who are dependent on treatment to live. Some of these persons are "terminal" under H.1991, i.e., if, without treatment, they "can reasonably be expected to die within 6 months."[2] 

2.  The significance of a terminal label.

Once a person is labeled "terminal," an easy justification can be made that his or her treatment should be denied in favor of someone more deserving. In Oregon, where assisted suicide is legal, "terminal" patients have not only been denied treatment, they have been offered assisted suicide instead. In a 2012 affidavit, Oregon doctor Kenneth Stevens put it this way:

Under the Oregon Health Plan [Medicaid], there is . . .  a financial incentive towards suicide because the Plan will not necessarily pay for a patient’s treatment. For example, patients with cancer are denied treatment if they have a "less than [two years] median survival with treatment" and fit other criteria. . . . 

All such persons . . .  will . . . be denied treatment. Their suicides under Oregon’s assisted suicide act will be covered."[3]

He also noted that some persons denied treatment as "terminal" would, if treated, in fact have years, even decades, to live. He stated: 

Some of the patients living longer than two years will likely live far longer than two years, as much as five, ten or twenty years depending on the type of cancer. This is because there are always some people who beat the odds.[4] 

California's ABX2-15: Governor Not Impressed; Bill Is But A "New Number With the Same Song."

By Margaret Dore, Esq., MBA

Yesterday, the deceptively named Compassion & Choices unveiled its "new" deceptively named End of Life Option Act to great fanfare in a press credentialed only press conference.

Governor Jerry Brown has already weighed in that the present special session "is not the appropriate venue to consider the issue."

The new bill, ABX2-15, is in substance an old bill (SB 128) that was unable to make it out of committee.

AB 15 has some new provisions and puts some of the old bill's provisions in a different order. ABX2-15 is in substance the same bill as the old bill. Key points include:

• ABX2-15 applies to patients with a "terminal disease." In Oregon, which has a similar law, such persons include young adults with chronic conditions such as insulin dependent diabetes and chronic lower respiratory disease. People living with HIV/AIDS, who are dependent on their medication to live, also qualify as "terminal." Such persons can have years, even decades, to live. 

• Once a person is "labeled 'terminal,' an easy justification can be made that his or her treatment or coverage should be denied in favor of someone more deserving."[1] In Oregon, where assisted suicide is legal, patients are not only denied coverage for treatment, they are offered assisted suicide instead.[2] Well known cases are Barbara Wagner and Randy Stroup.[3]

• The bill remains a recipe for elder abuse in which the patient's heir, who will financially benefit from his or her death, is allowed to actively participate in signing the patient up for the lethal dose. This fact alone does not meet the "stink test." 

• Once the lethal dose is issued by the pharmacy, there is no oversight. Not even a witness is required at the death. If the patient struggled, who would know?

• The death certificate is required to be falsified to reflect a natural death. The significance is a lack of transparency and an inability to prosecute for murder even in a case of outright murder for the money.

ABX2-15 is but a new number with the same song. Don't be fooled.

To view a detailed legal/policy analysis of ABX2-15, please click on the following links: Executive summary and index; Memo; and Appendix/Attachments.

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[1] Opinion Letter by Richard Wonderly MD and Attorney Theresa Schrempp, available at https://choiceisanillusion.files.wordpress.com/2012/07/schrempp_wonderly_opn_ltr1.pdf

[2] Id.
[3] Id.

"Compassion & Choices is a successor organization to the Hemlock Society"

http://helenair.com/news/opinion/readers_alley/assisted-suicide-law-could-lead-to-patient-mistreatment/article_32bac11c-4985-11e2-9338-0019bb2963f4.html?print=true&cid=print

12/19/12

Theresa Schrempp Seattle, Wash.

I am a lawyer in Washington State where assisted-suicide is legal. Robert Zimorino’s letter encourages readers to contact Compassion & Choices, a promoter of assisted-suicide (“aid in dying”).

Your readers should know that Compassion & Choices is a successor organization to the Hemlock Society, originally formed by Derek Humphry. In 2011, Humphry was the keynote speaker at Compassion & Choices’ annual meeting here in Washington State.  In 2011, he was also 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 used one of the kits to commit suicide.

In 2007, Compassion & Choices was a plaintiff in Montana’s assisted-suicide case. Therein, Compassion & Choices requested legalization of assisted-suicide for “terminally ill adult patients.” The definition of this phrase was broad enough to include an otherwise healthy 18 year old who is insulin dependent or a young adult with stable HIV/AIDS. Such persons can live for decades with appropriate medical treatment.

Once someone is labeled “terminal,” an easy justification can be made that their treatment should be denied in favor of someone more deserving. Those who believe that legalizing assisted-suicide will promote free choice may discover that it does anything but.

Supporting authority not included in the published letter, below:

Persons Living With HIV/AIDS: Is This What You Want? To be Just Like Us?

By Margaret Dore, Esq.

Some HIV/AIDS groups have endorsed Ballot Question 2, which seeks to legalize assisted suicide in Massachusetts via a proposed act.  This post suggests that these groups and/or persons living with HIV/AIDS should give the issue a second look. 

1.  "Terminal" Does Not Mean "Dying" 

The proposed act applies to persons with a "terminal disease," defined in terms of less than six months to live.[1]  In Oregon, where there is a similar act, the six months to live is determined without requiring treatment.[2] 

In other words, a person living with HIV/AIDS, who is doing well, but who is dependent on treatment to live, is "terminal" for the purpose of assisted suicide eligibility. 

2.  The Significance of a Terminal Label

Once someone is labeled "terminal," an easy justification can be made that his or her treatment should be denied in favor of someone more deserving.  In Oregon, "terminal" patients are not only denied treatment, they are offered assisted suicide instead.  In a recent affidavit, Oregon doctor Ken Stevens states:

"9.  Under the Oregon Health Plan, there is . . .  a financial incentive towards suicide because the Plan will not necessarily pay for a patient’s treatment.  For example, patients with cancer are denied treatment if they have a "less than 24 months median survival with treatment" and fit other criteria. . . . 

12. All such persons . . .  will . . . be denied treatment. Their suicides under Oregon’s assisted suicide act will be covered."[3]

Dr. Stevens concludes:

"14. The Oregon Health Plan is a government health plan administered by the State of Oregon. If assisted suicide is legalized in [your jurisdiction], your government health plan could follow a similar pattern. If so, the plan will pay for a patient to die, but not to live."[4]

3.  Barbara Wagner and Randy Stroup

In Oregon, the most well known persons denied treatment and offered suicide are Barbara Wagner and Randy Stroup.[5]  Neither saw this event as a celebration of their "choice."  Wagner said: "I'm not ready to die."[6]  Stroup said: "This is my life they’re playing with."[7] 

4.  Proposals for Expansion

I live in Washington State, where assisted suicide is legal under an act passed in 2008.[8]  Four years later, there have already been proposals to expand our act to non-terminal people.[9]  Moreover, this year, there was a Seattle Times column suggesting euthanasia as a solution for people unable to afford care, which would be involuntary euthanasia for those persons who want to live.[10]

Prior to our law's being passed, I never heard anyone talk like this.

Is this what you want?

To be just like us?

Legal assisted suicide puts anyone with a significant health condition at risk of being steered to suicide.  For other reasons to vote against assisted suicide, please click here for talking points.  I hope that AIDS groups and people living with AIDS reconsider any support of Ballot Question No. 2.  Thank you.

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Margaret Dore is a lawyer in Washington State where assisted suicide is legal. She is also President of Choice is an Illusion, a non-profit corporation opposed to assisted suicide and euthanasia.  Ms. Dore has been licensed to practice law since 1986. She is a former Law Clerk to the Washington State Supreme Court. She has several published court cases and many published scholarly articles. Her viewpoint is that people should be in control of their own fates, but that assisted suicide laws do not deliver. This year, she had an editorial published in the NY Times: "Assisted Suicide: A Recipe for Elder Abuse." For more information see www.margaretdore.com and www.choiceillusion.org