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.

Protect Health Care; Keep Assisted Suicide Out of Montana

http://www.ravallirepublic.com/news/opinion/mailbag/article_03dfa5e3-26fa-588f-8765-b85fc6f81622.html?comment_form=true


April 22, 2013

I was disturbed to see the (April 7) opinion by Eric Kress promoting physician-assisted suicide. I am a cancer doctor with more than 40 years experience in Oregon, where physician-assisted suicide is legal. I am also a professor emeritus and former chair of the Department of Radiation Oncology at Oregon Health and Science University.

I first became involved with the assisted-suicide issue shortly before my first wife died of cancer in 1982. We had just made what would be her last visit with her doctor. As we were leaving, he had suggested that she overdose herself on medication. I still remember the look of horror on her face. She said “Ken, he wants me to kill myself.”

In Oregon, the combination of assisted suicide legalization and prioritized medical care based on prognosis has created a danger for my patients on the Oregon Health Plan (Medicaid). First, there is a financial incentive for patients to commit suicide: the plan will cover the cost. Second, the plan will not necessarily cover the cost of treatment due to statistical criteria. For example, patients with cancer are denied treatment if they are determined to have “less than 24 months median survival with treatment” and fit other criteria. Some of these patients, if treated, would however have many years to live, as much as five, 10 or 20 years depending on the type of cancer. This is because there are always some people who beat the odds. The plan will cover the cost of their suicides.

In Oregon, the mere presence of legal assisted-suicide steers patients to suicide even when there is no coverage issue. One of my patients was adamant she would use the law. I convinced her to be treated instead. Twelve years later she is thrilled to be alive.

Don’t make Oregon’s mistake.

Kenneth Stevens, MD,
Sherwood, Ore.

The Oregon Health Plan Steers Patients to Suicide

Yesterday, the Canadian Department of Justice filed evidence in Leblanc v. Canada, including the affidavit of Oregon doctor Ken Stevens.  Therein, Dr. Stevens talks about his patient, Jeanette Hall.  He also describes how with legal assisted suicide, the Oregon Health Plan steers patients to suicide.  His affidavit concludes:

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

Please find the full text of his affidavit below.  To view a hard copy of his affidavit with supporting documentation, click here.  

Massachusetts Assisted-Suicide Initiative Fact Check: The Baloney Meter is Running High

Margaret Dore, Esq.

March 1, 2012

 

1.  Legalization will Empower the Government

Proponents claim that legalizing assisted suicide will keep the government out of people's lives.  The opposite is true.

Fact check:  In Oregon, where assisted suicide is legal, legalization has allowed the Oregon Health Plan, a government entity, to steer people to suicide.  The most well known cases involve Barbara Wagner and Randy Stroup.  Each wanted treatment.  The Plan denied coverage and steered them to suicide by offering to cover the cost of their suicides instead.  See  See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008; and "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008.

2.  The Initiative Allows Someone Else to Administer the Lethal Dose

Proponents claim that only the patient may administer the lethal dose.  This is not true.

Fact check:  The initiative (H.3884) states that patients "may" self-administer the lethal dose. There is no language stating that administration “must” be by self-administration.  "Self-administer" is also a specially defined term that allows someone else to administer the lethal dose to the patient.  See here.

3.  An Heir is Allowed to Witness the Lethal Dose Request

Proponents claim that the lethal dose request form must be "independently witnessed" by two people.  This is not true. 

Fact check:  The initiative, Sections 3 and 21, provides that one of two witnesses on the lethal dose request form cannot be a patient’s heir or other person who will benefit financially from the patient's death; the other witness can be an heir or other person who will benefit financially from the death.

4.  Substantial Compliance

Proponents claim that the initiative has "strict safeguards" to protect patients.  The initiative, however, only requires "substantial compliance" with its provisions.  Section 18(1)(a) states:  "A person who substantially complies in good faith with provisions of this chapter shall be deemed to be in compliance with this chapter." 

5.  Assisted Suicide is a Recipe for Elder Abuse

Proponents claim that the initiative is safe, which is not true.

Fact check: The initiative does not require witnesses at the death.  Without disinterested witnesses, the opportunity is created for an heir, or someone else who will benefit financially from the death, to administer the lethal dose to the patient without the patient's consent.  Even if he struggled, who would know?  

6.  Patients are not Necessarily Dying

Proponents imply that the initiative only applies to people in their "final days."  This is untrue.

Fact check:  See Nina Shapiro, "Terminal Uncertainty — Washington's new 'Death with Dignity' law allows doctors to help people commit suicide — once they've determined that the patient has only six months to live. But what if they're wrong?," Seattle Weekly, January 14, 2009; and Jeanette Hall, "She pushed for legal right to die, and - thankfully - was rebuffed," Boston Globe, October 4, 2011.

 

7.  Assisted Suicide is a Wedge Issue

Proponents deny that assisted suicide is a "wedge issue" to legalize direct euthanasia of non-terminal people.

Fact check:  In Washington state, where assisted suicide has been legal since 2009, there has been a proposal to expand Washington's law to direct euthanasia for non-terminal people.  See Brian Faller, "Perhaps it's time to expand Washington's Death with Dignity Act," The Olympian, November 16, 2011.

8.  Legal Assisted Suicide Threatens People with Disabilities 

Proponents claim that people with disabilities are not at risk from legalization of assisted suicide, which is untrue.

Fact check:  Disability rights groups such as Not Dead Yet oppose assisted suicide as a threat to their lives.  In Oregon and Washington, official government forms for assisted suicide acts in those states promote disability as a reason to commit suicide.[1]  People with disabilities are thereby devalued.  In 2009, there was a proposed assisted suicide bill in New Hampshire that squarely applied to people with disabilities.[2]  If the initiative were to be passed now, people with disabilities see themselves as potentially next in line under a future expansion of that law.  As noted above, there has already been a proposal in Washington state to expand its law to direct euthanasia for non-terminal people. 

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[1]  See e.g. "Oregon Death with Dignity Act Attending Physician Follow-up Form," question 15, providing seven suggested answers as to why there was a lethal dose request.  Some of the answers are written in terms of disability being an acceptable reason to kill yourself.  These answers include:  "[A] concern about . . . the loss of control of bodily functions."

[2]  Stephen Drake and Not Dead Yet, "New Hampshire Poised to Redefine "Terminally Ill" - to PWDs and others for Assisted Suicide Eligibility," January 30, 2009 (regarding New Hampshire's 2009 assisted suicide bill, HB 304, which applied to people with disabilities, people with HIV/AIDS and other non-dying people).

Canada: Assisted Suicide Too Easily Abused

http://www.timescolonist.com/news/Assisted+suicide+easily+abused/5525325/story.html

By John Coppard, Times ColonistOctober 9, 2011

Re: "Assisted dying should be an option," Oct. 4.

The danger in legalizing assisted suicide is that people's choices can so easily be undermined and abused. Whether it's greedy relatives hoping to speed up their inheritance, or cash-strapped bureaucrats looking to save on health-care costs, the weak and vulnerable can be all-tooeasily steered toward a death they do not truly want.

In Oregon, where physician-assisted suicide is legal and the government health plan is empowered to steer patients to suicide, two cases have gained public prominence - Barbara Wagner and Randy Stroup. Both wanted treatment, but their plan offered them suicide instead. Canadian laws prohibiting assisted suicide exist for a reason. Let's keep it that way.

John Coppard Victoria