Disability Community News Flash on "Death with Dignity"

http://www.mwcil.org/home/files/2012-02-29-newsflash-hearing-death-with-dignity.pdf
 
Stop Assisted Suicide in MA We Need Real Choices, Not Medical Killing

News Flash - Hearing on "Death with Dignity" . . .

Attend the hearing at the State House next Tuesday, and oppose H.3884.

What: Hearing of the Joint Judiciary Committee on H. 3884 - an act to allow "Death with Dignity" in MA.

When: Tuesday, March 6 at 1 p.m.
Where: State House, Room A-2
Why: This bill is dangerous for people with disabilities, elders and people with serious illness.
Contact: Second Thoughts and John Kelly at (617) 536-5140

Second Thoughts is a group of Disability Rights Organizations and Activists who oppose this "Death with Dignity" ballot initiative. Here are some of the compelling reasons why this bill is dangerous.

Deadly Mix: Assisted suicide is a deadly mix with a profit-driven health care system.

Self-determination: Assisted suicide is unnecessary to have control because each person has the right to refuse lifesaving treatment, and to have adequate pain relief, including palliative sedation. Assisted suicide decreases self-determination by giving doctors and insurers the power not just to cure, but to kill.

Abuse: The proposed law is a recipe for elder abuse. An heir can be a witness and help sign someone up, and once a lethal drug is in the home, no one will know how the drug is administered. If the person struggled, who would know?

No Safeguards: A lack of safeguards and oversight in the proposed law puts people at risk of misdiagnosis, deprivation of treatment and economic pressure to choose suicide, while protecting doctors from liability.

• If a doctor refuses lethal drugs, the patient or family simply can--and do--find another doctor ("doctor shopping"). 
• "Terminal condition" and "death within six months" are often misdiagnosed, opening the dangers of assisted suicide to many who are not terminally ill.
•  The law does not require that people are screened or treated for depression or other mental health conditions that cause suicidal feelings.
•  The law does not include enforcement provisions, investigation authority, oversight or data verification. The only foolproof safeguard is for the prescribing doctors. The law holds doctors to only a "good faith" standard, which makes any safeguards unenforceable.

Discrimination: A law that singles out some people (such as old, ill and disabled people) for assisted suicide instead of suicide prevention is no in step with Massachusetts' progressive tradition as a leader against discrimination.

Visit http://www.second-thoughts.org/

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. 

* * * 

[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).

VSED: Legal Complaint Alleges that Heirs Manipulated Doctors to Kill Father

Grim Complaint Against Kaiser Hospital

http://www.courthousenews.com/2012/02/06/43641.htm

By WILLIAM DOTINGA 

RIVERSIDE, Calif. (CN) - A son claims a Kaiser hospital ignored his wealthy father's power of attorney so the plaintiff's greedy siblings could collect multimillion-dollar inheritances. 

Hector Noval sued Kaiser Foundation Hospitals and affiliates, a doctor and two social workers on behalf of his father, Victorino Noval, who died in May 2010 after a "terminal extubation." Noval says his father had been involuntarily admitted to Kaiser's intensive care unit for pneumonia on April 28, 2010, while suffering from early-stage of Parkinson's and chronic obstructive pulmonary disease.

Before being hospitalized, Noval, 78, "lived in his own home, drove his own vehicle, and performed his own activities of daily living," according to the Superior Court complaint. "He was worth $60 million and had annual income of $3 million. He made investments and controlled his finances. He suffered from no neurological deficiencies. He did not have dementia or diminished capacity, He functioned independent of others. He was in no way nearing death, an irreversible coma, or a persistent vegetative state. Upon hospitalization, he only required temporary oxygen support while the pneumonia infection in his lungs cleared and he regained his strength. His condition was no more serious than that."

However, Hector Noval says, two of his sisters, Lourdes Frost and Tania Noval, told Kaiser doctors, "falsely and fraudulently," that their father had "'advanced' Parkinson's disease" and had been declining for 6 months before his hospitalization.

He claims that his siblings' false and fraudulent statements included "that he 'would not want to be hooked to a machine like a ventilator,' even if just temporarily, and that 'he had expressed this to [his] daughter both when he is well, and when not so well.' Frost and Noval told defendants that decedent 'would not [have] wanted to be resuscitated if he is to pass away ... he would want to die peacefully if that was to happen.' Each of these statements were untrue. Defendants performed no diligence into their veracity and accepted them as true."

Vermont: "Assisted suicide law sends contradictory message"

Editor’s note: This op-ed is by Guy Page, a parent and resident of Cambridge.

http://vtdigger.org/2012/02/01/page-assisted-suicide-law-sends-contradictory-message/

In the Jan. 19 mail I received a letter from Lamoille Union High School, where my daughter is enrolled. It begins with the following sentence: “Over the last few years Vermont has seen an increase in suicide among young people.” It went on to describe a school initiative to hopefully address this awful development. I hope they are successful. All of my children have friends, or friends of friends, who have taken their own lives.

My eldest son, Tim, was a constant suicide risk through his teens. Through the wise, compassionate help of state social workers, Tim escaped his teen years alive. I can tell you that he was personally shaken by the implications, to him, of the proposed assisted suicide law several years ago. When he heard about it, my brilliant, troubled son began to shake in anger and almost despair. “Those hypocrites,” he said. “They’ve been telling me all this time that suicide is never OK.” It didn’t matter when I said the law is meant to address another set of problems – his teenaged hypocrisy-o-meter had already pegged assisted suicide as another example of “do as I say, not as I do, it’s all right for adults, not OK for kids.”

Recently I researched teen suicide in Oregon, where assisted suicide became legal in 1998. According to the Oregon health department website, there were more teen suicides after the law passed than before — 1999: 29 suicides. 2000: 44 suicides. 2001: 31. 2002: 37. 2003: 46. 2004: 52. The last two years were the highest two-year period in their survey. Furthermore, 94 percent of teen suicide attempts leading to hospitalization were caused by ingesting drugs – the only form of assisted suicide permitted by Oregon state law. Kids learn from their elders.  [See:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5635a2.htm]

Does this “prove” a link between the Oregon physician-assisted suicide law and teen suicide? No. But the burden of proof is on those who say, “Don’t worry, it will all be OK, none of our teens will think that.” As a parent of an at-risk child, I think this law may unintentionally tell other troubled teens “when it gets too hard it’s okay to end it all.” As the letter from my daughter’s high school says, the real world is a very hard place for some teens right now, and I think this law will just make it harder.

There are plenty of other reasons to oppose this bill. Before my wife passed in February 2011, she was appalled and upset at end-of-life questions asked of her in the ICU that to her seemed motivated by hospital cost-control. It drove a (thankfully temporary) wedge of distrust between her and her caregivers. So Vermont Insurance Commissioner Steve Kimball’s newspaper comments connecting this end-of-life issue with the high cost of health care were chilling. By contrast, Orange County Sen. Mark MacDonald’s daughter was one of Diane’s nurses and provided skilled, affirming care that should be the goal of the state’s health policy. But for me the teen suicide connection is reason enough for the Senate to drop this bill before it does irreversible harm.

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Article printed from VTDigger: http://vtdigger.org/
URL to article: http://vtdigger.org/2012/02/01/page-assisted-suicide-law-sends-contradictory-message/
URLs in this post:

[1] : http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5635a2.htm

The Leblanc Case: A Recipe for Elder Abuse and a Threat to the Individual

By Margaret Dore

January 26, 2012

"Those who believe that legal assisted
suicide/euthanasia will assure their

autonomy and choice are naive."

William Reichel, MD

Montreal Gazette,

May 30, 2010[1]

A.  Introduction

Leblanc vs. Attorney General of Canada brings a constitutional challenge to Canada's law prohibiting aiding or abetting a suicide.  Leblance also seeks to legalize assisted suicide and euthanasia as a medical treatment.  In 2010, a bill in the Canadian Parliament seeking a similar result was overwhelmingly defeated. 

Legalization of assisted suicide and/or euthanasia under Leblanc will create new paths of elder abuse.  This is contrary to Canadian public policy.  Legalization will also empower the health care system to the detriment of individual patients. 

Not Dead Yet on Final Exit Network & Hospice

http://notdeadyetnewscommentary.blogspot.com/2012/01/georgia-response-letters-to-op-ed-by.html

Georgia:  Response Letters to op-ed by Final Exit Network (FEN) President Wendell Stephenson

On January 7, the Atlanta Journal-Constitution published an op-ed by Wendell Stephenson, current president of the Final Exit Network (FEN).  "Ensuring death with dignity" is no longer freely available at the AJC site, but the same essay was published in December last year in the Metrowest Daily News and can still be read here.

It's the usual conflation of terminal illness with chronic illness, sensationalist language describing FEN members and supporters as victims of oppression, etc.  This blog will probably be revisiting Stephenson's piece in the near future.

In the meantime, his op-ed drew some strong reactions that were published in the letters section of the AJC on January 15.  There were three letters - the first one agreeing with Stephenson and the following letters  disagreeing with him.  The letters can all be found on this page.

The first of the two taking issue with Stephenson and his op-ed was written by Eleanor Smith, a long-time disability rights leader and activist who is the founder of Concrete Change, an international network whose goal is to make all new homes visitable.  Her letter:

Right-to-die argument blurs a key distinction

“Ensuring death with dignity” (Opinion, Jan. 7) blurs the distinction between the freedom to end one’s own life, which cannot be denied, and the freedom to have others end one’s life, which endangers the lives of people less valued by society.

The elderly couple referred to in this column chose to inform their assisted-living facility of their intention to starve themselves to death (which the administration, unsurprisingly, could not support). They could have chosen instead to check out of the institution for a short stay with their children. I suspect organizational (rather than personal) advice led to this public confrontation.

Older and/or disabled people can be expensive to support. It is reprehensible to select them as the population encouraged to die before their time — rather than supporting them to live and making them feel welcome in the world.


Eleanor Smith, Decatur

The next letter was from Jennifer Hale, executive director, the Georgia Hospice and Palliative Care Organization.  Her letter:

Final Exit leader’s essay ‘inherently misleading’

The piece by Wendell Stephenson of the Final Exit Network attempting to link the philosophy of hastened death and assisted suicide — or, as he terms it, “self-deliverance” — with the ideals of dignity at the end of life provided through state-licensed and federally certified hospice care providers is absolutely wrong, inherently misleading and seems mildly predatory from my perspective (“Ensuring death with dignity,” Opinion, Jan. 7).

At the Georgia Hospice and Palliative Care Organization, it is our mission to provide education, information and advocacy to the public and to providers of end-of-life care to raise awareness of the options available to every person and improve on the quality of that care. Nowhere on the Final Exit Network’s website could I find where there was any support for families.

The couple mentioned in this piece made a decision about how they wished to spend the end of their lives. Hospice did not help them make this decision and did not help them carry it out. Hospice helped them return to their family’s residence and provided them with physical and emotional support and ongoing bereavement care for the family.


Jennifer Hale, executive director, the Georgia Hospice and Palliative Care Organization

Hale's letter opens with a strong and harsh assessment of both Stephenson and the Final Exit Network.

It's too bad that her concluding words contain a glaring contradiction of her claim that hospice played no role in helping the couple in question "carry out" their death through starvation and dehydration.  When she says that hospice gave the couple "physical and emotional support," that means they facilitated the process - at least to the extent that they made the couple as comfortable as possible and as free from the more unpleasant sensations of starvation and dehydration as they could manage.  That is a lot of help.  Similarly, I have concerns that "ongoing bereavement care for the family" means helping everyone in the family feel OK with themselves for their own sanction and support of the couple's long suicide through starvation and dehydration.  That, too, is a lot of help.

Maybe Ms. Hale could take a second stab at clarifying what hospice is and is not.  Because this last couple of sentences didn't help me at all.  --Stephen Drake

Ken Stevens MD: "legalizing assisted suicide can result in decreased patient choice"

Assisted Suicide
http://www.sltrib.com/sltrib/opinion/53280042-82/suicide-patients-assisted-oregon.html.csp

Updated Jan 19, 2012 01:01AM

Patty Henetz' "Do Utahns have the right to choose how they die?" (Tribune, Jan. 8) refers to the legalization of assisted suicide in Oregon. Utahns should understand that legalizing assisted suicide can result in decreased patient choice.

I have been a cancer doctor in Oregon for more than 40 years. 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).

The plan limits medical care and treatment for patients with a 5 percent or less likelihood of surviving five years. Patients in that category who have a good chance of living another three years and who want to live cannot receive surgery, chemotherapy or radiation therapy. However, the plan will cover the patient's suicide.

Oregon law says only patients with no more than six months to live are eligible for voluntary suicide, but the plan nonetheless offers suicide to patients in this category.

The mere presence of legal assisted suicide steers patients toward suicide. One patient was adamant to use the law. I convinced her to be treated. Eleven years later she is thrilled to be alive.

Kenneth Stevens, M.D.

Sherwood, Ore.

Hawaii: Assisted Suicide Not Lawful, Says State

http://www.staradvertiser.com/s?action=login&f=y&id=137466873

A 103-year-old act does not let doctors kill, the attorney general's office tells proponents

By B.J. Reyes

POSTED: 01:30 a.m. HST, Jan 17, 2012

An obscure 1909 law intended to ease suffering of Hansen's disease patients does not make physician-assisted suicide legal in Hawaii, according to an opinion by the state attorney general's office.

The opinion, dated Dec. 8, was in response to an inquiry from state Sen. Josh Green, chairman of the Senate Health Committee, who sought clarification of the law amid reports that supporters of physician-assisted suicide were seeking a patient willing to test the statute.

 

An obscure 1909 law intended to ease suffering of Hansen's disease patients does not make physician-assisted suicide legal in Hawaii, according to an opinion by the state attorney general's office.

 

The opinion, dated Dec. 8, was in response to an inquiry from state Sen. Josh Green, chairman of the Senate Health Committee, who sought clarification of the law amid reports that supporters of physician-assisted suicide were seeking a patient willing to test the statute. Login for more...

Utah: New Website!

Click here to see the website: Utah Against Assisted Suicide:  "Choice" is an Illusion!

Massachusetts voters, reject Petition 11-12

http://www.washingtontimes.com/news/2012/jan/11/massachusetts-voters-reject-petition-1112/

If adopted this November, a ballot initiative in Massachusetts will legalize physician-assisted suicide for patients whose conditions are predicted to produce death within six months. Initiative Petition 11-12 claims to ensure that the patient's decision to commit suicide is voluntary. That claim, however, is misleading.

The initiative petition requires that two persons witness the patient's written request for a lethal prescription. One witness, however, can have a financial interest in the patient's death. That person can be the only witness present when the lethal drug is taken. Thus, an interested heir could pressure the patient, and no one would know because no objective witness is required when the drug is taken. Also, the petition would require the death certificate fraudulently to list the patient's underlying condition, rather than the lethal drug, as the cause of death.

Initiative Petition 11-12 uses terms like life-ending "medication" and death in a "humane and dignified manner." But there is nothing medicinal about poison and nothing dignified about the prospects for the abuse the initiative petition would allow. It is a bad law that the voters of Massachusetts should reject decisively.

STEPHEN L. MIKOCHIK
Professor emeritus
Temple Law School