Canada: What about the right to cry for help?

http://www.montrealgazette.com/news/about+right+help/6907100/story.html

By Amy E. Hasbrouck

It has taken me a long time to read through the nearly 400 pages of the June 15 decision of the British Columbia Supreme Court on the issue of assisted suicide. I found reading it to be like a journey to a dark place, full of raw emotions.

The long and the short of the reasons for judgment issued by Justice Lynn Smith is that legal provisions in Canada prohibiting assisted suicide law are unconstitutional because they impede disabled people’s rights to life, liberty and security of the person.

The judge believes that having a disability or degenerative illness is a rational reason to want to die, and that those of us with disabilities should be helped to die if we can’t do it neatly or efficiently ourselves.

Justice Smith doesn’t appear to believe that people with disabilities and terminal illness are ever coerced, persuaded, bullied, tricked or otherwise induced to end our lives prematurely. She believes those researchers who contend there have been no problems in jurisdictions where assisted suicide is legal, and she rejects evidence suggesting there have been problems.
She writes: “It is unethical to refuse to relieve the suffering of a patient who requests and requires such relief, simply in order to protect other hypothetical patients from hypothetical harm.”

I’ll have to mention that to some of my hypothetical friends who say they have been pressured by doctors, nurses and social workers to hypothetically “pull the plug.”

The same goes for all those folks who succumbed to the pressure; I guess they’re only hypothetically dead.

Montanans Against Assisted Suicide Pushes Legal Challenge Forward

By Margaret Dore

July 6, 2012, Montanans Against Assisted Suicide (MAAS) filed documents with the Montana Medical Examiner Board for the purpose of vacating Position Statement No. 20, titled "Physician Aid in Dying."  The documents filed included: "Summary of Legal Arguments Requiring Position Statement No. 20 to be Vacated as a Matter of Law," which states: 

"Position Statement No. 20 puts physicians and/or the public at risk by encouraging them to engage in illegal and tortious conduct that could result in their being charged with a crime and/or sued.  Statement No. 20 also puts vulnerable people at risk of being killed or steered to suicide by their heirs or  predators.  With these circumstances, the Board’s enactment of Statement No. 20 violates its duty to protect the public (and puts the Board itself at risk of liability)."

To view the above document in its entirety, read the text below or click here to read the hard copy filed with the Board.  Other documents filed with the Board included a cover letter and a proposed order. 

The Text: 

1.  On March 16, 2012, the Board adopted a revised version of  Position Statement No. 20, which refers to “aid in dying” as a “medical procedure or intervention.”[1]

2.  The term, “aid in dying,” means assisted suicide and euthanasia.[2]

3.  On December 31, 2009, the Montana Supreme Court issued Baxter v. State, 354 Mont. 234 (2009), which addressed a narrow form of “aid in dying.”  Baxter did not legalize “aid in dying,” although that fact is disputed by some proponents.[2]

4.  Position Statement No. 20 implies that “aid in dying” is confined to “end-of-life” matters.[4]  In Baxter, however, the plaintiffs sought to legalize assisted suicide for people who were not necessarily at the “end of life,” for example, an 18 year old who is insulin dependent.[5] 

5.  In the last [2011] legislative session, a bill seeking to legalize aid in dying, SB 167, was defeated.[6]

6.  The Medical Examiner Board derives its power from the Administrative Procedure Act, §§ 2-4-101 to 2-4-711, MCA, and other statutes such as § 37-1-307, MCA, which defines the authority of Boards in general.[7]  These statutes do not grant the Medical Examiner Board authority to interpret the meaning of a court decision such as Baxter.[8]  These statutes do not grant the Board the power to enact new legislation, for example, to legalize “aid in dying” as a medical procedure or intervention.

7.  Interpreting court decisions and enacting legislation are the province of the Judiciary and the Legislature, not the Board.  With these circumstances, the Board had no authority to adopt Position Statement No. 20, which effectively interpreted Baxter and/or effectively enacted new legislation to legalize “aid in dying.”  Position Statement 20 is null and void.

8.  The Board’s lack of authority is a lack of subject matter jurisdiction and requires Position Statement No. 20 to be vacated to the extent that it purports to legalize “aid in dying” and/or refers to “aid in dying” as an “end-of-life” matter.

9.  Position Statement No. 20 is also invalid and/or void in its entirety because it is a “rule” under the Administrative Procedure Act, which was adopted without attempting to comply with rulemaking procedures.[9]

10.  Position Statement No. 20 is also invalid and/or void in its entirety because there was no oral argument scheduled for members of the public to speak prior to its enactment.  § 2-4-302(4), MCA  states: “If the proposed rulemaking involves matters of significant interest to the public, the agency shallschedule an oral hearing.”  (Emphasis added).  A matter is of “significant interest to the public” if the agency knows it “to be of widespread citizen interest.”  In the case at hand, the record is overflowing with citizen input including more than 3000 signatures opposed to assisted suicide.[11]  The Board knew of “widespread citizen interest” as a matter of law.  The Board adopted Position Statement No. 20 without previously scheduling oral argument for the public.  For this reason also, the statement is null and void.  

11. Position Statement No. 20 is also null and void because it purports to expand a physician’s scope of practice to include “aid in dying.”  This is the function of the Legislature, not the Board.  Board of Optometry v. Florida Medical Association, 463 So.2d 1213, 1215 (1985).

12.  Position Statement No. 20 puts physicians and/or the public at risk by encouraging them to engage in illegal and tortious conduct that could result in their being charged with a crime and/or sued.  Statement No. 20 also puts vulnerable people at risk of being killed or steered to suicide by their heirs or  predators.  With these circumstances, the Board’s enactment of Statement No. 20 violates its duty to protect the public (and puts the Board itself at risk of liability).

13.  For the above reasons, Position Statement No. 20 is null and void as a matter of law.  It must be vacated and removed from the Board’s website." 

* * *

[1]  The revised statement [titled Physician Aid in Dying] says: "The Montana Board of Medical Examiners has been asked if it will discipline physicians for participating in  aid-in-dying.  This statement reflects the Board’s position on this controversial question. [paragraph break] The Board recognizes that its mission is to protect the citizens of Montana against the unprofessional, improper, unauthorized and unqualified practice of medicine by ensuring that its licensees are competent professionals.  37-3-101, MCA.  In all matters of medical practice, including end-of-life matters, physicians are held to professional standards.  If the Board receives a complaint related to physician aid-in-dying, it will evaluate the complaint on its individual merits and will consider, as it would any other medical procedure or intervention, whether the physician engaged in unprofessional conduct as defined by the Board’s laws and rules pertinent to the Board."  [To view the statement of the Board's website, click here.] 
[2]  Model Aid-in-Dying Act, § 1-102(3), atwww.uiowa.edu/~sfklaw/euthan.html  Note the letters “euthan” in the link. 
[3]  See Greg Jackson Esq. and Matt Bowman Esq., “Analysis of Implications of the Baxter Case on Potential Criminal Liability,” Spring 2010 (“the Court's narrow decision didn't even "legalize" assisted suicide”), available athttp://www.montanansagainstassistedsuicide.org/p/baxter-case-analysis.html; statement by Dr. Stephen Speckart conceding that assisted suicide is not legal under Baxter (“[M]ost physicians feel significant dis-ease with the limited safeguards and possible risk of criminal prosecution after the Baxter decision"), at [the following link with a similar statement by Senator Anders Blewett] http://maasdocuments.files.wordpress.com/2011/07/blewett_speckhart_trans_001.pdf; statement by Senator Anders Blewett conceding that a doctor who assisted a suicide could be prosecuted under the Baxter decision (“under current law, ... there’s nothing to protect the doctor from prosecution”), athttp://maasdocuments.files.wordpress.com/2011/07/blewett_speckhart_trans_001.pdf; and The Montana Lawyer, November 2011 (featuring pro-con articles by Senator Blewett and Senator Jim Shockley), available athttp://www.montanabar.org/associations/7121/November%202011%20mt%20lawyer.pdf.
[4]  Id.
[5]  See opinion letter from attorney Theresa Schrempp and Dr. Richard Wonderly to the Euthanasia Prevention Coalition, October 22, 2009 (attaching the plaintiffs’ interrogatory answers with a definition of “terminally ill adult patient” broad enough to include “an 18 year old who is insulin dependent”).  (Attached hereto at B-1 to B-3). [To view, click here]
[6] See Detailed bill information page, attached hereto at B-4. [To view, click here]
[7]  For more information about the Administrative Procedure Act and other statutes, see Memorandum dated May 2, 2012, pp. 1-2, pp. 8-10.  A copy of the Act and other statutes are attached thereto at A-1 through A-28
[8]  Id.
[9]  See Memorandum dated May 2, 2012, pp. 8-10. [To view citation, use link at note 7, above]
[10]  § 2-4-102(12)(a). 
[11]  Memorandum dated May 2, 2012, p. 3; attachments at A-37 to A-45.  [To view citations, use links at note 7, above]

False & Misleading "Aid in dying" Letter

Below, a letter to physicians responding to a prior "false and misleading" letter claiming that assisted suicide is legal in Montana. To see a hard copy of this letter as sent, click here.


Dear Physician:


I represent Montanans Against Assisted Suicide & For Living with Dignity.  You may have received a letter from Compassion & Choices, formerly known as the Hemlock Society, dated June 5, 2012.  The letter claims that assisted suicide, referred to as "aid in dying," is legal under the Baxter decision issued by the Montana Supreme Court on December 31, 2009.  This is untrue.  I urge you to read the materials below or contact your own counsel for advice regarding the court's decision in Baxter.

"Especially if older people have money or real estate, our laws against assisted suicide are there to protect them"

http://www.abbotsfordtimes.com/news/Assisted+suicide+answer/6840769/story.html

Editor, the Times:

Assisted suicide should not be legal because older people are at great risk for abuse. In my experience as a licensed practical nurse working with older people in home care, I have come across many concerning situations.  I have seen firsthand a family fighting over the will of their parents while they are still alive.


I see that this greatly affects the way the parent feels as they grow older.  They feel as if the family wants them to die so they can have their money.  Some express the pain that they feel when they see loved ones discussing their money as if they have already passed away.


If assisted suicide was legal, some older people would feel the need to say yes - to die - because they are given the message that they are a burden to their family. Some of these older people can be easily convinced and put their trust fully in their caregivers and families.


If assisted suicide were legal, then some would really not make the decision, but let someone else make the decision for them. How is this right?  


Especially if older people have money or real estate, our laws against assisted suicide are there to protect them.


Changing the law to allow assisted suicide would violate their right to be protected in this way.


Arlena Vane Aldergrove

Canada, Carter & Outrage!

"Canada will be known as the country where a Provincial Judge has more power than the Federal Government. "

* * *

Dear Ms. Kerry-Lynne Findlay MP,

I am angry and upset about Justice Lynn Smith's decision in the Carter case, giving Ms. Carter the "right" to assisted suicide/euthanasia. 

This erroneous and presumptuous decision by Justice Smith is a guarantee of elder abuse unto death. We already have a problem with elder abuse in Canada. I witnessed this firsthand with my mother, when, after a mild stroke, the relative holding power of attorney decided my mother would have no treatment. I sat by my mother's bedside in a Nova Scotia nursing home, unable to do anything except hold her hand while she suffered for six days, before finally succumbing to dehydration and starvation. If Justice Smith's decision is allowed to stand, there will be no need for inconvenienced or greedy relatives to wait for even this questionable medical procedure of withholding treatment.

It appears that Justice Smith holds herself above the Government of Canada. She has given our elected representatives, such as yourself, a year to comply with her decision to allow people to "help" kill other Canadians. This is the right to commit homicide. The Federal Government of Canada decided many years ago that Canada would not kill convicted murderers, even if they want to die, but now Justice Smith had deemed that anyone in Canada can kill another person who allegedly asks to be killed. 

MP Findlay, the "right" to kill someone is not a decision for a Provincial Court Justice to make. If Justice Smith's decision is upheld, Canada will be a place of supreme irony. We will have the distinction of protecting the lives of convicted murders, while allowing our vulnerable elders and others to be subject to human error or deliberate murder. We will also be, I believe, unique as a nation: Canada will be known as the country where a Provincial Judge has more power than the Federal Government. 

I look forward to your response on this matter.

Thank you.

Yours truly,

Kate Kelly, B.A., B. Ed.

The Carter Opinion: Unclear Legal Effect & Invalid Reasoning

By Margaret Dore

On June 15, 2012, Justice Lynn Smith of the BC Supreme Court issued an opinion purporting to legalize assisted suicide and euthanasia in Canada.[1]  As discussed below, the legal effect of this opinion is unclear.  The reasoning is also invalid. 

A.  Legal Effect 

The opinion was the result of a summary trial in which both the Attorney General of Canada and the Attorney General of British Columbia argued that the court had no power to do anything other than dismiss the case.  This was due to the Supreme Court of Canada's prior decision on similar facts (the Rodriguez case).  The opinion states:

"They [Canada and British Columbia] say that it is not open to this Court to do anything other than dismiss the plaintiffs' claim."[2]

If Canada and British Columbia are correct, the opinion is nothing more than an advisory document.  Unless and until this point is resolved, any person participating in a death under the opinion will remain at risk of criminal prosecution, civil lawsuits and/or professional discipline.

B.  Invalid Reasoning

The opinion is also written in double-speak, which means to say one thing and to mean another, sometimes the opposite.  Most centrally, the opinion bases the plaintiff's "right to die" on her "right to life" in the Canadian Charter of Rights and Freedoms.[3]  These are opposite concepts.[4] 

The opinion also argues that because Canadian law does not prohibit suicide as a crime, that commiting suicide is a right.[5]  This claim ignores other Canadian law  discouraging suicide. Indeed, a suicidal person can be committed against his or her will in order to prevent a suicide.[6]  With suicide actively discouraged under the law, it cannot be said that the law somehow grants a right to commit suicide.   Once again, the opinion's logic is flawed.

* * *

[1]  To view the opinion, click here.
[2]  Opinion, page 251, paragraph 891.
[3]  Id., pages 365-8.
[4]  See e.g., the opinion at 366, pargraph 1314, which states:  "Canada argues that the right to life does not include the right to choose death.  [Canada] submits that such an interpretation would directly contradict the plain and obvious meaning of a right to life and would mark a significant departure from existing Supreme Court of Canada jurisprudence."
[5]  See e.g., the opinion at 10, pargraph 15:  "The claim that the legislation infringes Ms. Taylor's equality rights begins with the fact that the law does not prohibit suicide.  However, persons who are physically disabled such that they cannot commit suicide without help are denied that option because s. 241(b) prohibits assisted suicide."
[6]  See BC Mental Health Act, Part 3, Section 22 (allowing involuntary admissions "to prevent the person's or patient's substantial mental or physical deterioration or for the protection of the person or patient or the protection of others").

From Afghanistan to Activist Against Assisted Suicide: "These are things worth fighting for"

By John Coppard

To view the original publication in Brain Tumour Magazine, click here.
To learn more about Brain Tumour Magazine, click here.

It was early summer 2009 and I was on my second “tour” in Kabul, Afghanistan, this time as NATO’s civilian spokesman.  I was responsible for representing NATO to media from the Alliance’s 28 member nations - regional powers such as Iran, Russia and Pakistan, and other troop contributing nations to the International Security Assistance Force, as well as Afghanistan’s own emerging media.  While my military counterpart handled military-specific issues, I was responsible for explaining the political and diplomatic aspects of NATO’s support to this brave and tragic country. With lukewarm support for the mission in many contributing nations, and a traumatised Afghan population bombarded by Taliban propaganda and wary of Western intentions, the stress of the job could be intense.

I felt up to the challenge.

In Oregon, other suicides have increased with legalization of physician-assisted suicide

Scott Helman's article about legalizing assisted suicide in Massachusetts implies that doing so will eliminate violent suicides.  I am physician in Oregon where assisted suicide is legal.  Official statistics from the state of Oregon do not support this claim.

Based on an Oregon Public Health report released in 2010, Oregon's overall suicide rate, which excludes suicide under Oregon's assisted suicide act, is 35% above the national average. The report documents that the rate has been "increasing significantly since 2000." 

Just three years prior, in 1997, Oregon legalized assisted suicide.  Suicide has thus increased, not decreased, with legalization of assisted suicide.  Moreover, many of these deaths are violent.  For 2007, which is the most recent year reported on Oregon's website, "[f]irearms were the dominant mechanism of suicide among men."  The claim that legalization prevents violent deaths is without factual support.

Factual support for the above statistics:

Oregon Health Authority News Release September 9, 2010 athttp://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf and,

"Suicides in Oregon, Trends and Risk Factors," Executive Summary, p.4, at

http://public.health.oregon.gov/DiseasesConditions/InjuryFatalityData/Documents/Suicide%20in%20Oregon%20Trends%20and%20risk%20factors.pdf  

William L. Toffler MD

Professor of Family Medicine

Oregon Health & Science University

Posrtland OR

Massachusetts: Legal Challenge to Ballot Measure

Disability Rights Group Challenges Language for Assisted Suicide Ballot Measure as "Misleading, Inaccurate, and Euphemistic"

CONTACT  John Kelly 617-536-5140 

(Boston, MA) – On Thursday, May 17, 2012, Massachusetts voters including members of the disability rights group Second Thoughts filed a challenge before the Supreme Judicial Court regarding the proposed ballot language for the measure that, if approved, would legalize assisted suicide in the state.

"The ballot language is clearly misleading," said Second Thoughts director John Kelly of Boston. "We want the voters ofMassachusetts to know exactly what they are voting on this November," he said.

The petition asks the Supreme Judicial Court to remand the language to Massachusetts Attorney General Martha Coakley and Secretary of State William Galvin with the requirement that they amend the language for clarity and accuracy.

"The ballot language repeats the problems of the bill itself," said Second Thoughts member Paul Spooner of Taunton. "The title is euphemistic, with the word ‘medication’ twisted beyond recognition. People will be led to believe that the measure is about palliative care, when it is about taking a lethal overdose -- in other words, poison. Why not just call the act by its common and legal name, 'physician-assisted suicide?'"

"The way 'terminally-ill' is used in the description is clearly misleading ," said Kelly, "people will be encouraged to assume that being 'terminally ill' is a biological fact, rather than a human guess."

"People with disabilities are very familiar with so-called terminal diagnoses," said Second Thoughts member John Norton of Florence. "Everyone knows someone who has outlived their terminal diagnosis -- I was diagnosed with Lou Gehrig's Disease as a teenager; I'm alive and well fifty years later.  The ballot language misleads by implying that a 'terminally-ill' diagnosis actually leads to death within six months.  Instead, it should say ‘diagnosed as terminal’ or something similar in terms of accuracy."

"And what about choice?," asked Spooner. "There are no safeguards to protect patients from having the poison given to them by an heir or abusive caretaker. No witnesses are required under the law, so if someone else were to administer the drugs, who would know?"

The language submitted by the Attorney General Martha Coakley and Secretary of State is:

Title: Prescribing Medication to End Life [11-12] - Petition G

A YES VOTE would enact the proposed law allowing a physician licensed in Massachusetts to prescribe medication, at the request of a terminally-ill patient meeting certain conditions, to end that person’s life.

Second Thoughts has taken a leading role in opposing the ballot measure, and has been featured in the Boston Sunday Globe Magazine, the Wall Street Journal, and on local TV and radio.

Not Dead Yet: Minnesota Grand Jury Convening on Final Exit Network Member Charges

From Not Dead Yet:
http://notdeadyetnewscommentary.blogspot.com/2012/05/minnesota-dakota-grand-jury-convening.html  


Right now, this latest story involving the Final Exit Network (FEN) is getting only local coverage, but it could become a national story, depending on the outcome.  From the story, by reporter Laura Adelmann:

Apple Valley woman may have killed herself using information from Final Exit Network

In a March 26 letter to a defense attorney, Dakota County Attorney James Backstrom’s office stated it will convene a grand jury May 9-11 seeking an indictment to prosecute right-to-die advocates for their role in an Apple Valley woman’s May 30, 2007 suicide.

Doreen Nan (Gunderson) Dunn, then 57, suffered years of intense chronic pain and depression when she killed herself using a hood and helium gas, according to Robert Rivas, attorney for the Final Exit Network, a national nonprofit organization accused of assisting suicides and named in the investigation.

Before taking her life, Dunn had paid a $50 membership fee to Final Exit Network, according to a March 20 search warrant issued by the Georgia Bureau of Investigation detailing evidence forwarded to the Dakota County Attorney’s Office and obtained by Sun Thisweek.

The warrant cites phone records, documents, airline tickets and car rental contracts as evidence Dunn had contact with some Final Exit members months before taking her life and on the day she died.

Final Exit members named in the investigation are Thomas “Ted” Goodwin, former president of Final Exit Network; Roberta Massey, a Final Exit “case coordinator;” Jerry Dincin, then-Final Exit Network president; and Dr. Lawrence Egbert, Final Exit medical director who Newsweek dubbed “The New Doctor Death.”

Charges the grand jury will be asked to consider are aiding suicide, conspiracy to commit the crime of aiding suicide and interference with a dead body, according to the search warrant.

Those names should look familiar.  Goodwin and Egbert were both involved in the suicide of John Celmer, a man in Georgia who committed suicide after successful cancer treatment left him distressed about his appearance after surgery.  Massey and Egbert were defendants in the case involving Jana Van Voorhis, a woman with no serious physical problems but who had a long history of emotional and psychological issues.

The reporter is pretty careful in most cases in this story to qualify statements about FEN practices with wording such as "the website states."

That's important because not all of what the FEN website claims is true. Take this, for example, from the latest article:

A Final Exit Medical Committee reviews information, and if approved, an “Exit Guide” is assigned who provides detailed information how a person may purchase equipment and take steps to end their own life, according to the website.

“The Network never supplies equipment,” the website states.

That right there - about FEN never supplying equipment.  It's not true.  How do we know?  The overly-modest and zealous Dr. Larry Egbert told us so, in an interview that appeared in the Washington Post in January:

Egbert tells me that years ago he asked someone who was about to “exit” if he could reuse the hood to save future patients the cost of buying a new one. The patient was delighted with the idea, Egbert says. He started asking everyone.

The hood in my bare hands feels slightly slick. So, this one, the one I’m holding, has been used to end someone’s life? I ask. Egbert tells me it has surely been used at least once, and maybe several times, and the same could be said for most of the other 17 hoods in the garbage bag. 

So, Egbert, by his own admission, has provided equipment on a regular basis in his work as an 'exit guide.'  That might seem like a minor point to some in and of itself, but the fact is, there is no way for us - the public - to verify any claim FEN makes.  It's only when someone like Egbert gets to talking and bragging we get to hear some facts that depart from the established script.

We don't know who else has supplied equipment to 'clients.'  We don't know how many FEN members 'pushed' so-called 'clients' with second thoughts to get on with it, not wanting their valuable times wasted.  We don't know how if any of the FEN members have held down the hands of a person trying desperately to tear the bag off.

We don't know.  And even Robert Rivas (FEN atty.) and Jerry Dincin cannot swear that they know the parameters of what has gone on in each and every so-called 'peaceful exit.'  They weren't there and they don't know.  When they try to tell us that everyone is behaving responsibly, remind them that Egbert already revealed one lie about their practices and we're not inclined to believe any other unverified claims they make.  --Stephen Drake

Washington Assisted Suicide Report: No Information About Consent

By Margaret Dore

Washington assisted suicide act was enacted via a ballot initiative in 2008 and went into effect in 2009.[1]  During the election, proponents claimed that its passage would ensure individuals control over their deaths.  A glossy brochure declared, "Only the patient — and no one else — may administer the [lethal dose]."[2]  The Act, however, does not say this anywhere.


Today, the Washington State Department of Health issued its annual report about Washington's act.[3]  That report, similarly, does not demonstrate that individuals are in control. The report provides no information as to whether the people who died under the act consented and/or acted voluntarily at the time of death.  The report instead talks about "ingestion" of the lethal dose.  A drug can be "ingested" while a person is asleep, sedated and/or not aware of his or her surroundings.


For more information about Washington's act, See Margaret Dore, "'Death with Dignity': What Do We Advise Our Clients?," Bar Bulletin, May 2009.[4]  

* * *

[1]  Washington's act was passed by in November 2008 as Initiative 1000 and has now been codified as RCW chapter 70.245.
[2]   I-1000 color pamphlet, "Paid for by Yes! on 1000."
[3]  See News Release here and report here.
[4]  Further information can be viewed here.