Saturday, July 12, 2014

UK: Falconer Assisted Suicide Bill: "Eligible" Patients May Have Years, Even Decades, to Live

By Margaret Dore, Esq., MBA

In the UK, HL Bill 6 is an assisted suicide law proposed by Lord Falconer, which is based on the Oregon and Washington assisted suicide laws.  Bill 6 would legalize assisted suicide for persons with a "terminal illness," defined in terms of a prediction of less than six months to live.[1]  The Oregon and Washington laws have a similar six months to live criteria.[2]

Under all three laws, "eligible" patients may have years, even decades, to live.  This is true for the following the following reasons: 

1.      Predictions of life expectancy can be wrong.  

Patients may have years or even decades to live because predicting life expectancy is not an exact science.  Consider John Norton who was diagnosed with ALS.  He was told that he would get progressively worse (be paralyzed) and die in three to five years.  Instead, the disease progression stopped on its own.  In a 2012 affidavit, at age 74, he states:
If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.  http://www.massagainstassistedsuicide.org/2012/09/john-norton-cautionary-tale.html [3]
2.      The six months to live is determined without treatment. 

Consider Oregon resident, Jeanette Hall, who was diagnosed with cancer and decided to "do" Oregon's law.  Her doctor, Kenneth Stevens, didn't believe in assisted suicide and encouraged her to be treated instead.  It is now 14 years later and she is "thrilled" to be alive.  This is Dr. Steven's affidavit filed by the Canadian government in Leblanc v. Canada, now dismissed, discussing Jeanette.  http://choiceisanillusion.files.wordpress.com/2013/07/signed-stevens-aff-9-18-12-as-filed.pdf   This is Jeanette's affidavit, also filed by the Canadian government:  http://choiceisanillusion.files.wordpress.com/2013/05/jeanette-hall-affidavit.pdf  

3.      In Oregon, the six months to live criteria is now being interpreted to include chronic conditions such as diabetes.  

Oregon doctor, William Toffler, explains: 
Our law applies to “terminal” patients who are predicted to have less than six months to live. In practice, this idea of terminal has recently become stretched to include people with chronic conditions such as chronic lower respiratory disease and diabetes. Persons with these conditions are considered terminal if they are dependent on their medications, such as insulin, to live. They are unlikely to die in less than six months unless they don’t receive their medications. Such persons, with treatment, could otherwise have years or even decades to live.[4]  
* * *
[1]  See HL Bill 6, Sections 2, at http://services.parliament.uk/bills/2014-15/assisteddying.html (defining "terminal illness" as an "inevitably progressive condition which cannot be reversed by treatment," and for which the patient "is reasonably expected to die in six months.").
[2]  See ORS 127.800 s.1.01(12) and RCW 70.245.010(13) at    http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx and http://apps.leg.wa.gov/RCW/default.aspx?cite=70.245.010  (both stating:  "'Terminal disease' means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.").
[3]  See also:  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? The Seattle Weekly, January 14, 2009 http://choiceisanillusion.files.wordpress.com/2013/10/terminal-uncertainty.pdf and http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty
[4]  Letter from William Toffler, MD, to the New Haven Register, published February 26, 2014, 2nd letter at http://www.nhregister.com/opinion/20140226/letters-to-the-editor-dying-deserve-right-to-choice  See also, Dore Memo at pp 6-7, at http://choiceisanillusion.files.wordpress.com/2014/06/nj-a2270-legal-analysis_001.pdf and Margaret Dore, “Oregon's new assisted suicide report: chronic conditions;  people with money and more,” February 19, 2014, at http://www.choiceillusion.org/2014/01/oregons-new-assisted-suicide-report.html 

What results from assisted suicide laws

http://www.washingtonpost.com/opinions/what-results-from-assisted-suicide-laws/2014/07/11/2704d612-0768-11e4-9ae6-0519a2bd5dfa_story.html

July 11 at 5:42 PM 

As a former three-term state representative in New Hampshire, I was alarmed to see that Maryland is being urged to adopt an assisted-suicide law similar to those in Oregon and Washington state [" Controlling the end of life, Local Opinions, July 6]. 

Four months ago, the New Hampshire House rejected such a law by a 219 to 66 vote. Many representatives in the Democratic-controlled House initially thought they were for the bill but became uncomfortable when they studied the issue further. 

Contrary to promoting "choice" for older people, assisted-suicide laws are a prescription for abuse. They empower heirs and others to pressure and abuse older people to cut short their lives, especially when they have money. No assisted-suicide bill could correct this huge problem.

Nancy Elliott, Merrimack, N.H.

Friday, July 4, 2014

Washington’s ‘Death with Dignity’ law imperils the poor

http://realchangenews.org/index.php/site/archives/9122

Last week’s article by an assisted suicide/euthanasia advocate struck me as a bizarre article for Real Change, which advocates for the dignity and self-determination of the poor. (“Terminally ill patients face shortage of right-to-die drug amid controversy over capital punishment,” Real Change, June 18)
Washington’s assisted suicide law was passed in 2008 and went into effect in 2009. This was after a deceptive initiative campaign promised us that “only” the patient would be allowed to take the lethal dose. Our law does not say that anywhere. See Margaret K. Dore, “’Death with Dignity,” What Do We Advise Our Clients?,” King County Bar Association, Bar Bulletin, May 2009, available at https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm.
In Oregon, which has a similar law, there are documented cases of that state’s Medicaid program using the law to steer patients to suicide. In other words, indigent patients are offered suicide in lieu of desired treatments to cure or to extend life. The most well-known cases are Barbara Wagner and Randy Stroup.  See: Susan Donaldson James, “Death Drugs Cause Uproar in Oregon,” ABC News, August 6, 2008, at http://abcnews.go.com/Health/story?id=5517492&page=1; and “Letter noting assisted suicide raises questions,” KATU TV, July 30, 2008, at http://www.katu.com/news/specialreports/26119539.html  See also the Affidavit of Kenneth Stevens, MD, filed by the Canadian government in Leblanc v. Canada, available at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf.
Finally, consider this quote from a March 8, 2012 Jerry Large column in the Seattle Times. He says that at least a couple of his readers suggested euthanasia “if you couldn’t save enough money to see you through your old age.” http://seattletimes.com/text/2017693023.html  For the poor, this would be non-voluntary or involuntary euthanasia. 
So much for the dignity and self-determination of the poor.

Margaret Dore, Esq., MBA *
Seattle

Wednesday, June 18, 2014

Legal/Policy Analysis Against New Jersey Bill, A2270 (Assisted Suicide & Euthanasia)

By Margaret Dore, Esq., MBA

A legal/policy analysis against New Jersey's proposed assisted suicide/euthanasia bill, A2270, can be viewed by clicking here.

If the analysis is "too big" for your computer, you can view it in pieces, by clicking the following links to: the cover sheet and index; the memo; and the appendices.

There are three main points:

1.  A2270 is titled "Aid in Dying for the Terminally Ill Act."  "Aid in Dying" is a euphemism for assisted suicide and euthanasia.  The title is, regardless, deceptive because it implies that A2270 is limited to people who are dying, which is untrue.  A2270 applies to people who may have years, even decades, to live.  See memo, pp. 5-8.

2. The bill is a recipe for elder abuse with the most obvious reason being a complete lack of oversight when the lethal dose is administered to the patient.  Even if he struggled, who would know? See memo, pp. 8-17.

3. The bill lacks transparency and accountability.  Id., pp. 17-19.

The last part of the memo is a discussion of the "Oregon and Washington Experience," with supporting documentation attached.

Please contact me with any questions or concerns at contact@choiceillusion.org or margaretdore@margaretdore.com.

Margaret Dore, President
Choice is an Illusion, a human rights organization
Law Offices of Margaret K. Dore, P.S.
www.choiceillusion.org
www.margaretdore.com
1001 4th Avenue, 44th Floor
Seattle, WA 98154

Thursday, June 12, 2014

Assisted suicide is a mistake

http://www.courierpostonline.com/story/opinion/readers/2014/06/11/letter-assisted-suicide-mistake/10348363/

I am a doctor in Oregon, where physician-assisted suicide is legal. I understand that your Legislature is considering taking a similar step.

I was first exposed to this issue in 1982, shortly before my first wife died of cancer. We had just visited 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.”

Our assisted-suicide law was passed in 1997. In 2000, one of my patients was adamant she would use our law. Over three or four visits, I stalled her and ultimately convinced her to be treated instead. Nearly 14 years later, she is thrilled to be alive.

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).

Helpful treatments are often not covered. The plan will cover the patient’s suicide.

Protect your health care. Tell your legislators to vote “no” on assisted suicide.

Don’t make Oregon’s mistake.

KENNETH STEVENS, M.D.
Sherwood, Ore.

Wednesday, April 30, 2014

Arizona Strengthens its Law Against Assisted Suicide

http://www.kansascity.com/2014/04/30/4993778/brewer-signs-bill-targeting-assisted.html

Brewer Signs Bill Targeting Assisted Suicide

PHOENIX — Arizona Gov. Jan Brewer has signed a bill that aims to make it easier to prosecute people who help someone commit suicide.

Republican Rep. Justin Pierce of Mesa says his bill will make it easier for attorneys to prosecute people for manslaughter for assisting in suicide by more clearly defining what it means to "assist."

House Bill 2565 defines assisting in suicide as providing the physical means used to commit suicide, such as a gun. The bill originally also defined assisted suicide as "offering" the means to commit suicide, but a Senate amendment omitted that word.

The proposal was prompted by a difficult prosecution stemming from a 2007 assisted suicide in Maricopa County.

Brewer signed the bill on Wednesday.

Wednesday, April 23, 2014

Attend the New Hampshire Victory Celebration Dinner!

Featured Speaker
John B. Kelly
Former New Hampshire State Representative, Nancy Elliott has organized a "Victory Celebration Dinner" to celebrate the overwhelming defeat of assisted suicide in New Hampshire. The dinner is sponsored by the Euthanasia Prevention Coalition.

The dinner speaker will be John B. Kelly, New England Regional Director for Not Dead Yet.  

The dinner will also celebrate opposition to assisted suicide throughout New England and Quebec.  

Where:  Crowne Plaza Hotel, Nashua New Hampshire, USA
When:    Friday, May 30, 2014
Cost:     $35.00

Book a room at the Crowne Plaza Hotel for $119 under the name "Euthanasia Prevention Coalition."  

Please make payments for the dinner to the Euthanasia Prevention Coalition, Box 611309 Port Huron MI 48061-1309, or contact Alex Schadenberg at: 1-877-439-3348 or info@epcc.ca

Please consider a generous donation to the Euthanasia Prevention Coalition, Not Dead Yet and other groups that were instrumental to defeating assisted suicide in New England and Quebec this year.

To donate to the Euthanasia Prevention Coalition, click here.
To donate to Not Dead Yet, click here.

Wednesday, April 16, 2014

I want assistance living, not dying

http://www.thespec.com/opinion-story/4465271-i-want-assistance-living-not-dying/

Assisted suicide

I was born with cerebral palsy and I have lived all of my life with pain. I now have scoliosis, which affects my mobility and gives me further pain. My prognosis is living with a wheelchair.

MP Steven Fletcher has introduced euthanasia bills with language that specifically focuses on people with disabilities because his bills are about him dying by euthanasia.

Fletcher seems to be saying that he does not value his life, but I value my life and the lives of others with disabilities. His "right to die" ends at the point where it affects other people. Don't take me down with your death wish.

As a member of parliament, Fletcher has the opportunity to make a difference in the lives of people with disabilities, to work toward improving social supports and living opportunities, but his euthanasia bills say that our lives are not worth living.

People with disabilities are at risk from euthanasia because they are often dependent on others who legally have the right to make decisions for them. Any legislation that lessens protections in law for people with disabilities is very concerning.

I have overcome many physical and social barriers in my life, I am busy wanting to live, but Fletcher's bill directly affects my right to live.

People with disabilities, who live with a positive mindset, show society how to overcome challenges. We see these challenges as opportunities for personal growth.

Fletcher wants your pity. People with disabilities don't want your pity and we don't want your death.

The concept of euthanasia creates great fear for me. Legalizing euthanasia or assisted suicide abandons me as a person. That society would rather help me die with dignity, than help me live with dignity. We will fight for the right of people with disabilities to live with equality, value and acceptance.

Steven Passmore, Hamilton                             

Saturday, April 12, 2014

This woman needed help NOT Dignitas

http://www.express.co.uk/comment/columnists/richard-and-judy/469987/The-tale-of-an-unwarranted-death-this-woman-needed-help-NOT-Dignitas


IN a week of disturbing stories right across the news gauntlet – Peaches, Pistorius, the political car-crash of Maria Miller – one dark and troubling tale went almost unnoticed: The death of a retired art teacher, only identified as Anne, by assisted suicide at the infamous Dignitas clinic in Switzerland. 


The truly disturbing nature of Anne’s story is this: she was not suffering from any form of terminal disease. True, at 89, she had had her health problems – diseases of the lung and heart, requiring spells in hospital (which she hated). But she wasn’t dying of cancer, or one of the nasties such as Huntington’s Chorea, or multiple organ failure.

Anne simply felt alienated from the modern world. Speaking days before she died – from a lethal dose of drugs provided by the clinic – she said she felt she faced a choice either to “adapt or die”, and announced she was not prepared to adapt to a world in which technology took precedence over humanity. She added that she had become frustrated with the trappings of modern life, such as fast-food, consumerism, and the amount of time people spend watching television.

“They say ‘adapt or die,’” she said, having already made the decision to take the latter option by drinking a deadly dose of barbiturates. “I find myself swimming against the current, and you can’t do that. If you can’t join them, get off... all the old fashioned ways of doing things have gone.”
Now you may or may not agree with Anne’s world view, but judging by her comments (and there were more in the same vein) it sounds very much to me as if the poor woman was suffering from a classic case of clinical depression – feelings of hopelessness, alienation, despair and suicidal thoughts.

Is that a condition Dignitas should be giving itself permission to treat with a lethal cocktail of drugs? I don’t think so. Its own rules state that it will only provide help in cases of “illness which will lead inevitably to death, unendurable pain or an unendurable disability”.

Anne’s niece, Linda, 54, accompanied her aunt to Zurich and was by her side when she died. She has said she “cannot think of a better death”.

Hmm. I don’t doubt her personal belief in that statement and I am sure she genuinely believes she did the right thing by her aunt. But Anne’s death raises disturbing questions. What if she’d been 10 years younger, say, 79, but held exactly the same bleak view of the world? Would she still have been offered assisted suicide?

Or what about 69? Or 59? At exactly what point does the combination of (undiagnosed) depression plus advancing years get the thumbs-up from the Dignitas doctors?

Personally I have always supported the principle of assisted suicide but Anne’s exit from this world has made me seriously wonder if it can ever be properly controlled.

This disturbing story could be the thin end of a very unpleasant wedge.

Thursday, April 10, 2014

Late actor Mickey Rooney was a strong voice against elder abuse

https://ca.news.yahoo.com/blogs/dailybrew/actor-mickey-rooney-voice-against-elder-abuse-170443794.html
By  | Daily Brew
As the details of Mickey Rooney's death will make headlines today — he disinherited his eight surviving children and his estranged wife just weeks before his death, leaving his meager $18,000 estate to his stepson and caregiver Mark Rooney — so do claims that the Hollywood legend was a victim of elder abuse.
According to the Associated Press, Rooney said he lost most of his fortune because of elder abuse and financial mismanagement by another of his stepsons, Christopher Aber.
He cut his children out of his will because they were better off financially than he was.
Rooney's lawyer, Michael Augustine, said that an agreement was in place for millions to be repaid to the 93-year-old actor, but it was unlikely the estate will ever collect on it.
Almost three years ago, Rooney appeared before a U.S. Senate committee that was considering legislation that would crack down on elder abuse.
In March of 2011, then-90-year-old Rooney told the Senate Special Committee on Aging that he had been "stripped of the ability to make even the most basic decisions about my life" and financially exploited by his stepson, Aber, and didn't seek help because he was "overwhelmed" with fear, anger and disbelief.
"But above all, when a man feels helpless, it's terrible," Rooney testified.
Engaging in a war of he said/he said, Aber told the Daily Mail that his younger brother, Mark, and his wife were the real abusers, not him.
"They were keeping him from access to a phone, they kept him hostage," he claimed, making the horrific accusation that Rooney died of choking on his own food with no one there "to pat him on the back."
News outlets have reported only that Rooneydied of natural causes, including complications related to diabetes. Read Aber's messy allegations here.
Elder abuse has been making headlines in Canada this month.
Toronto woman Norma Marshall, 94, was victimized by her housekeeper and her family who systematically spent Marshall's life savings and sold her belongings without her knowledge, confining Marshall to a small room in her own home.
A delivery man for a local pharmacy determined something wasn't right when he dropped off her medications and alerted authorities.
Seniors are particularly susceptible to elder abuse and frauds, and regrettably, there is a great reluctance to disclose these types of incidents. —  Patricia Fleischmann, Toronto police vulnerable-persons coordinator
And earlier this week, we shared Bert Matthews' story.
Matthews claims he was tackled and restrained at a Vancouver Island hospital after he tried to leave. He went to the hospital fearing signs of a heart attack or stroke and was admitted, instead, to a psychiatric ward.
According to a poll commissioned by Bayshore HealthCare earlier this year, one in five Canadians visit their elderly loved ones just twice a year at most, citing distance and busyness as reasons for staying away.
With reports of elder abuse and neglect increasing across the nation, last month, British Columbia became the first Canadian province to appoint a seniors' advocate. Isobel Mackenzie vows to represent seniors, not the government, in her new role.   (Photo courtesy Reuters)

Wednesday, March 26, 2014

Connecticut Bill Dead!

Assisted suicide bill won't be voted on

[For a legal and policy analysis against the bill, please click here]

THE ASSOCIATED PRESS, March 25, 2014 - 7:32 pm EDT


HARTFORD, Connecticut — A bill that would allow Connecticut physicians to prescribe medication to help terminally ill patients end their lives won't be voted on during this year's legislative session, the co-chairman of the General Assembly's Public Health Committee said Tuesday.

Windham Rep. Susan Johnson said Tuesday there is not enough time to address various outstanding issues with the bill. This year's short legislative session ends May 7.

"We worked very hard on that bill and there's a lot of work left to do," Johnson said.

This marks the second year in a row that the Public Health Committee has held a public hearing on such legislation and committee members did not take a vote.

Johnson said the Judiciary Committee is better suited to tackle certain outstanding issues with the bill, such as determining a patient's competency, whether they're under any duress, and how they can be protected from people with criminal intentions.

"Those kinds of things need to be ironed out," she said.

Proponents vowed to return with another bill next year, when there will be a longer legislative session.

"I'm very sorry that we're not able to move the bill further this year," said Rep. Betsy Ritter, D-Waterford. "We heard from people who wanted it badly."

Ritter said she was pleased, however, by the attention paid to the issue this year, adding how "the discussion just exploded across the state." Tim Appleton, the state director of the advocacy group Compassion and Choices, said he expects support will grow more between now and next year's legislative session.

Opponents have questioned the level of support for the bill, claiming outside groups are pushing the issue in Connecticut. They've vowed to fight future bills.

"The collateral damage from legalizing assisted suicide — including massive elder abuse, the deadly mix with a cost-cutting health care system steering people to suicide, misdiagnosis and incorrect prognosis, suicide contagion, and disability discrimination in suicide prevention — is simply not fixable," said Stephen Mendelsohn, of Second Thoughts Connecticut.

Wednesday, March 19, 2014

Assisted suicide is a "prescription for abuse"

http://www.theday.com/article/20140318/OP02/303189999

I am a former three-term state representative in New Hampshire. Just last week, our House of Representatives voted down an assisted-suicide law similar to Connecticut's Raised Bill No. 5326. The vote was an overwhelming 3 to 1 defeat, 219 to 66.

In New Hampshire, the House is controlled by the Democrats. The vote against assisted suicide was strongly bipartisan and included libertarians. Many representatives, who initially thought that they were for the law, became uncomfortable when they studied it further.

Contrary to promoting "choice" for older people, assisted suicide laws are a prescription for abuse. They empower heirs and others to pressure and abuse older people to cut short their lives. This is especially an issue when the older person has money. There is no assisted suicide bill that you can write to correct this huge problem.

Do not be deceived.

Nancy Elliott Merrimack, NH
Publication: The Day

Published 03/18/2014 12:00 AM
Updated 03/17/2014 04:33 PM

Sunday, March 16, 2014

Connecticut: Dore Letter and Memo to Committee

Dear Committee Members:

I am a Democrat and a lawyer in Washington State where assisted suicide is legal.  Our law is modeled on a similar law in Oregon.  Both laws are similar to H.B. No. 5326.

Below are highlights to a memo I wrote, providing a legal analysis of  H.B. No. 5326.  To view the memo, please click here.

1.  H.B. No. 5326 is a recipe for elder abuse

  • "Financial considerations [are] an all too common motivation for killing someone." (memo, page 7)
  • Your heir, who will financially benefit from your death, is allowed to act as a witness on the lethal dose request form.  See  H.B. No. 5326, Section 3 (allowing one of two witnesses to be an heir)
  • There is a complete lack of oversight once the lethal dose is issued by the pharmacy.  Not even a witness is required.  Even if you struggled, who would know?

2.  H.B. No. 5326 encourages people to throw away their lives.

  •  H.B. No. 5326 applies to patients with a "terminal illness," which is defined in terms of a doctor's prediction of less than six months to live. (memo, pages 4-5).
  •  In Oregon, a similar definition is being interpreted to include people with chronic conditions such as diabetes.  (Id.)
  • The six months to live is determined without treatment.  Consider, for example, my friend, Jeanette Hall, who had cancer and who was adamant that she would "do" Oregon's law.  Her doctor convinced her to be treated instead.  She is thrilled to be alive today, nearly 14 years later.  (memo, pages 5-6)

3.  H.B. No. 5326 will allow health care providers and insurers to steer people to suicide


4.  I have had two clients whose fathers signed up for the lethal dose. 

  • In the first case, one side of the family wanted the father to take the lethal dose, while the other did not.  He  spent the last months of his life caught in the middle and traumatized over    whether or not he should kill himself.  My client, his adult daughter, was also traumatized.  The father did not take the lethal dose and died a natural death.  (Memo, page 22)
  • In the other case, it's not clear that administration of the lethal dose was voluntary.  A man who was present told my client that the father refused to take the lethal dose when it was  delivered (?You?re not killing me.  I?m going to bed?), but then took it the next night when he was high on alcohol.  The man who told this to my client later recanted.  My client did not want to pursue the matter further. (Memo, pages 22-3)
  • Do you want this to happen to you or your family?

5.  Two weeks ago, a similar bill was defeated by a 3 to 1 margin

  •  On March 6, 2014, the New Hampshire House, which is controlled by the Democrats, defeated a bill similar to H.B. No. 5326.  
  • The vote was 219 to 66. 
  •  Please click here

I urge you to not make Washington's mistake.

Please vote No on H.B. 5326.

Thank you.

Margaret Dore
Law Offices of Margaret K. Dore, P.S.
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, 44th Floor
Seattle, WA  98154
206 389 1754 main reception line
206 389 1562 direct line

Thursday, March 6, 2014

Live Free or Die! New Hampshire Obliterates Oregon-Style Death with Dignity Act!

Today, the New Hampshire House of Representatives defeated HB 1325. The bill had sought to enact an Oregon-style assisted suicide law in New Hampshire. The bipartisan vote was an overwhelming 219 to 66.

To view a short testimony against the bill, click here.

Wednesday, March 5, 2014

New Hampshire: Pro-Assisted Suicide Bills Go Down in Flames!

Today, HB 1216, which sought to decriminalize soliciting a suicide, and HB 1292creating an affirmative defense for a person who causes or aids another in committing suicide, went down in flames!  The votes were 259 to 45 and 232 to 59, respectively.