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

By Margaret Dore, Esq.

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

1.  "Terminal" Does Not Mean "Dying" 

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

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

2.  The Significance of a Terminal Label

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

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

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

Dr. Stevens concludes:

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

3.  Barbara Wagner and Randy Stroup

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

4.  Proposals for Expansion

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

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

Is this what you want?

To be just like us?

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

* * *

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

Defeating Assisted Suicide Before it Gets Started

I'm giving a lecture this weekend titled: "Arguing Smart: Defeating Assisted Suicide & Euthanasia Before it Gets Started."

The course description is below.  A hard copy of the course materials can be viewed by clicking here.

Margaret Dore

Course Description:

In 2010, assisted suicide advocates targeted Idaho for legalization of assisted suicide, which they termed "aid in dying." Their legal director owned a home there and was in the state actively meeting people, talking to newspapers and otherwise drumming up support. The legal director had also got an article published in The Advocate, the official publication of the Idaho State Bar Association. And then she was defeated by nine well-placed letters.

Ripping off Grandma: Why seniors should practice tough love

http://www.theglobeandmail.com/globe-investor/personal-finance/household-finances/ripping-off-grandma-why-seniors-should-practice-tough-love/article4614312/

ROB CARRICK, The Globe and Mail

Published Monday, Oct. 15 2012, 8:07 PM EDT
Last updated Tuesday, Oct. 16 2012, 9:18 AM EDT

The Bank of Grandma and Grandpa needs to toughen up.

It’s one thing for seniors to plan inheritances for family members and provide cash gifts when affordable.

Where they must set limits is in co-signing or guaranteeing loans for relatives.

Seniors guaranteeing loans is bad business and it also comes dangerously close to elder financial abuse, an unseen but serious problem that can leave seniors destitute.

Elder financial abuse means the illegal or unauthorized use of seniors’ assets – money or property. Laura Tamblyn Watts, a lawyer and senior fellow at the Canadian Centre for Elder Law, said research shows one in 12 seniors will experience financial abuse. Given how under-reported the problem is, she suspects the actual figure is one in eight.

What about the seriously ill or disabled people who want to live?

http://doughtyblog.dailymail.co.uk/2012/10/what-about-the-seriously-ill-or-disabled-people-who-want-to-live.html

The "Liverpool Pathway":  "It comes down to this: there are a lot of people who believe that, rather than trying to help their loved ones, hospitals have been keen to kill them off."

What about the seriously ill or disabled people who want to live?

By Stephen Doughty, 12 October 2012 6:56 PM

We have heard an awful lot about the suffering of people who bear terrible afflictions or disabilities and who wish to die. We have heard very little about the desperately sick who want to live, and the families who stand by them in hope.

It is looking like we have got this the wrong way round.

The highly organised campaign for assisted dying has brought together pressure groups, think tanks, celebrities like Sir Terry Pratchett, and some fairly prominent politicians, notably in recent years Tony Blair’s Lord Chancellor and one-time flatmate, Lord Falconer.

It has been based around a brilliantly conceived series of legal cases in which the judiciary have been presented with deeply affecting hard cases. Each one has asked for a modest legal concession, usually involving human rights and the 1961 law that makes helping with a suicide a serious crime.

The individuals who have brought these cases are sometimes merely sympathetic and at others pitiable, as in the recent instance of Tony Nicklinson, the 58-year-old victim of 'locked-in syndrome' who lost his call for help from his doctor to die in the High Court in August. Mr Nicklinson died a few days after his legal defeat.

Occasionally the legal campaigns have scored successes. The most notable was that of multiple sclerosis sufferer Debbie Purdy, who persuaded the Law Lords that the Director of Public Prosecutions should provide guidance on whether her husband might face prosecution for assisted suicide, were he to help her travel to the Dignitas clinic in Zurich to die.

As a result of the Purdy case, DPP Keir Starmer QC introduced rules on assisted dying prosecutions that mean no-one is likely to be prosecuted, with the risk of a 14-year-jail term, if they help in the death of someone who is a suffering relative or friend, and if they act out of compassion rather than malice or greed.

However you paint it, this is a major change in the law as set down by Parliament, a law which takes no account of the motives of the individual aiding and abetting the suicide.

Indeed, Mr Starmer has brought no prosecutions against anybody from the trail of stricken families who have helped members travel to Switzerland to die.

What is interesting is that, despite all the campaigning, all the high-profile court cases, all the BBC interviews, all the endless hand-wringing about the cruelty of keeping those who are suffering alive against their will, few people seem to want to take advantage of the new right to die.

We do not have very recent figures, but I would guess that no more than 200 British people have died at Dignitas since the clinic became well-known here in 2003.

It is a number small enough to raise the question of how big, really, is the demand for assisted dying?

The campaign for assisted dying has certainly been effective in influencing care of the incapacitated in the Health Service.

It was surely a factor in the successful passage of the Mental Capacity Act, pushed through by Lord Falconer in the teeth of a rebellion by backbench Labour MPs, which gave legal status to living wills. These mean people can leave orders for their doctors to kill them by withdrawing nourishment and fluid by tube if they become too sick to speak for themselves.

The assisted dying campaign formed the background to the introduction of the Liverpool Care Pathway into hospitals across the country. This, for those who have not noticed, is the system by which medical staff withdraw treatment from those judged to be close to death, in the cause of easing their passing. It often involves heavy sedation and the removal of nourishment and fluid tubes.

I do not wish to try to step into the shoes of those medical professionals and care workers who deal every day with people at the extreme end of life and in the depths of the worst illnesses. I have no qualifications or knowledge to second guess their decisions, and no intention of criticising those who work with great professionalism and compassion in jobs that are far beyond my capability.

But all the indications suggest there are many families who are unhappy with the way in which their relatives have died in hospitals, and that they are increasingly willing to complain about it.

Many of these people may be speaking out of misdirected grief. As one well-informed MP put it to me this week, very few expect a loved one who goes into hospital to die, but people do have the habit of dying. Some of those complaining may be troublemakers, some inspired by political or religious agendas.

Nevertheless there seem to be a lot of them. And they are not celebrities or legal grandees or Westminster faces. They are little people, people like you and me, not the kind you usually hear on the radio or see on the TV.

The courageous Professor Patrick Pullicino, the hospital consultant who defied the NHS consensus to speak out against the Liverpool Care Pathway this summer, reckoned it is used in around 130,000 deaths each year. That is a number that dwarfs the assisted dying lobby.

I think we are going to hear a lot more about the Liverpool Care Pathway, and I think the medical professions, the Department of Health, and a number of politicians are going to have to put some time into considering what has been happening.

It comes down to this: there are a lot of people who believe that, rather than trying to help their loved ones, hospitals have been keen to kill them off.

They believe that, while the assisted dying lobby has been parading in the courts and publicising itself on the BBC, assisted dying has quietly become a reality in our hospitals.

Massachusetts: Vote no on Question 2

"Ignoring any moral issues, the initiative is vulnerable to abuse and should not be passed into law."

By Anthony Speranza

http://www.salemnews.com/opinion/x1684126269/Column-Vote-no-on-Question-2

This year in Massachusetts, voters will decide on Question 2: an initiative petition to legalize physician-assisted suicide in the commonwealth. Ignoring any moral issues, the initiative is vulnerable to abuse and should not be passed into law.

Dignity 2012, a group in support of the issue referred to as "Death with Dignity," claims the proposed law "contains strict safeguards to ensure that the patient is making a voluntary and informed decision." The safeguards written into the law, however, are insufficient. First, nearly all responsibility rests in the hands of a patient's physician. Section 6 of the initiative states that no patient shall be prescribed the life-ending medication if either of two physicians deem that the patient suffers from a "psychiatric or psychological disorder or depression." While the theory behind this precaution is practical, it falls short of effective. Only 15 days separate the date of request from the date of prescription of the lethal dose. There is no clear definition of what tests must be run in this time to check a patient's mental capacity. According to Jennifer Popik, a medical ethics attorney, "There is no requirement that the patient be given a psychiatric evaluation... This means that a physician ... can prescribe suicide to that patient without even a specialist's evaluation." The "safeguard" concerning mental health is rendered useless because a psychiatric evaluation is not compulsory. A similar law in Oregon serves as a warning: According to a report by the Oregon Public Health Department, of the 71 patients who chose physician-assisted suicide last year, only one was referred for psychiatric evaluation.

Kate Kelly on the "Liverpool Pathway"

If you think the "Liverpool Pathway" is painless, gentle, and/or dignified, think again. My mother had a mild stroke in a Canadian care facility. The relative with power of attorney, along with a doctor who had never seen my mother before, decided she would have morphine only, although she was conscious, trying to speak, and indicating she wanted water. She moaned for days, had blisters inside her mouth, had to be given suppositories to prevent convulsions, and clamped her lips on a dampened cloth, which provided only the illusion of moisture. After 6 days without food or water, she finally died.

 
We already have abuse of authority by some doctors. Assisted suicide will give them even more power. The push for suicide as a "cure" indicates a society gone mad.


To read my mother's story, see http://www.choiceillusion.org/p/vsed.html

Study: Assisted suicide helpers distressed

http://worldradio.ch/wrs/news/wrsnews/study-assisted-suicide-helpers-distressed.shtml?32735

Thursday, October 4, 2012

One in four people who accompany someone to commit assisted suicide suffer massive psychological distress, according to a new study by the University of Zurich.

Researchers at the university spoke to 85 people who went with a family member or close friend to an EXIT euthanasia clinic.

A quarter suffered from post traumatic stress disorder while 16 percent had depression. Five percent were found to have long-term grief.

The interviews were carried out one to two years after the assisted death of loved ones.

The results state that problems can surface 14 to 24 months later and that a death not from natural causes was a heavy burden for those who supported the deceased.

Although the research didn’t include a direct comparison with the effects of a natural death on a loved one, the study was compared to others.

This showed the researchers that post traumatic stress disorder was more common for people close to an assisted suicide case rather than a natural death.

The results have been published in the journal European Psychiatry, which can be viewed here:  
http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf  

Massachusetts: Ballot Question 2, Whose Choice?

"[This] would be on an involuntary basis for those persons who want to live."

By Margaret Dore

I am an attorney in Washington State, where assisted suicide is legal.  Our law was passed by a ballot initiative in November 2008 and went into effect in March 2009.  Our law is similar to Ballot Question 2. 

In Washington State, my former clients own two adult family homes (small elder care facilities).  Four days after the election, the adult child of one of their residents asked about getting pills for the purpose of causing his father's death.  It wasn't the older gentleman asking for his "right to die."[1]

At that time, our law had not yet gone into effect; the man died before it did.  But if our law had been in effect, whose choice would it have been?  The choice of his son, or the choice of the older gentleman?

In Washington state, we have already had suggestions to expand our law to direct euthanasia for non-terminal people.[2].  More disturbing, there was this discussion in the Seattle Times suggesting euthanasia for people unable to afford care, which would be on an involuntary basis for those persons who want to live.  Columnist Jerry Large stated:

"After Monday's column, some readers were unsympathetic [to people unable to afford care], a few suggested that if you couldn't save enough money to see you through your old age, you shouldn't expect society to bail you out.  At least a couple mentioned euthanasia as a solution."[3]

I never saw anything like this prior to our law's being passed in 2008.  Be careful what you vote for.

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.  

Montana State Senator Corrects New England Journal of Medicine

Assisted Suicide is Not Legal in Montana
Dear Editor:

I am a Montana State Senator.  I disagree with your article, "Redefining Physicians' Role in Assisted Dying," claiming that assisted suicide is legal in Montana.  At the very least, Montana law is unclear.

Last year, Senate Bill 167, which would have legalized assisted suicide in Montana, failed.  This leaves assisted suicide governed by a Montana Supreme Court case, Baxter v. Montana.  An analysis by attorneys Greg Jackson and Matt Bowman describes Baxter as follows:

"The Montana Supreme Court s assisted-suicide decision . . . didn't even 'legalize' assisted-suicide. . . . After Baxter, assisted-suicide continues to carry both criminal and civil liability risks for any doctor, institution, or lay person involved."[1]

Since then, competing articles have appeared in the official Montana State Bar publication disputing whether Baxter legalized assisted suicide.[2]  The editor's headline states: "Court ruling still leaves the issue open to argument." [3]

Correct reporting would be that assisted suicide is not legal in Montana and/or hotly disputed.  Thank you for your attention to this matter.

Senator Greg Hinkle
Thompson Falls, MT 

* * *

[1] Greg Jackson, Esq., and Matt Bowman, Esq., "Analysis of Implications of the Baxter Case on Potential Criminal Liability," Montanans Against Assisted Suicide & For Living with Dignity, April 2010, available at http://montanansagainstassistedsuicide.org/wp-content/uploads/2011/05/Analysis-of-Baxter.pdf                                                
[2] Senator Anders Blewett (pro article), Senator Jim Shockley and Margaret Dore (con article), "The aid-in-dying debate: Can a physician legally help a patient die in Montana?  Court ruling still leaves the issue open to argument," The Montana Lawyer, November 2011, available at http://maasdocuments.files.wordpress.com/2012/07/montana-lawyer-pro-con-articles-nov-2011.pdf[3]  Id.

New England Journal of Medicine Article Misleading

Dear Editor:

I am a lawyer in Washington State, one of two states where assisted-suicide is legal.  The other state is Oregon, which has a similar law.  Lisa Lehmann's article, "Redefining Physicians' Role in Assisted Dying," is misleading regarding how these laws work.

First, the Oregon and Washington laws are not limited to people in their "final months" of life.[1,2]  Consider for example, Jeanette Hall, who in 2000 was persuaded by her doctor to be treated rather than use Oregon's law.  She is alive today, twelve years later.[3]

Second, these laws are not "safe" for patients.[4][5]  For example, neither law requires a witness at the death.  Without disinterested witnesses, the opportunity is created for the patient's heir, or someone else who will benefit from the patient's death, to administer the lethal dose to the patient without his consent.  Even if he struggled, who would know?  

Third, the fact that persons using Oregon's law are "more financially secure" than the general population is consistent with elder financial abuse, not patient safety.  Do not be deceived. 

* * *

[1]  Margaret K. Dore, "Aid in Dying: Not Legal in Idaho; Not About Choice," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 18-20, September 2010, available at http://www.margaretdore.com/pdf/Not_Legal_in_Idaho.pdf.
[2]  Kenneth Stevens, MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 16-17, September 2010, available athttp://www.margaretdore.com/info/September_Letters.pdf 
[3]  Ms. Hall corresponded with me on July 13, 2012.
[4]  See article at note 1.  See also Margaret Dore, "Death with Dignity": A Recipe for Elder Abuse and Homicide (Albeit Not by Name)," at 11 Marquette Elder's Advisor 387 (Spring 2010), original and updated version available at http://www.choiceillusion.org/p/the-oregon-washington-assisted-suicide.html 
[5]  Blum, B. and Eth, S.  "Forensic Issues: Geriatric Psychiatry." InKaplan and Sadock's Comprehensive Textbook of Psychiatry, Seventh Edition, B. Sadock and V. Sadock editors.  Baltimore, MD: Lippincott, Williams and Wilkins, pp. 3150-3158, 2000. 

Support of assisted suicide questioned

http://www.burlingtonfreepress.com/article/20120821/OPINION03/308210010/Letter-Support-assisted-suicide-questioned   Burlington Free Press , 4:03 PM, Aug 20, 2012   |

I would like to commend T.J. Donovan for recognizing the need to enforce the law against those committing physical and financial abuse against the elderly and other vulnerable people. However, according to the Burlington Free Press coverage of the attorney general candidates (Aug. 8), T.J. also supports passage of doctor-prescribed suicide legislation.

My question is this: If an elderly woman can be bullied into turning over her social security check, why doesn't Donovan understand that it is possible to pressure her into making a request for a lethal dose and bullying her into taking it?

BRENDA PEPIN

Montpelier

"Any change to the law must be a matter for Parliament to decide"

Below is a media release from the Judiciary of England   and Wales regarding today's decision to reject a legal challenge to a legal prohibition on euthanasia.  "[A]ny change to the law must be a matter for Parliament to decide."  To read the original print version, click here.

Tony Nicklinson v Ministry of Justice

AM v Director of Public Prosecutions and others

High Court (Administrative Court)

16 August 2012

SUMMARY TO ASSIST THE MEDIA

The High Court (Lord Justice Toulson, Mr Justice Royce and Mrs Justice Macur) has today rejected challenges to the legal ban on voluntary euthanasia, and to the policy of the Director of Public Prosecutions in cases of assisted dying, brought by two men suffering from “locked in syndrome”.

The Court recognised that the cases raise profoundly difficult ethical, social and legal issues, but it judged that any change to the law must be a matter for Parliament to decide.

Users of Assisted Suicide are Seniors with Money

By Margaret Dore, Esq.

Users of assisteds suicide are "overwhelmingly white, well educated and financially comfortable."[1]  They are also age 65 and older.[2]  In other words, users are older people with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.[3]  

In the United States, elder financial abuse costs elders an estimated $2.9 billion per year.[4]  Perpetrators include strangers, family members and friends.[5].  The goals of financial abuse perpetrators are achieved "through deceit, threats, and emotional manipulation of the elder."[6]

The Oregon and Washington assisted suicide acts, and the similar Massachusetts proposal, do not protect users from this abuse. Indeed, the terms of these acts encourage abuse.  These acts allow heirs and other persons who will benefit from an elder's death to actively participate in his or her lethal dose request.[7]  There is also no oversight when the lethal dose is administered, not even a witness is required.[8]  This creates the opportunity for an heir, or someone else who will benefit from the person's death, to administer the lethal dose to that person without his consent.  Even if he struggled, who would know?

For more information about problems with the Massachusetts' proposal, click here and here.  For a "fact check" on the proposal, click here.

* * * [1]  Katie Hafner, "In Ill Doctor, a Surprise Reflection of Who Picks Assisted Suicide," New York Times, August 11, 2012.
[2]  See e.g., the most current official report from Oregon, "Oregon Death with Dignity Act--2011" ("Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70 years"), available at http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf
[3]  The MetLife Study of Elder Financial Abuse, "Crimes of Occasion, Desperation, and Predation Against America's Elders," June 2011 (a follow up to MetLife's 2009 "Broken Trust: Elders, Family, and Finances"), available at http://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf
[4]  Id., page 2, key findings  
[5]  Id.
[6]  Id., page 3.
[7]  See Memo to Joint Judiciary Committee (regarding Bill H.3884, now ballot measure No. 2), Section III.A.2. ("Someone else is allowed to speak for the patient"), available at http://www.massagainstassistedsuicide.org/p/memo-to-joint-judiciary-committee.html
[8]  See above memo at Section III.A.1("No witnesses at the death").  See also entire proposed Massachusetts Act at http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf

Virginia: Assisted Suicide Conviction

http://www.pressdemocrat.com/article/20120808/ARTICLES/120809558 

Ex-Navy sailor from Willits convicted in assisted suicide

By GLENDA ANDERSON, THE PRESS DEMOCRAT, Published: Wednesday, August 8, 2012 at 7:31 p.m; Last Modified: Thursday, August 9, 2012 at 7:36 a.m.

A former Navy enlisted sailor who graduated from Willits High School has been sentenced to five years in prison for helping a senior non-commissioned officer commit suicide in Virginia, according to the Virginian-Pilot newspaper.

Paul Stephen Bricker, 27, had pleaded guilty April 4 to voluntary manslaughter in the July 2009 death of Gerard Curran in Virginia Beach. Bricker, a petty officer second class at the time, testified that Curran said he was ill and asked him to help him commit suicide and make it appear to be a homicide so his family would receive Navy death benefits, the newspaper reported.

Curran, 45, who was having marital and alcohol-related problems, previously had attempted to stab himself in the chest, the Virginian-Pilot reported.
On the day of his death, he choked himself with a yellow physical therapy band. When he passed out, Bricker stabbed him in the chest.

Bricker was sentenced Monday to 10 years in prison, but the judge suspended five, according to the Virginian-Pilot.

Montana Board Denies Hearing; New Legal Challenge Anticipated

On May 7, 2012, the Montana Board of Medical Examiners voted to postpone consideration of whether Position Statement No. 20 should be vacated.[1]  Position Statement No. 20 concerns "aid in dying," a euphemism for assisted suicide and euthanasia.[2]  The reasons given for the delay included "to allow additional time for public input."[3]


On July 6, 2012, Montanans Against Assisted Suicide filed additional "public input" including a letter and a legal memorandum titled:  "Summary of Legal Arguments Requiring Position Statement No. 20 to be Vacated as a Matter of Law."[4]  The letter requested twenty minutes oral argument.[5]


On July 20, 2012, the Board held the postponed hearing.  The Board acknowledged that it had received the above documents and also acknowledged the presence of Cory Swanson, attorney for Montanans Against Assisted Suicide.  The Board did not allow Mr. Swanson to speak.

Melchert-Dinkel Decision

The syllabus from the decision affirming Melchert-Dinkel's conviction is set forth below.  To view the entire decision, click here.  


"1. Minnesota Statutes section 609.215, subdivision 1, which criminalizes advising, encouraging, or assisting another to commit suicide, is not unconstitutionally overbroad under the First Amendment.


2. The First Amendment does not bar the state from prosecuting a person for advising, encouraging, or assisting another to commit suicide by sending coercive messages to suicide-contemplating Internet users instructing them how to kill themselves and coaxing them to do so." 

Melchert-Dinkel Assisted-Suicide Conviction Upheld!

http://minnesota.publicradio.org/display/web/2012/07/17/news/melchert-dinkel-aiding-suicide-conviction/

Appeals Court upholds nurse's aiding suicide conviction


by Amy Forliti, Associated Press

July 17, 2012

[To view other information/trial court documents, click here]

MINNEAPOLIS (AP) — The Minnesota Court of Appeals on Tuesday affirmed the convictions of a former nurse who scanned online chat rooms for suicidal people then, feigning compassion, gave a British man and a young woman in Canada instructions on how to kill themselves.


William Melchert-Dinkel, 49, of Faribault, acknowledged that what he did was morally wrong but argued he had merely exercised his right to free speech and that the Minnesota law used to convict him in 2011 of aiding suicide was unconstitutional.


The appeals court disagreed, saying the First Amendment does not bar the state from prosecuting someone for "instructing (suicidal people on) how to kill themselves and coaxing them to do so."


Melchert-Dinkel's attorney, Terry Watkins, was not immediately available for comment.


Court documents show Melchert-Dinkel searched online for depressed people then, posing as a female nurse, offered step-by-step instructions on how they could kill themselves.


Melchert-Dinkel was convicted last year of two counts of aiding suicide in the deaths of 32-year-old Mark Drybrough, of Coventry, England, who hanged himself in 2005; and 18-year-old Nadia Kajouji, of Brampton, Ontario, who jumped into a frozen river in 2008.


He was sentenced to more than six years in prison but the terms of his parole meant he would only be imprisoned for about a year. His sentence was postponed pending his appeal, but at the time of sentencing, he was told that if his convictions were upheld, he'd have seven days to report to jail.


In arguing to overturn the conviction, Watkins said his client didn't talk anyone into suicide but instead offered emotional support to two people who had already decided to take their lives.


Assistant Rice County Attorney Benjamin Bejar had argued that Melchert-Dinkel wasn't advocating suicide in general, but had a targeted plan to lure people to kill themselves. Prosecutors have said he convinced his victims to do something they might not have done without him.


Bejar said Tuesday that prosecutors were pleased with the decision.


In a statement read at his sentencing last year, Melchert-Dinkel said he was sorry for his role in the suicides and that he realized he had rejected a unique opportunity to talk his victims out of killing themselves.


Melchert-Dinkel's nursing license was revoked in 2009

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]