Killing with kindness: Why the Death With Dignity Act endangers people with disabilities

http://thephoenix.com/boston/news/146648-killing-with-kindness-why-the-death-with-dignity-/#ixzz2AvS5wlXH

 

By S.J. Rosenbaum

I think my opinions about doctor-assisted suicide crystallized the night Mike — my wheelchair-using, ventilator-breathing boyfriend — choked on pineapple juice, passed out, and died.

He was dead for several minutes, on a steel table in the ER. The doctor shocked the pulse back into his heart and dropped him into an induced coma, but it still wasn't clear whether he would make it. As I stood by his bedside, shaking, one of the nurses touched me on the shoulder.

"Maybe it's better this way," she murmured.

I'll never forget that moment. We'd been watching a movie together a few hours before. We had plans to go clubbing. Maybe it's better this way?

I'm not a violent person, but I wanted to punch that lady in the face.

When I started going out with Mike, I thought that prejudice against people with disabilities was something we'd left behind along with Jim Crow and sodomy laws. I was shocked, again and again, to find that I was wrong. So wrong. Everyone I met had ideas about what it must be like to date Mike — that we never went out, that we couldn't have sex, that I must have to take care of him all the time — that were so false as to be laughable. We did laugh at that stuff. We had to. But for every person who came up to us to congratulate Mike on his "bravery" in taking a trip to the mall, there was someone who actually thought he'd be better off dead.

Some of those people were doctors.

Not the young doctor who fought like a demon to restart his heart in the ER. But there were others: well-meaning doctors who saw Mike, and people like him, as pitiable — as "bad outcomes." In fact, that's the norm: study after study has shown that doctors, as a group, consistently underestimate the quality of life of their disabled patients. Those prejudices — unquestioned and unacknowledged — can have disastrous results.

I don't know anyone born with a serious disability whose doctors didn't tell their parents that they would never be able to live independently. A doctor at Mass General, who treats children with muscular dystrophy, told me about colleagues who had counseled their patients against using the ventilators that would prolong their lives by decades. Those doctors weren't trying to do harm. They simply saw their patients' lives as not worth living.

As disability activist Carol Gill writes: "Many of us have been harmed significantly by medical professionals who knew little about our lives, who thought incurable functional impairments were the worst things that could happen to a person, and who were confident they knew best."

All this, then, is why I'll be voting against referendum Question 2, the Death with Dignity Act, on November 6.


The language of the bill sounds reasonable: it would allow doctors to prescribe lethal doses of medication, upon request, to patients with terminal diseases. But it wouldn't actually have much benefit for the dying, who already have the same access to self-administered suicide as anyone else. Instead, it could present doctors with an option to offer the patients they think they can't help: the bill's definition of "terminal disease" is so vague as to encompass disabilities like Mike's, and it has no requirement that a person seeking the fatal dose see a counselor or be screened for depression.

So why would a person with a disability ask for a suicide pill? My ex never would. Disabled from birth, Mike has been fighting for his rights since he was in grade school. He's a badass with 60 tattoos, and he's not ready to die any time soon.

But for the late-disabled, it's different. People diagnosed with a progressive disease — MS, ALS, and other such dire acronyms — still carry the same prejudices they've held all their able-bodied lives. Often, they don't know anyone living a full, enjoyable life with disabilities, don't know such lives are possible. So if a doctor offers them an exit, they're all too likely to take it.

It's happened. One of the earliest right-to-die cases, in 1989, was that of David Rivlin, a spinal-cord-injury survivor. Isolated in a nursing home, cut off from meaningful work, unable to live independently on the meager assistance the state offered at the time, he demanded to die. "I don't want to live an empty life lying helplessly in a nursing home for another 30 years," he told a reporter.

No one offered him an alternative. "The nondisabled people around him assumed that when a person with such a disability said he would rather be dead, he was acting rationally," disability activist Paul K. Longmore wrote a few years after Rivlin's death. Neither Rivlin, nor other people with disabilities seeking "death with dignity," realized that they could have been fighting for the support to live, rather than the right to die. Longmore observed, "The only real aid the system offered any of them . . . was assistance in ending their lives."

It's not 1989 anymore. The disabled in Massachusetts have more access, and more agency, than those in almost any other state, and activists fought hard to make it that way. Disabled Bostonians are filmmakers, tattoo artists, psychologists, writers. They ride the T. They own houses and businesses. And like Mike and me, they fall in love.

But not everyone knows that those things are an option. And with Romney — a man who sees adequate health care as a privilege, not a right — on the same ballot as Question 2, all that progress is scarily close to rolling back. Now is the worst time to perpetuate the myth that death is better than disability.

Vote no on Question 2.

Read more: 

http://thephoenix.com/boston/news/146648-killing-with-kindness-why-the-death-with-dignity-/#ixzz2AvRHl7Jn

Assisted Suicide Users are Older People with Money

By Margaret Dore, Esq., Updated October 29, 2012

Users of assisted suicide in Oregon and Washington are overwhelmingly white and generally well-educated.[1]  Many have private insurance.[2]  Most are age 65 and older.[3]  Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.[4] 

In the United States, elder financial abuse costs elders an estimated $2.9 billion per year.[5] Perpetrators include strangers, family members and friends.[6]. The goals of financial abuse perpetrators are achieved "through deceit, threats, and emotional manipulation of the elder."[7]

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.[8] There is also no oversight when the lethal dose is administered, not even a witness is required.[9] 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.[10]  Even if he struggled, who would know?

This is not to say that all persons who use the Oregon and Washington acts are subject to abuse or that their actions are not voluntary.  Rather, the Oregon and Washington acts do not protect such persons from abuse.  Neither will the Massachusetts proposal.

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

[1] See the most current official report from Washington State, "Washington State Department of Health 2011 Death with Dignity Act Report, Executive Summary ("Of the 94 participants in 2011 who died, . . . 94% were white, non-Hispanic . . .75 percent had at least some college education"), available at http://www.doh.wa.gov/portals/1/Documents/5300/DWDA2011.pdf  See also the most current official report from Oregon, also for 2011 ("most [users] were white (95.6%) [and] well-educated (48.5% had at least a baccalaureate degree) . . .", available at http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf
[2] See Washington's report in note 1, page 5, table 2 (46% had private insurance only, or a combination of private and Medicaid/Medicare).  See Oregon's report in note 1("patients who had private insurance (50.8%) was lower in 2011 than in previous years (68.0%). . ."
[3] See Washington's report in note 1, page 5, Table 2 (74% were aged 65 or older).  See Oregon's report in note 1, page 2 ("Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70 years").
[4]  Educated persons are generally financially better off than non-educated persons; persons with private insurance have funding to pay for it; seniors generally are well off.  See "Broken Trust:  Elders, Family, and Finances, a Study on Elder Financial Abuse Prevention, by the MetLife Mature Market Institute, the National Committee for the Prevention of Elder Abuse, and the Center for Gerontology at Virginia Polytechnic Institute, March 2009, Executive Summary, page 4 ("Elders’ vulnerabilities and larger net worth make them a prime target for financial abuse").
[5]  The Met Life Study of Elder Financial Abuse, " Crimes of Occasion, Desperation, and Predation Against America's Elders," June 2011, page 2, key findings ("The annual financial loss by victims of elder financial abuse is estimated to be at least $2.9 billion dollars, a 12% increase from the $2.6 billion estimated in 2008"). 
[6] Id.
[7] Id., page 3.
[8] See e.g. Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009; and Margaret K. Dore, Memo to Joint Judiciary Committee (regarding Bill H.3884, now Ballot Question No. 2), Section III
[9] Id.  See also entire proposed Massachusetts Act at http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf
[10]  The drugs used, Secobarbital and Pentobarbital, are water and alcohol soluable, such that they can be injected without consent, for example, to a sleeping individual.  See "Secobarbital Sodium Capsules, Drugs.Com, at  http://www.drugs.com/pro/seconal-sodium.html  If the person wakes up and trys to fight, who would know? 

UK govt agrees to investigate "death pathway"

Article below regarding abuse of the Liverpool Pathway, from Michael Cook of Bio Edge.

A problem also in the US and Canada.  See, for example, Kate Kelly's article about her mother and "VSED" by clicking here

With some doctors abusing the power they already have with the Liverpool Pathway, etc., why would you give them more power to effect patient death, i.e., by legalizing assisted suicide and/or euthanasia?

The problem will only get worse.

* * *

http://www.bioedge.org/index.php/bioethics/bioethics_article/10293
by Michael Cook | Oct 27, 2012 |

Pressure from the British media has forced an investigation into the controversial Liverpool Care Pathway by National Health Service and the Association of Palliative Medicine.

The medical establishment appears very reluctant to question the LCP. Only a few days ago 22 organisations signed a consensus statement supporting it. It quoted the Parliamentary Under Secretary of State for Health, Earl Howe:

"The Liverpool Care Pathway has sometimes been accused of being a way of withholding treatment, including hydration and nutrition. That is not the case. It is used to prevent dying patients from having the distress of receiving treatment or tests that are not beneficial and that may in fact cause harm rather than good."

But the campaign by the Daily Mail and the Telegraph has been relentless. "When well over 100,000 are dying on the LCP each year, the suspicion inevitably arises that the pathway is being used to hasten death and free up beds," said the Daily Mail in an editorial.

Neurologist Patrick Pullicino contends that the LCP has made euthanasia a "standard way of dying on the NHS". He and his supporters were scathing about the consensus statement: 

"It is self-evident that stopping fluids whilst giving narcotics and sedatives hastens death... The median time to death on the Liverpool Care Pathway is now 29 hours. Statistics show that even patients with terminal cancer and a poor prognosis may survive months or more if not put on the LCP."

The investigation coordinated by the NHS will examine poor experiences under the LCP, which everyone acknowledges do happen. The NHS will talk to family members of people who have died on the pathway, investigate complaints and speak with clinicians. "Poor experiences must be explored, acknowledged and learnt from," says Professor Mayur Lakhani, Chair of the Dying Matters Coalition.

Will the investigation result in a thorough revision of the LCP? Even though the medical establishment admits that there are problems, it may not admit that they are due to the basic framework. The Consultant Nurses in Palliative Care Reference Group is already interpreting criticisms as dangerous and offensive. "Counter-productive comments", it says, are "deeply offensive to public servants who abide by clear codes of conduct and the law".

Las Vegas Man Sentenced After Assisted Suicide

http://www.themonitor.com/news/local/article_05c7fdd6-1fc4-11e2-9b32-001a4bcf6878.html

Posted: Friday, October 26, 2012 6:22 pm | Updated: 6:30 pm, Fri Oct 26, 2012.
Jared Taylor, Twitter: @jaredataylor The Monitor

McALLEN -  A federal judge sent to prison a Las Vegas man convicted of smuggling powerful animal tranquilizers from Mexico used in an assisted suicide in Nuevo Progreso.

Chief U.S. District Judge Ricardo Hinojosa sentenced Jeff George Ostfeld to six years in federal prison Wednesday, after he pleaded guilty to importation of a controlled substance.

But after the assisted suicide in Mexico, Hinojosa opted to follow sentencing guidelines for Ostfeld under a charge of voluntary manslaughter - not the drug charge.

U.S. Immigration and Customs Enforcement arrested Ostfeld in May 2009 as he attempted to smuggle animal tranquilizers across the Progreso International Bridge.

The arrest came moments after Mexican police discovered the body of 32-year-old Jennifer Malone at a Nuevo Progreso motel.

Ostfeld shot video of Malone as she died, investigators said. He retrieved some of her personal effects and abandoned her body in the motel room.

Mexican investigators found an empty bottle of Barbithal and a book about depression beside the body of Malone, of Roseburg, Ore.,  according to Monitor archives. The same drug was found by U.S. Customs and Border Protection officers as Ostfeld tried to return to the United States.

Ostfeld told ICE agents he had flown from Las Vegas to McAllen to buy animal tranquilizers in Nuevo Progreso for resale in the United States. The drug can sell for as little as $20 per bottle in Mexico, but can net as much as $5,000 north of the Rio Grande.

Canada: Crown files opening brief in Carter

Assisted suicide too risky, allowing it demeans value of life, federal gov't says

http://www.vancouversun.com/news/Assisted+suicide+risky+allowing+demeans+value+life+federal+says/7447066/story.html

The Canadian Press October 25, 2012 12:30 PM

 

VANCOUVER - The federal government says allowing doctor-assisted suicide demeans the value of life and puts vulnerable people at risk in moments of weakness.

Ottawa has filed its arguments in an appeal of a B.C. decision that struck down the prohibition on doctor-assisted suicide, arguing the trial judge was wrong to conclude the law is unconstitutional.

In documents filed with the B.C. Court of Appeal, the government says the law reflects a reasonable belief that allowing assisted suicide would put vulnerable people at risk of being coerced or even forced to end their lives.

The government says the law reflects Parliament's desire to discourage and prevent suicide in all cases, and it should be up to lawmakers, not the courts, to decide if that needs to change.

Ottawa argues the Supreme Court of Canada's 1993 decision upholding the law in a case involving Sue Rodriguez was final.

The B.C. case was launched by several plaintiffs, including Gloria Taylor, who won a constitutional exemption from the law but died earlier this month without resorting to assisted suicide.
Read more: http://www.vancouversun.com/news/Assisted+suicide+risky+allowing+demeans+value+life+federal+says/7447066/story.html#ixzz2AM32CGOR

Legalization And Violent Deaths

By Margaret Dore

Assisted suicide proponents claim that legal assisted suicide will prevent violent deaths such as those by murder-suicide and suicide involving a handgun.[1] In Oregon where assisted-suicide has been legal since 1997, murder-suicide has not been eliminated.[2]  Indeed, murder-suicides follow "the national pattern."[3]  As discussed below, suicides involving a handgun have also not been eliminated.  Oregon's suicide rate has instead increased with legalization of assisted suicide.

Oregon’s overall suicide rate, which excludes suicides under Oregon’s assisted suicide act, is 35% above the national average.[4] This rate has been "increasing significantly since 2000."[5]  Just three years prior, in 1997, Oregon legalized physician-assisted suicide.[6] Other suicides 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, "[f]irearms were the dominant mechanism of suicide among men."[7] The claim that legalization will prevent violent deaths is without factual support.

* * *

[1]  See e.g. Lindsey Anderson, Associated Press, "Mass. Voters Consider Physician-Assisted Suicide," October 20, 2012, at http://www.wbur.org/2012/10/20/physician-assisted-suicide ("Dr. Marcia Angell ... believes [her father] would've lived longer and not turned to a pistol had assisted suicide been available").
[2]  See Don Colburn, "Recent murder-suicides follow the national pattern," The Oregonian, November 17, 2009 ("In the span of one week this month in the Portland area, three murder-suicides resulted in the deaths of six adults and two children") (Available at http://www.oregonlive.com/health/index.ssf/2009/11/recent_murder-suicides_follow.html); Baldr Odinson, "Fourth Murder-Suicide for the Eugene Area," New Trajectory:  A blog for Ceasefire Oregon, March 2, 2011, ("Harry Hanus, age 74, shot and killed his wife, Barbara, before taking his own life")

Canada: Russian bride leaves elderly man with $25 K welfare bill

Another example of an older person who was easily persuaded to act in someone else's best interests, not his own. The Canadian government, instead of helping him, is billing him.

http://ca.news.yahoo.com/russian-bride-leaves-elderly-man-25k-welfare-bill-094830580.html

An 82-year-old B.C. pensioner is on the hook to the government for $25,000, after marrying a Russian woman who left him the day after she got permanent resident status in Canada.

“Several times I thought I will have a nervous breakdown over this,” said Heinz Munz, of Black Creek.

Munz said he believes his now ex-wife used him, with the help of her daughter, to get legal status in Canada. He is going public because the B.C. government is now forcing him to pay for social assistance she collected after she left.

Massachusetts: Bob Joyce on Elder Abuse, etc. - Vote No on Question 2

Dear Editor:

It's not clear why The Bulletin titled Joe Galeota's recent column as it did ["Terrible," October 11, 2012].

If it's because the column offered no information about the content of the physician-prescribed suicide referendum, I agree. That is terrible. . . .

Let's get serious, and consider just a few of the many reasons why voters should defeat this flawed bill.

The referendum shockingly increases the risk of abuse to elders, many of whom do not have loving families and/or have lost their circle of friends and/or have no one to advocate for them. We should consider that Massachusetts had 19,500 reported cases of elder abuse in 2011. There are insufficient elder abuse investigators to keep up with the 54 new cases reported each day. One study has suggested that there are 23.5 unreported cases for every one reported case.

The referendum does not even provide the level of protection required when a person signs a will in Massachusetts (i.e., two disinterested witnesses), and there is absolutely no oversight at the time the lethal drugs would be administered. 

The Massachusetts Medical Society, representing more than 24,000 physicians and medical students, opposes the bill. So does the American Medical Society.

Insurance companies, hospitals and governmental medical providers have a clear and compelling financial interest in denying us of adequate end-of-life care.

How much do you trust insurers, hospitals and governments? Unless you answer "with my life," you should oppose physician-prescribed suicide and vote NO on Question Two.

It would indeed be "terrible"  if we allow this referendum to pass!

Robert W. Joyce

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.