Friday, July 4, 2014

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

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

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

Margaret Dore, Esq., MBA *
Seattle

Wednesday, June 18, 2014

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

By Margaret Dore, Esq., MBA

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

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

There are three main points:

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

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

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

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

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

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

Thursday, June 12, 2014

Assisted suicide is a mistake

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

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

I was first exposed to this issue in 1982, shortly before my first wife died of cancer. We had just visited her doctor. As we were leaving, he had suggested that she overdose herself on medication.

I still remember the look of horror on her face. She said, “Ken, he wants me to kill myself.”

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

In Oregon, the combination of assisted-suicide legalization and prioritized medical care based on prognosis has created a danger for my patients on the Oregon Health Plan (Medicaid).

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

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

Don’t make Oregon’s mistake.

KENNETH STEVENS, M.D.
Sherwood, Ore.

Wednesday, April 30, 2014

Arizona Strengthens its Law Against Assisted Suicide

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

Brewer Signs Bill Targeting Assisted Suicide

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

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

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

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

Brewer signed the bill on Wednesday.

Wednesday, April 23, 2014

Attend the New Hampshire Victory Celebration Dinner!

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

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

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

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

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

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

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

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

Wednesday, April 16, 2014

I want assistance living, not dying

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

Assisted suicide

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

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

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

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

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

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

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

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

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

Steven Passmore, Hamilton                             

Saturday, April 12, 2014

This woman needed help NOT Dignitas

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


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


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

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

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

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

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

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

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

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

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

Thursday, April 10, 2014

Late actor Mickey Rooney was a strong voice against elder abuse

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

Wednesday, March 26, 2014

Connecticut Bill Dead!

Assisted suicide bill won't be voted on

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

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


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

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

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

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

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

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

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

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

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

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

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

Wednesday, March 19, 2014

Assisted suicide is a "prescription for abuse"

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

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

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

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

Do not be deceived.

Nancy Elliott Merrimack, NH
Publication: The Day

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

Sunday, March 16, 2014

Connecticut: Dore Letter and Memo to Committee

Dear Committee Members:

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

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

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

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

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

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

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


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

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

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

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

I urge you to not make Washington's mistake.

Please vote No on H.B. 5326.

Thank you.

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

Thursday, March 6, 2014

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

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

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

Wednesday, March 5, 2014

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

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

"Older people are no longer valued as they were before."

http://www.nhregister.com/opinion/20140304/letters-to-the-editor-time-to-rethink-who-our-leaders-are (second letter)

Dear Editor:  

I am a high school student in Washington state, where assisted suicide is legal. I want to become a doctor. My mother is a caregiver. Sometimes, I help her with her clients.
I am writing to tell you about how older people are at risk in Washington, from doctors and hospitals. I will also talk about how attitudes about older people have changed for the worse. This is especially true since our assisted-suicide law was passed in 2008.
I grew up in an adult family home. An adult family home is a small elder care facility located in a residential home. The caregivers live in the home with the clients.
My parents and two of my brothers lived in the home. With the clients there, it was like having six grandparents at once. It was a very happy environment.
This was true for the clients, too, no matter what their condition was or how long they had to live. My mom could make them happy even when they were dying. The clients’ family members were supportive and seemed happy, too, and never suggested that one of the clients should die.
Today, in 2014, we no longer live in an adult family home. My mother is a caregiver for private clients. She also now fears for her clients, especially in the hospital. She is afraid that the hospital will begin “comfort care” (that’s morphine) and her patient will suddenly die. This has already happened. She tries to never leave her patients alone in the hospital. Either she or a family member will be there.
She has also had one client where a family member wanted the client to do the assisted-suicide.
In short, older people are no longer valued as they were before.
I hope that you will not follow our path.
— Elizabeth Poianna 

Tuesday, March 4, 2014

The High Financial Cost of (Regular) Suicides.

Dear New Hampshire House Members:

I am an attorney in Washington State where physician-assisted suicide is legal.  Our law is based on a similar law in Oregon.  I previously sent you materials, which can be viewed here

I write to discuss another factor for your consideration: Government reports from Oregon, showing a positive correlation between the legalization of physician-assisted suicide and an increase in other (regular) suicides. Of course, a statistical correlation does not prove causation.  The statistical correlation described herein, is, however, consistent with a suicide contagion (legalizing and thereby normalizing one type of suicide encouraged other suicides).  Please consider the following.

Oregon's assisted suicide act went into effect in 1997.  See top line at this link: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx

By 2000, Oregon's regular suicide rate was "increasing significantly"  See second paragraph, http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000"). 

By 2007, Oregon's other (regular) suicide rate was 35% above the national average. See second page at "A-57) http://maasdocuments.files.wordpress.com/2013/02/oregon-suicide-info_001.pdf

In 2010, the most recent report, Oregon's other (regular) suicide rate was 41% above the national average. http://choiceisanillusion.files.wordpress.com/2014/02/oregon-suicide-report-2012-through-2010-pdf.pdf  Moreover and per this report, the financial cost of these other (regular) suicides is huge.  The report, page 3, elaborates:
In 2010, there were 685 Oregonians who died by suicide and more than 2,000 hospitalizations due to suicide attempts.  Suicide is the second leading cause of death among Oregonians ages 15-34, and the 8th leading cause of death among all ages in Oregon.  The cost of suicide is enormous.  In 2010 alone, self-inflicted injury hospitalization charges exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars.  The loss to families and communities broadens the impact of each death.  (Footnotes omitted).
Oregon is the only state where there has been legalization of physician-assisted suicide long enough to have valid statistics showing this positive statistical correlation between assisted suicide legalization and other (regular) suicides.

The enormous cost of increased (regular) suicides in Oregon, positively correlated to physician-assisted suicide legalization, is a significant factor for the House to consider in its vote on HB 1325, which seeks to legalize physician-assisted suicide.

For this and other reasons, I urge you to vote No in HB 1325.

Thank you.

Margaret Dore, Esq., MBA, President
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion, a nonprofit corporation
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, 44th Floor
Seattle, WA  98154
206 389 1754 main line
206 389 1562 direct line

"I hope that Connecticut does not repeat Oregon's mistake."

http://www.journalinquirer.com/opinion/letters_to_the_editor/march-letters/article_ccb4e384-a2bb-11e3-b9c8-001a4bcf887a.html (second letter)

I have been a professor of family medicine and a practicing physician in Oregon for more than 30 years. I write to provide some insight on the issue of assisted suicide, which is legal in Oregon, and which has been proposed for legalization in Connecticut (raised bill No. 5326).

Our law applies to “terminal” patients who are predicted to have less than six months to live.  In practice, this idea of “terminal” has recently become stretched to include people with chronic conditions, such as “chronic lower respiratory disease” and “diabetes”.  Persons with these conditions are considered terminal if they are dependent on their medications, such as insulin, to live.  They are unlikely die in less than six months unless they don’t receive their medications.  Such persons, with treatment, could otherwise have years or even decades to live.

This illustrates a great problem with our law — it encourages people with years to live, to throw away their lives.

I am also concerned that by starting to label people with chronic conditions “terminal,” there will be an excuse to deny such persons appropriate medical treatment to allow them to continue to live healthy and productive lives.

These factors are something for your legislators to consider. Do you want this to happen to you or your family? Furthermore, in my practice I have had many patients ask about assisted-suicide. In each case, I have offered care and treatment but declined to provide assisted suicide. In one case, the man’s response was “Thank you.”

To read a commentary on the most recent Oregon government assisted-suicide report, which lists chronic conditions as the “underlying illness” justifying assisted suicide, please go here:  http://www.noassistedsuicideconnecticut.org/2014/02/oregons-new-assisted-suicide-report.html

To read about some of my cases in Oregon, please go here:  http://www.choiceillusion.org/p/what-people-mean_25.html

I hope that Connecticut does not repeat Oregon’s mistake.

William L. Toffler
Portland, Ore.

Don’t make Oregon’s mistake

I am a doctor in Oregon, where physician assisted-suicide is legal. I understand that Connecticut’s legislature is considering taking a similar step.
I was first exposed to this issue in 1982, shortly before my first wife died of cancer. We had just visited her doctor. As we were leaving, he had suggested that she overdose herself on medication. I still remember the look of horror on her face. She said, “Ken, he wants me to kill myself.”
Our assisted-suicide law was passed in 1997. In 2000, one of my patients was adamant she would use our law. Over three or four visits, I stalled her and ultimately convinced her to be treated instead. Nearly 14 years later she is thrilled to be alive.
In Oregon, the combination of assisted-suicide legalization and prioritized medical care based on prognosis has created a danger for my patients on the Oregon Health Plan (Medicaid). Helpful treatments are often not covered. The plan will cover the patient’s suicide.
For more details, read my affidavit filed on behalf of the Canadian government at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf
Protect your health care. Tell your legislators to vote no on assisted suicide. Don’t make Oregon’s mistake.
Kenneth Stevens
Sherwood, Ore.

Saturday, March 1, 2014

Sign the Petition

http://ireneogrizek.ca/2014/02/26/14654/

Assisted Suicide: Sign the Petition



Citizens of all countries are free to sign this petition. My politics, for the record, are left and centrist. I believe in a view of society that is not simply utilitarian: every sentient life deserves our protection and care. My focus is not religious or moral — I am not religious — it is about the risk assisted suicide poses for the disabled and the elderly. 

When it comes to assisted suicide, I am a conscientious objector. Like those who oppose war, I oppose killing, even when it’s ‘mercy killing’. This is because I feel that mercy, like beauty, is in the eye of the beholder. Vulnerable individuals in our healthcare system may die prematurely — if we stop valuing their lives, we send the wrong message to policy-makers and healthcare workers.
It almost happened to my mother. It is now 2014 and she is still alive, even though we were strongly urged to ‘let her go’ in 2008. After going public with our hospital experience and speaking to other Canadian families, I discovered we were not alone. The elderly in Canada (and the U.K. and U.S.) are often hastened toward death, even when they are not terminally ill. I have spoken to many family members who believe this has happened to a parent or grandparent. 
Our Canadian government and national media outlets are not allowing for a full discussion of all the risks of assisted suicide. Attempts to do so have been discouraged and our arguments are not reaching the wider public. Even our nation’s broadcaster, the CBC, is unwilling to be impartial. It seems a concerted effort is being made to ‘manufacture consent’ in favour of assisted suicide.
A frank discussion about its risks is in order. 
Allowing our nation’s healthcare workers — physicians and nurses — to euthanize patients endangers all of us. And so I am a conscientious objector: I do not want a system that endangers my life and the lives of others. Canada is a first world nation and we have the resources to manage illnesses humanely. Patients have the right to refuse treatment or to ask for terminal sedation; good options already exist. 
I’m not sure what actions will follow from this petition, but objecting is a start. We need to get talking.

Monday, February 24, 2014

Concerns about assisted suicide include hiding malpractice and "lazy doctoring."

http://helenair.com/news/opinion/readers_alley/against-physician-assisted-suicide/article_7b17e3b6-9b57-11e3-ab51-001a4bcf887a.html

I am a general medical practitioner, with 30 years experience. I was glad to see that Montanans Against Assisted Suicide has decided to appeal its case with the Montana Medical Examiner Board to the Montana Supreme Court. My hope is that the appeal will end the controversy about assisted suicide possibly being legal in Montana.

My concerns about legalizing assisted suicide include that it will encourage "lazy doctoring." I say this because it is easier for a doctor to write a prescription (to end the patient's life,) as opposed to doing the sometimes hard work of figuring out what is wrong with a patient and providing treatment. I am also concerned that legalization will give bad doctors the opportunity to hide malpractice by convincing a patient to take his or her life.

The American Medical Association, Ethics Opinion No. 2.211, states: "Physician-assisted suicide is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks."

I agree with this statement. Allowing legalization of physician-assisted suicide in Montana will compromise and corrupt my profession. Legalization will also put the lives and well-being of my patients at risk.

Carley C. Robertson, MD
Havre MT

Tuesday, February 18, 2014

New Swiss Study Misses the Obvious: Wealthy Older People May Have been Targeted for Their Money.

"How sharper than a serpent's tooth it is
To have a thankless child!"
- William Shakespeare
King Lear Act 1, Scene 4

Below is post from Medical Xpress, regarding a new study finding that people from wealthier areas are more likely to die from assisted suicide.  The post also says:  "Having children was associated with a lower risk of assisted suicide in younger people, although not in older people."  The "inheritance factor" is completely overlooked.

More educated people from wealthier areas, women, more likely to die from assisted suicide

http://medicalxpress.com/news/2014-02-people-wealthier-areas-women-die.html

Researchers in Switzerland, where assisted suicide is legal, have conducted a study – published online in the International Journal of Epidemiology today – that shows assisted suicide is more common in women, the divorced, those living alone, the more educated, those with no religious affiliation, and those from wealthier areas.

While euthanasia is prohibited in Switzerland, the penal code states that assisted is legal if no selfish interests are involved. Assisted suicides in Switzerland involve volunteers working for "right-to-die" associations. The role of physicians is restricted to assessing the decisional capacity of the person requesting assistance and to prescribing the lethal drug. Notably, the person requesting assistance does not need to have a terminal illness.

In this study Professor Matthias Egger and colleagues at the University of Bern linked data from three right-to-die organisations to the Swiss national Cohort, a of mortality based on linkage of census and mortality records. The study followed those aged 25 to 94 from 1 January 2003 until their death, emigration, or the end of the study: a total of 5,004,403 people. Anonymous data on 1,301 cases of between 2003 and 2008 were provided by the three right-to-die organisations.

Study findings showed assisted suicide was more common in than men, in people with secondary or tertiary rather than compulsory education, in those living alone, and in those with no . The rate was also higher in urban compared to rural areas, in wealthier neighbourhoods, and in the French rather than German or Italian speaking areas of the country. Having children was associated with a lower risk of assisted suicide in younger people, although not in older people.

In 84% of cases the listed at least one underlying cause of death. In the age group 25-64 years the majority had cancer ( 57%), followed by diseases of the nervous system (21%). Eleven individuals had a mood disorder listed as the first underlying cause, and three had another mental or behavioural disorder. For all causes, except Parkinson's disease, the percentage of assisted suicides was higher in women than men. In the 65-94 years age group, cancer was again the most common underlying cause (41%), followed by circulatory (15%) and diseases of the nervous system (11%). Thirty people had a mood disorder, and six had another mental or behavioural disorder.


Dr Egger says, "Our study is relevant to the debate on a possibly disproportionate number of assisted suicides among vulnerable groups. The higher rates among the better educated and those living in neighbourhoods of higher socio-economic standing does not support the 'slippery slope' argument but might reflect inequities in access to assisted suicide. On the other hand, we found a higher rate among people living alone and the divorced. Social isolation and loneliness are well known risk factors for non-assisted suicides and our results suggest that they may also play a role in assisted suicide. Also, the observation that women die more frequently by assisted suicide than men is potentially of concern. Interestingly, though, studies from the Netherlands and Oregon in the USA reported more men than women among assisted deaths."

16% of death certificates did not register an underlying cause. A previous study of suicides by two right-to-die organizations showed that 25% of those assisted had no fatal illness, instead citing "weariness of life" as a factor. In 2013 the European Court of Human Rights asked Switzerland to clarify whether and under what conditions individuals not suffering from terminal illnesses should have access to help in ending their lives, suggesting that Switzerland should more precisely regulate assisted dying.

Dr Egger says: "We believe that such new regulation should mandate the anonymous registration of assisted suicides in a dedicated database, including data on patient characteristics and underlying causes, so that suicides assisted by right-to-die associations can be monitored."

More information: 'Suicide assisted by Right-to-Die Associations: Population based cohort study' by Nicole Steck, Christoph Junker, Maud Maessen, Thomas Reisch, Marcel Zwahelen, and Matthias Egger, International Journal of Epidemiology, DOI: 10.1093/ije/dyu010


Tuesday, February 11, 2014

Margaret Dore writes the New Hampshire Judiciary Committee: Vote "No" on HB 1325

Madame Chair and Members of the Committee,

During the recent hearing on assisted suicide, I mentioned that there had been a significant increase in other suicides in Oregon after assisted suicide legalization.  This is consistent with a suicide contagion (legalizing and thereby normalizing one type of suicide encouraged other suicides). 

Of course, a correlation does not prove causation. 

However, as set forth below, there is a significant statistical correlation between the two events.  Moreover, the financial cost to Oregon from the other suicides is enormous.  Please see the data below:
Oregon's assisted suicide act went into effect in 1997. See top line at this link: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx
By 2000, Oregon's regular suicide rate was "increasing significantly"  See http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000")

In 2010, Oregon's other suicide rate was 35% above the national average.  http://maasdocuments.files.wordpress.com/2013/02/oregon-suicide-info_001.pdf

In 2012, the most recent report, Oregon's other suicide rate was 41% above the national average.  http://choiceisanillusion.files.wordpress.com/2014/02/oregon-suicide-report-2012-through-2010-pdf.pdf  Moreover, this report, page 3, states:
"Suicide is the second leading cause of death among Oregonians ages 15-34, and the 8th leading cause of death among all ages in Oregon.  The cost of suicide is enormous.  In 2010 alone, self-inflicted injury hospitalization changes exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars.  The loss to families and communities broadens the impact of each death."
The report, itself, does not address the possible influence of assisted suicide legalization.  But, again, the significant statistical correlation is there.  The cost to the state is enormous.
Please feel free to contact me for any further information.

Thank you.

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

Monday, February 10, 2014

Dr. Toffler Writes the New Hampshire Judiciary Committee: "Vote NO on HB 1325"

Dear Members of the Committee:

I am a doctor in Oregon where assisted suicide is legal.  As a professor of Family Medicine and practicing physician in Oregon for over 30 years, I write to urge you to not make Oregon's mistake and vote No on HB 1325.

I understand that there was a question during your recent hearing regarding the appropriateness of suicide prevention with a terminal patient.  Terminal patients, like other patients, will sometimes express suicidal desires and ideation.  Terminal patients, like other patients do not necessarily mean it and may even want you to say "no."  They may also be clinically depressed, i.e., colloquially not in their "right minds."  With this situation, suicide prevention is not only appropriate, but necessary to provide good medical care and to avoid discrimination based on the patient's quality of life as perceived by the doctor.

In my practice, I have had well over twenty patients ask me about participating in their suicides or giving them information about assisted suicide.  In every case I have explored the issues behind their request, and then assured them that I will provide their medical care to the best of my ability. At the same time, I also strive to reflect and convey their inherent worth and my inability to collude with their request to help end their life.  I remember one case in particular, the man's response was "Thank you." 

To read more about that case and some of my other cases in Oregon, please read my statement to the BBC, since re-titled as "What do People Mean When They Say they Want to Die?"  http://www.choiceillusion.org/p/what-people-mean_25.html

Please vote No on HB 1325,

Thank you,

William L. Toffler MD
Professor of Family Medicine
3181 SW Sam Jackson Park Road
Portland, OR 97239
503-494-5322
503-494-8573 (patient care)
503-494-4496 (fax)
toffler@ohsu.edu

Wednesday, February 5, 2014

Preventing Abuse and Exploitation: A Personal Shift in Focus. An article about guardianship, elder abuse and assisted suicide.

http://www.americanbar.org/publications/voice_of_experience/2014/winter/preventing_abuse_and_exploitationa_personal_shift_focus.html

http://choiceisanillusion.files.wordpress.com/2014/02/dore-preventing-abuse-and-exploitation-aba.pdf

By Margaret K. Dore, Esq., MBA
The Voice of Experience, American Bar Association
Volume 25, No. 4, Winter 2014

I graduated from law school in 1986.  I first worked for the courts and then for the United States Department of Justice.  After that, I worked for other lawyers, and then, in 1994, I officially started my own practice in Washington State.  Like many lawyers with a new practice, I signed up for court-appointed work in the guardianship/probate context.  This was mostly guardian ad litem work.  Once in awhile, I was appointed as an attorney for a proposed ward, termed an “alleged incapacitated person.”  In other states, a guardianship might be called a “conservatorship” or an “interdiction.”  A guardian ad litem might be called a “court visitor.”

My Guardianship Cases

Most of my guardianship cases were straightforward.  There would typically be a elderly person who could no longer handle his or her affairs.  I would be the guardian ad litem.  My job would be to determine whether the person needed a guardian, and if that were the case, to recommend a person or agency to fill that role.

My work also included private pay cases with moderate estates.  With these cases, I would sometimes see financial abuse and exploitation.  For example, there was an elderly woman whose nephew took her to the bank each week to obtain a large cash withdrawal.  She had dementia, but she could pass as “competent” to get the money.  In another case, “an old friend from 30 years ago” took “Jim,” a 90 year old man, to lunch.  The friend invited Jim to live with him in exchange for making the friend sole beneficiary of his will.  Jim agreed.  The will was executed and he went to live with the friend in a nearby town.  A guardianship was started and I was appointed guardian ad litem.  I drove to the friend’s house, which was dilapidated.  Jim did not seem to have his own room.  I asked him if he would like to go home.  He said “yes” and got in my car.  He was not incompetent, but he had allowed someone else to take advantage of him.  In another case, there was a disabled man whose caregiver had used his credit card to remodel her home.  He too was competent, but he had been unable to protect himself.

In those first few years, I loved my guardianship cases.  I had been close to my grandmother and enjoyed working with older people.  I met guardians and other people who genuinely wanted to help others.

But then I got a case involving a competent man who had been railroaded into guardianship.  The guardian, a company, refused to let him out.  The guardian also appeared to be churning the case, i.e., causing conflict and then billing for work to respond to the conflict and/or to cause more conflict.  I have an accounting background and also saw markers of embezzlement.  I tried to tell the court, but the supervising commissioner didn’t know much about accounting.  She allowed the guardian to hire its own CPA to investigate the situation, which predictably exonerated the guardian.  The guardian had many cases and if what I said had been proved true, there would have been political fallout.  There were also conflicts of interest among the lawyers.

At this point, the scales began to fall from my eyes.  My focus started to shift from working within the system to seeing how the system itself sometimes facilitates abuse.  This led me to write articles addressing some of the system’s flaws.  See e.g., Margaret K. Dore, Ten Reasons People Get Railroaded into Guardianship, 21 AM. J. FAM. L. 148 (2008), available at www.margaretdore.com/pdf/Dore_AJFL_Winter08.pdf; Margaret K. Dore, The Time is Now: Guardians Should be Licensed and Regulated Under the Executive Branch, Not the Courts, WASH. ST. B. ASS’N B. NEWS, Mar. 2007 at 27-9, available at http://maasdocuments.files.wordpress.com/2013/08/dore-the-time-is-now-ashx.pdf

The MetLife Studies 

In 2009, the MetLife Mature Market Institute released its landmark study on elder financial abuse. See https://www.giaging.org/documents/mmi-study-broken-trust-elders-family-finances.pdf  The estimated financial loss by victims in the United States was $2.6 billion per year.

The study also explained that perpetrators are often family members, some of whom feel themselves “entitled” to the elder’s assets.  The study states that perpetrators start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or coercing elders to sign over the deeds to their homes, change their wills or liquidate their assets.

In 2011, Met Life released another study available at www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf, which described how financial abuse can be catalyst for other types of abuse and which was illustrated by the following example.  “A woman barely came away with her life after her caretaker of four years stole money from her and pushed her wheelchair in front of a train.  After the incident the woman said, “We were so good of friends . . . I’m so hurt that I can’t stop crying.”

Failure to Report

A big reason that elder abuse and exploitation are prevalent is that victims do not report.  This failure to report can be for many reasons.  A mother being abused by her son might not want him to go to jail.  She might also be humiliated, ashamed or embarrassed about what’s happening.  She might be legitimately afraid that if she reveals the abuse, she will be put under guardianship.

The statistics that I’ve seen on unreported cases vary, from only 2 in 4 cases being reported, to one in 20 cases.  Elder abuse and exploitation are, regardless, a largely uncontrolled problem.

A New Development: Legalized Assisted Suicide

Another development relevant to abuse and exploitation is the ongoing push to legalize assisted suicide and euthanasia in the United States.  “Assisted suicide” means that someone provides the means and/or information for another person to commit suicide.  If the assisting person is a physician who prescribes a lethal dose, a more precise term is “physician-assisted suicide.”  “Euthanasia,” by contrast, is the direct administration of a lethal agent with the intent to cause another person’s death.

In the United States, physician-assisted suicide is legal in three states:  Oregon, Washington and Vermont.  Eligible patients are required to be “terminal,” which means having less than six months to live.  Such patients, however, are not necessarily dying.  One reason is because expectations of life expectancy can be wrong.  Treatment can also lead to recovery.  I have a friend who was talked out of using Oregon’s law in 2000.  Her doctor, who did not believe in assisted suicide, convinced her to be treated instead.  She is still alive today, 13 years later.

Oregon’s law was enacted by a ballot measure in 1997.  Washington’s law was passed by another measure in 2008 and went into effect in 2009.  Vermont’s law was enacted on May 20, 2013.  All three laws are a recipe for abuse.  Onw reason is that they allow someone else to talk for the patient during the lethal dose request process.  Moreover, once the lethal dose is issued by the pharmacy, there is no oversight over administration.  Even if the patient struggled, who would know? [See e.g., http://www.choiceillusion.org/2013/11/quick-facts-about-assisted-suicide_11.html]

Here in Washington State, we have already had informal proposals to expand our law to non-terminal people.  The first time I saw this was in a newspaper article in 2011.  More recently, there was a newspaper column suggesting euthanasia “if you couldn’t save enough money to see yourself through your old age,” which would be involuntary euthanasia.  Prior to our law being passed, I never heard anyone talk like this.

I have written multiple articles discussing problems with legalization, including Margaret K. Dore, "Death with Dignity”: What Do We Advise Our Clients?," King Co. B. ASS’N, B. BuLL., May 2009, available at  www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm; Margaret K. Dore, Aid in Dying: Not Legal in Idaho; Not About Choice, 52 THE ADVOCATE [the official publication of the Idaho State Bar] 9, 18-20 (Sept. 2013) available at www.margaretdore.com/pdf/Not_Legal_in_Idaho.pdf  

My Cases Involving the Oregon and Washington Assisted Suicide Laws

I have had two clients whose parents signed up for the lethal dose.  In the first case, one side of the family wanted the father to take the lethal dose, while the other did not.  He  spent the last months of his life caught in the middle and traumatized over whether or not he should kill himself.  My client, his adult daughter, was also traumatized.  The father did not take the lethal dose and died a natural death.

In the other case, it's not clear that administration of the lethal dose was voluntary.  A man who was present told my client that the father refused to take the lethal dose when it was  delivered (“You’re not killing me.  I’m going to bed”), but then took it the next night when he was high on alcohol.  The man who told this to my client later recanted.  My client did not want to pursue the matter further.

Conclusion

In my guardianship cases, people were financially abused and sometimes treated terribly, but nobody died and sometimes we were able to make their lives much better.  With legal assisted suicide, the abuse is final.  Don’t make Washinton’s mistake.

Margaret K. Dore (margaretdore@margaretdore.com) JD, MBA, is an attorney in private practice in Washington State where assisted suicide is legal.  She is a former Law Clerk to the Washington State Supreme Court and the Washington State Court of Appeals.  She worked for a year with the U.S. Department of Justice and is president of Choice is an Illusion, www.choiceillusion.org, a nonprofit corporation opposed to assisted suicide and euthanasia.