California: Memo to Senate Appropriations Committee: "Vote 'NO' on SB 128: The financial impact is potentially 'enormous.'"

By Margaret K. Dore, Esq., MBA

To view a pdf version,  please click here.

A. Introduction

SB 128 seeks to legalize physician-assisted suicide.  The bill is based on a similar law in Oregon, which was enacted in 1997.  In Oregon, the law is rarely used, but since passage, there has been a significant increase in other (conventional) suicides.  This increase is consistent with a suicide contagion in which legalization and promotion of physician-assisted suicide has led to an increase in other suicides.  Moreover, the financial cost is “enormous.”  A government report from Oregon states:

In 2010 alone, self-inflicted injury hospitalization charges exceeded 41 million dollars.

This Committee must vote NO unless the proponents can show that California will not have a similar increase in conventional suicides. Otherwise, the financial cost in California could be “enormous.”

California: "SB 128 has the potential for a large and adverse financial impact."

LETTER submitted to the Senate Appropriations Committee (edited for the web):

Please accept this cover letter and memo in opposition to SB 128 for the purpose of the May 11th hearing. 

Based on the "Oregon experience," passage of SB 128 has the potential for a large and adverse financial impact on the state of California.  The cover letter explains why as follows:

SB 128 seeks to legalize physician-assisted suicide. 

In Oregon, which has had a similar law since 1997, legalization is statistically correlated with an increase in other suicides.  This increase is consistent with a suicide contagion in which the legalization of one type of suicide (physician-assisted) has led to an increase in other (conventional) suicides.  Moreover, the financial cost is "enormous."  A government report from Oregon states:

"In 2010 alone, self-inflicted injury hospitalization charges exceeded 41 million dollars."  (Emphasis added).

Here are the full links:  

https://choiceisanillusion.files.wordpress.com/2015/05/dore-ltr-ca-sen-appr-com_001.pdf

https://choiceisanillusion.files.wordpress.com/2015/05/sb-128-senate-appropriations-memo-updated.pdf

Thank you for your consideration.

Margaret Dore, Esq., MBA, President
Choice is an Illusion, a nonprofit corporation
Law Offices of Margaret K. Dore, P.S.
www.choiceillusion.org 
www.margaretdore.com 
1001 4th Avenue, Suite 4400
Seattle, WA  98154

Vermont: “Repeal the Sunset” Bill Moves Out of Committee

From True Dignity Vermont

April 24, 2015 by Administrators, To view original post, click here.

The House Human Services Committee this afternoon voted to approve S.108, the bill that calls for the repeal of the “sunset provision” in Act 39 (not to be confused with a wholesale repeal of Act 39). It is expected that the bill will be debated on the House floor next week, possibly Wednesday.

“Repealing the sunset” would mean that the law will retain the few so-called protections that were included in the original bill that was passed and became law in 2013. Without a repeal of the sunset, these minimal protections, which primarily relate to the procedure around obtaining a prescription, are scheduled to go away in July 2016.  As Guy Page testified last week on behalf of the Vermont Alliance for Ethical Healthcare, “Without the sunset, Act 39 gets an ‘F’.  With it, it rates an ‘F-minus’.  A distinction without a difference.”

Nurse Admits Killing Patients to Ease Her Workload

By John Hall for MailOnline 

 http://www.dailymail.co.uk/news/article-3032137/Nurse-Death-Vera-Maresova-admits-murdering-five-patients-potassium-injections.html#ixzz3XJ806uDP

A former nurse in the Czech Republic has admitted murdering six of her elderly patients with massive doses of potassium in order to ease her workload.

Vera Maresova, 50, confessed to killing five women and one man over a four-year period at a hospital in Rumburk - a small town in the north of the country.

Dubbed 'Nurse Death' by local media, Maresova was initially arrested over the death of a 70-year-old woman last August, but has now admitted killing five more people between 2010 and 2014 following a police investigation.

According to the prosecution, Maresova injected the potassium straight into the blood stream of her six elderly patients, which caused them to suffer heart failure and eventually death.

All of her victims were already in the intensive care unit at the hospital and it is believed Maresova thought their deaths would simply be attributed to natural causes.

Alaska: Memo Against HB 99

HB 99 seeks to legalize assisted suicide and euthanasia in Alaska.

The sponsor says that the bill applies to terminally ill patients with an “inevitable and certain death.” Eligible persons, however, may have years, even decades, to live. The bill is, regardless, a recipe for elder abuse, especially for people with money.

Other problems include: steerage to suicide by health care providers; trauma to patients; trauma to family members; and the risk of suicide contagion.

To view a detailed memo arguing against HB 99, please click here. To view the attachments, please click here.

Margaret Dore, Esq., MBA

Choice is an Illusion has a New Website!

The website's purpose is to fight SB 128, which seeks to legalize assisted suicide and euthanasia in California.  To view the new website, please click here.

California: Vote NO on SB 128

To read a legal/policy analysis against SB 128, please click here.  To view supporting documentation,  please click here.

Key points include:

People "eligible" for assisted suicide/euthanasia may have years, even decades, to live, i.e., if they don't die of assisted suicide/euthanasia under SB 128.  The bill encourages people with years to live to throw away their lives.

The thrust of SB 128 is to protect doctors and other participants in a patient's death, including family members.  This is done in three ways:

Montana: Vote "Yes" on HB 477!

HB 477 will reverse Baxter and send a clear message that medical killings are prohibited and against public policy.  Individuals will be protected from the medical establishment, individual doctors and family members with something to gain.

A.  Involuntary Medical Killings.

Throughout the US, there are increasing reports of involuntary medical killings.[1] Consider a 2012 case against Kaiser Healthcare. Doctors killed the patient, a wealthy older man, through a “terminal extubation.” His daughters had allegedly urged this result in order to obtain large inheritances.[2]  In Montana, examples include Dr. James Mungas, who was killed under the guise of hospice/palliative care.  His widow, Carol Mungas, states:

It is traumatic, still, to realize his last communications were attempts to get help.[3]

B.  Likely Problems

Baxter has created confusion in the law and has emboldened some doctors and family members to publicly admit participation in assisted suicides.  If HB 477 is not enacted, this situation will likely lead to defacto legality and the following problems:

    1.  New paths of elder abuse, especially for people with money.

Legal assisted suicide creates new paths of elder abuse. Consider, for example, the Thomas Middleton case, where legal physician-assisted suicide in Oregon was part of a financial elder abuse fraud.

    2.  Steerage to suicide.

It is well documented that Oregon's Medicaid program steers patients to suicide (suicide is covered in lieu of treatments for cure or to extend life).  Private health plans and providers have this same ability. To learn more, see this affidavit by Oregon doctor, Kenneth Stevens, MD.

    3.  Pressure on patients. 

See this letter by Marlene Deakins, RN, describing the pressure put on her brother after he merely asked a question about assisted suicide in Washington State. 

    4.  More conventional suicides, including violent suicides.

In Oregon, conventional suicides, including violent suicides, have substantially increased with legalization of assisted suicide. This is consistent with a suicide contagion.  The financial cost of these suicides is "enormous."  For more information, click here.

    5.  Pressure to expand to non-terminal people.

In Washington state, there have been "trial balloon" proposals to expand its law to non-terminal people, including those who have simply fallen on hard times. See e.g., this column in the Seattle Times, suggesting euthanasia for people without money for their old age.  

C.  Contact Your Legislators.

Contact your legislators and urge them to vote "YES" on HB 477.

* * *
[1]  Peter Whoriskey, "As More Hospices Enroll Patients who Aren't Dying, Questions About Lethal Doses Arise," The Washington Post, August 21, 2014. 
[2] William Dotinga, “Grim Complaint Against Kaiser Hospital,” Feb. 6, 2012.
[3] Carol Mungas, athttp://www.montanansagainstassistedsuicide.org/2013/03/i-support-house-bill-505-which-clearly.html 

Montana: HB 477 PASSES the House!

Yesterday, HB 477, which overrules Montana/s Baxter decision by clarifying that physician-assisted suicide is against public policy and prohibited, passed Montana's House of Representatives.

Elderly Murder-Suicide: Should We Praise Old Men Who Kill Their Wives and Themselves?

"A man who murders his sick, innocent, helpless wife is no hero."

http://www.huffingtonpost.com/elizabeth-marquardt/elderly-murder-suicide_b_1402935.html

By Elizabeth Marquardt

On Thursday, March 29, the bodies of Adrienne and Charles Snelling were found. Police believe Charles killed Adrienne -- her exact cause of death is still pending -- and then shot himself. Only last December, Charles Snelling published in the New York Times a poignant and widely-circulated piece about loving and caring for his wife with Alzheimer's disease. (Columnist David Brooks, whose query for life stories initiated Snelling's piece, wrote in his column yesterday about this case.)

Montana one step closer to reversing Baxter.

Today, the Montana House of Representatives voted to pass HB 477, which clarifies that "physician-assisted suicide" is prohibited and against public policy in Montana.  

To view HB 477, please click here.

Washington State: SB 5919 passes Senate!

SB 5919, clarifying that patients who request assisted suicide have the right to be told about options for cure or to extend life, has PASSED the Senate!  The vote was a bipartisan, 34-14, with one member excused.  To see the vote breakdown, click here .

Utah: Problems with H.B. 391

By Margaret Dore, Esq., MBA

H.B. 391 seeks to legalize physician-assisted suicide in Utah.  I am a lawyer in Washington State where we have a similar law.  Our law is based on a law in Oregon.

Problems include:

1.  HB 391, if enacted, will encourage people with years to live to throw away their lives.

HB 391 seeks to legalize assisted suicide for persons with a "terminal disease," which is defined as having less than six months to live.  In Oregon's law, which uses the same definition, young adults with chronic conditions, such as diabetes, are "eligible" for assisted suicide.  Such persons can have years, even decades, to live.  See https://choiceisanillusion.files.wordpress.com/2014/12/a-2270-3r-memo-12-02-14.pdf   "Eligible" patients can also have years to live because doctors can be wrong.  See https://choiceisanillusion.files.wordpress.com/2013/10/terminal-uncertainty.pdf and https://choiceisanillusion.files.wordpress.com/2014/08/signed-john-norton-affidavit_001.pdf

Massachusetts: High School Student Charged with Manslaughter for Encouraging Suicide

http://www.thesunchronicle.com/news/local_news/kp-student-charged-with-manslaughter-in-

fairhaven-friend-s-death/article_821a5d5e-be30-11e4-ada1-7b43f5417c27.html

BY JIM HAND SUN CHRONICLE STAFF | Posted: Friday, February 27, 2015 1:00 am

PLAINVILLE  A King Philip Regional High School senior has been indicted for involuntary manslaughter, allegedly for urging a friend to commit suicide. She then raised money for mental illness in the name of her friend.

Michelle Carter, 18, of Plainville was indicted as a “youthful offender” by a Bristol County grand jury, and was arraigned in New Bedford Juvenile Court.

She is accused of urging Conrad Roy III, 18, of Fairhaven and Mattapoisett to kill himself, which he did while idling a truck last July in the parking lot of a Fairhaven Kmart. Authorities said he died of carbon monoxide poisoning.

Washington State: SB 5919 on the move!

Last night, SB 5919, which clarifies that a person considering assisted suicide has the right to be told of options for cure or to extend life, has passed out of the Law & Justice Committee.

The vote was bipartisan.  The seven member committee voted as follows:  6 "do pass" and 1 "without recommendation."  See here

Marlene Deakins, RN, Supporting SB 5919

"I hope that  with the proposed bill, doctors will get the message that they need to back off , to make sure that patients are freely choosing what’s best for them, as chosen by them."

* * * 

Dear Senator Padden, Members of the Law and Justice Committee and Senator Angel:

I am a Registered Nurse.  I am writing this letter in support of SB 5919, which would make it clear that persons asking about assisted suicide remain eligible to be told about options for cure or to extend life.  I hope that this law will provide protection for people like my brother, Wes Olfert, who died a few years ago (2011) in Washington State.

When he was first admitted to the hospital, he made the mistake of asking about assisted suicide.  I say a mistake, because this set off a chain of events that interfered with his care and caused him unnecessary stress in what turned out to be the last months of his life.

By asking the question, he was given a "palliative care" consult by a doctor who heavily and continually pressured him to give up on treatment before he was ready to do so.  It got so bad that Wes became fearful of this doctor and asked me and a friend to not leave him alone with her.

I hope that  with the proposed bill, doctors will get the message that they need to back off, to make sure that patients are freely choosing what’s best for them, as chosen by them.

Please vote “yes” on SB 5919

Marlene Deakins, RN
Tuscon Arizona

Senator Jan Angel, Supporting SB 5919

This bill . . . is about choice and common sense. Patients should know all their options before having to make a life-or-death decision.

The bill does not impose any limitations on a person's ability to choose what is best for him or her. It could even be called a technical amendment as it just expands the list of information that is provided to patients before they make their decision.

Kenneth Stevens, MD, supporting SB 5919.

My name is Dr. Kenneth Stevens. I live in Sherwood, Oregon. I'm testifying in favor of Senate Bill 5919, which amends Washington's Death with Dignity Act.

I'm a cancer doctor in Oregon, where we've had the similar act since 1997. I'm also a professor emeritus at Oregon Health and Science University. I previously served as Chair of the Department of Radiation Oncology. I have treated thousands of patients with cancer.

Jeanette Hall

I practice in both Washington state as well as Oregon. I've read the proposed bill, which amends Washington's act to make it clear that patients who request a lethal dose under the act have the right to be told of treatment options for cure and to extend life.

I strongly support this bill, especially due to my experience with a patient named Jeanette Hall. The Oregon and Washington acts apply to patients predicted to have less than six months to live.  This does not necessarily mean that the patients are dying. This is true for two reasons:

WA State: Vote "YES" on SB 5919.

This is a simple bill, which clarifies that patients considering assisted suicide have a right to be told of their options for cure or to extend life. Passing the bill will be consistent with how Washington's assisted suicide act was marketed to the voters, as providing choice for patients. I urge you to vote "Yes.”

* * *

Below please find my updated memo supporting SB 5919, currently pending in the Washington State Senate. To see a print version, please click here.

Margaret Dore, Esq., MBA

www.margaretdore.com

Montana, SB 202 Defeated!

On February 11, 2012, SB 202, which would have legalized assisted suicide and euthanasia in Montana, was tabled in Committee.

Montana: Defeat SB 202!

The Montana Legislature is considering SB 202, which if passed, would legalize assisted suicide and euthanasia in Montana.

SB 202 is modeled on a similar law in Oregon.

The bill, if passed and interpreted in the same way as Oregon's law, will render young adults with chronic conditions such as diabetes, "eligible" for assisted suicide/euthanasia.  Such persons can live long healthy lives, for years, even decades.  See e.g., here, pp. 4-6 and here, p. A-39.

The bill, if passed, will create the following problems:

• It will encourage people with years to live to throw away their lives. 
• It will create new paths of elder abuse, especially in the inheritance context.  See e.g., here, p. 15 and here.
• It will empower health care systems to steer patients to suicide, which is well documented in Oregon where assisted suicide is legal.  See e.g., here, p. 16, here, p. A-49 and here.

If the bill is passed, and Montana follows the "Oregon experience," other "conventional" suicides will increase, which will create serious public welfare/financial issues in Montana (in Oregon, conventional suicides are a $41 million problem, due to hospitalizations, injuring other people, rehab, etc).  See e.g., here, p. 18 and here, pp. A-70 to A-76.

To view documentation regarding other problems with legalization, please click here for the text; click here for the attachments

Please tell the Montana Legislature to vote "NO" on SB 202.

Thank you,

Margaret Dore, Esq., MBA, President

Choice is an Illusion, a human rights organization
206 697 1217.

C & C Defeated on Home Turf!

Yesterday, a Colorado House committee summarily defeated a "death with dignity" act, which had sought to legalize assisted suicide/euthanasia in that state.

The vote was 9 to 4 to postpone House Bill 15-1135 indefinitely.

Thank you to everyone who worked so hard to make this happen!

Margaret Dore

Preventing Abuse and Exploitation: A Personal Shift in Focus. An Article About Guardianship, Elder Abuse and Assisted Suicide

By Margaret K. Dore, Esq., MBA

The Voice of Experience, American Bar Association

Volume 25, No. 4, Winter 2014

To view the original version, click here and here

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); 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 https://www.giaging.org/documents/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 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. One 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 [or non-voluntary] 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 atwww.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) 

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 Washington'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.