California Prohibition Against Assisted Suicide is Constitutional.

Margaret Dore, Esq., MBA

A California trial court has upheld the constitutionality of that state's criminal statute prohibiting assisted suicide, which states:

Every person who deliberately aids, or advises, or encourages another to commit suicide, is guilty of a felony.

Penal Code § 401

The court's reasoning is contained in a 19 page "Ruling on Demurrer," filed on July 24, 2015. The ruling uses the term, "Aid in Dying" to mean physician-assisted suicide.  The term also means euthanasia. The court states in part:

Since "Aid in Dying" is quicker and less expensive, there is a much greater potential for its abuse, e.g,, greedy heirs-in-waiting, cost containment strategies, ímpulse decision-making, etc. Moreover, since it can be employed earlier in the dying process, there is a substantial risk that in many cases, it may bring about a patently premature death. For example, consider that a terminally ill patient, not in pain but facing death within the next six months, may opt for “Aid in Dying”' instead of working through what might have been just a transitory period of depression. Further, "Aid in Dying" creates the possible scenario of someone taking his life based upon an erroneous diagnosis of a terminal illness illness, which was, in fact, a mis-diagnosis that could have been brought to light by the passage of time. After all, doctors are not infallible.

Are Vermonters Being Pressured to Use Act 39?

From True Dignity Vermont

http://www.truedignityvt.org/from-the-netherlands-to-vermont-patients-under-pressure-to-die/

Around one in five patients who choose euthanasia in the Netherlands acts under pressure from family members, according to a leading expert on the ethics of assisted dying, as reported last week in Dutch News: http://www.dutchnews.nl/news/archives/2015/07/pressure-on-patients-is-cause-for-concern-euthanasia-expert/

According to the report, Professor Theo Boer, who teaches ethics at Groningen’s Protestant Theological University and has for nine years served as a member of one of five review committees that assess every euthanasia case, said, “Sometimes it’s the family who go to the doctor. Other times it’s the patient saying they don’t want their family to suffer. And you hear anecdotally of families saying: ‘Mum, there’s always euthanasia.’”

Here in Vermont, where physician-assisted suicide has been legal for just two years, cases of pressure are already starting to emerge, and it isn’t always family members providing the pressure. True Dignity has spoken with the family of a 90-year-old Medicaid patient who felt pressured by caregivers in the facility where she was admitted for recovery from a fall. The patient did not have a terminal diagnosis.

According to Beth Neill, clinicians at the Berlin Health and Rehab Center informed her mother at regular intervals during her 4-month stay there that she had a “right” to use Act 39, and that, “She didn’t even have to discuss it with her family.” It was the act of repeatedly bringing up Act 39 as a health care “option” that caused her mother to feel pressure, and not overt efforts by clinicians to convince her to request the lethal prescription, Neill said. However, she said her mother made it clear she wanted nothing to do with Act 39 and was disturbed that staff re-introduced the topic repeatedly.

Washington DC: "No" on B21-38.

Below please find the executive summary to my submission against the DC assisted suicide/euthanasia bill. To view the entire submission and its attachments, please click here and here.

EXECUTIVE SUMMARY

B21-38 is promoted as assuring patient choice and control, which is false.  Points addressed by this memo include:

• There is a complete lack of oversight when the lethal dose is administered (even if the patient struggled, who would know?) 
• The bill requires falsification of the death certificate to reflect a natural death.  The significance is a lack of transparency and an inability to prosecute even in a case of outright murder.
• B21-38 will likely legalize assisted suicide and euthanasia for young adults with chronic conditions such as diabetes. 

Even if you like the concept of assisted suicide and euthanasia, B21-38 is the wrong bill.

* * *

Thank you to everyone who donated and helped me to get this done. Please consider a generous donation to continue to make this work possible. Thank you again.

Margaret Dore, Esq., MBA

Law Offices of Margaret K. Dore, P.S

Choice is an Illusion, a nonprofit corporation.

www.margaretdore.com

www.choiceillusion.org

1001 4th Avenue, Suite 4400

Seattle, WA 98154

Laws allowing assisted suicide can have far-reaching impact

http://newsok.com/laws-allowing-assisted-suicide-can-have-far-reaching-impact/article/5434390/?page=2

The Oklahoman Editorial Board Published: July 20, 2015

Advertisement

AN effort to legalize “assisted suicide” in California has been put on hold. The rationales that caused California lawmakers to rethink the proposal deserve attention elsewhere.

This is especially true of arguments put forth by Dr. Aaron Kheriaty, a psychiatrist who is director of the Program in Medical Ethics at the University of California Irvine. Proponents of assisted suicide portray it as a humane solution for people in the last stages of painful, debilitating, terminal illnesses. But in a letter sent to California lawmakers, Kheriaty demonstrated that such laws can lead to death for a far wider, and often healthier, population.

"Big Business" and Assisted Suicide

By Margaret Dore, Esq., MBA*

Assemblyman Roger Hernandez was recently quoted as concerned that big business would use California's assisted suicide proposal, SB 128, to "guide people in that direction," meaning early death via a lethal overdose.

This is a valid concern.

I am an attorney in Washington State where assisted suicide is legal. Our law is based on a similar law in Oregon. Both laws are similar to SB 128, which seeks to legalize assisted suicide and euthanasia in California.

In Oregon, it is well documented that Oregon's Medicaid program uses coverage incentives to steer people to suicide.  See Affidavit of Oregon doctor, Ken Stevens, pp 3-4 athttps://maasdocuments.files.wordpress.com/2014/08/dr-stevens-affidavit_001.pdf  With legal assisted suicide, private health plans have this same ability.  Dr. Stevens states:

If assisted suicide is legalized in [your state], your government health plan could follow a similar pattern.  Private health plans could also follow this pattern.  If so, these plans would pay for you and/or your family to die, but not to live.  (Emphasis added).

Id, ¶16.

Dr. Stevens also notes that the mere presence of legal assisted suicide steers people to suicide, which was the case with his patient Jeanette Hall.  Her cancer treatment was fully covered, but with the existence of Oregon's law, she nonetheless became adamant that she would kill herself.  Dr. Stevens convinced her to be treated instead.  (Affidavit, ¶¶ 5-9).  She is alive today, fifteen years later.

As for Assemblyman Hernandez's specific "big business concern," in 2013, a Montana State Senator made a similar observation:

I found myself wondering, Where does all the lobby money come from?  If it really is about a few terminally ill people who might seek help ending their suffering, why was more money spent on promoting assisted suicide than any other issue in Montana?

Could it be that convincing an ill person to end their life early will help health insurance companies save a bundle on what would have been ongoing medical treatment?  How much would the government gain if it stopped paying social security, Medicare, or Medicaid a few months early? [it could actually be years earlier].  How much financial relief would pension systems see?  Why was the proposed law to legalize assisted suicide [SB 220] written so loosely?  Would vulnerable old people be encouraged to end their life unnecessarily early by those seeking financial gain? 

http://www.montanansagainstassistedsuicide.org/2013/06/beware-of-vultures-senator-jennifer.html

Finally, there is the expansion issue. In Washington State, we have had informal "trial balloon" proposals to expand our law to non-terminal people. For me, the most disturbing one was in the Seattle Times, which is our largest paper. A column suggested euthanasia as a solution for people without funds in their old age, which could be any of us, say if the company pension plan went broke.**

Assemblyman Hernandez is right to be concerned about what could happen to his constituents if SB 128 is passed.

Don't let California make Washington and Oregon's mistake.  Urge your legislators to vote "NO" on SB 128.

///
             
* Margaret Dore is a former Law Clerk to the Washington State Supreme Court and the Washington State Court of Appeals.  She is a former Chair of the Elder Law Section of the ABA Family Law Committee.  She also worked for a year with the United States Department of Justice.  She is president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia.  To learn more, see www.margaretdore.com and www.choiceillusion.org

**  Jerry Large, "Planning for old age at a premium," The Seattle Times, March 8, 2012 ("After Monday's column, . . . a few [readers] 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.") (Emphasis added).https://choiceisanillusion.files.wordpress.com/2014/10/jerry-large_001.pdf

California: SB 128 Defeated!

SB 128 Defeated!

The bill did not have the votes to go forward in Committee, and is reportedly dead for the year.

Special thanks to Nina Rhea, Mike Hodas and everyone else who went the extra mile to defeat the bill.

THANK YOU!

Margaret Dore

Minnesota: Vote "NO" on SF 1880!

Here is a memo with attachments in opposition to SF 1880, which seeks to legalize assisted suicide and euthanasia in Minnesota.  Major points include:

• There is no oversight at the death (even if the patient struggled, who would know?).
• The death certificate will be falsified to reflect a natural death via a terminal disease (reducing transparency, and more importantly, preventing prosecution even in the case of outright murder)
• "Eligible" people may have years, even decades, to live (people are encouraged to throw away their lives)

Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, P.S
Choice is an Illusion, a non-profit corporation
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, Suite 4400
Seattle, WA  98154
206 389 1754

Legalize Doc Decides

Belgian GPs 'killing patients who have not asked to die': Report says thousands have been killed despite not asking their doctor 

http://www.dailymail.co.uk/news/article-3120835/Belgian-GPs-killing-patients-not-asked-die-Report-says-thousands-killed-despite-not-asking-doctor.html   Steve Doughty, Social Affairs Correspondent for the Daily Mail

Published: 18:49 EST, 11 June 2015 | Updated: 19:00 EST, 11 June 2015

Thousands of elderly people have been killed by their own GPs without ever asking to die under Belgium’s euthanasia laws, an academic report said yesterday.

It said that around one in every 60 deaths of a patient under GP care involves someone who has not requested euthanasia.

Half of the patients killed without giving their consent were over the age of 80, the study found, and two thirds of them were in hospital and were not suffering from a terminal disease such as cancer.

In about four out of five of the cases, the death was not discussed with patients subjected to ‘involuntary euthanasia’ because they were either in a coma, they were diagnosed with dementia, or because doctors decided it would not be in their best interests to discuss the matter with them.

Very often doctors would not inform the families of plans to lethally inject a relation because they considered it a medical decision to be made by themselves alone, the report published by the Journal of Medical Ethics said.

Great News! Delaware Bill Tabled in Committee

Great News!

A Delaware State Representative just wrote me that their assisted suicide proposal, HB 150,  was tabled today in Committee.  (The bill is stuck in committee).

For more information, please go here:  http://legis.delaware.gov/

Margaret Dore

Delaware Talking Points

1.  HB 150 legalizes assisted suicide for persons with a "terminal disease," which is defined as having less than six months to live.  In Oregon, 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.  Consider also, Jeanette Hall, who was adamant that she would do assisted suicide, but was convinced to be treated instead.  Today, nearly 15 years later, she is "thrilled to be alive."  See  http://www.montanansagainstassistedsuicide.org/2013/04/if-kress-had-been-my-doctor-in-2000-i_27.html

2.  In Oregon, it is well-documented that Medicaid steers people to suicide through coverage incentives.  Private insurers have this same ability.  For more information, see the affidavit of Kenneth Stevens, MD, at this link:  https://maasdocuments.files.wordpress.com/2014/08/dr-stevens-affidavit_001.pdf

3.  Legalization of assisted suicide is a recipe for elder abuse. Once the lethal dose is issued by the pharmacy, there is no oversight.  Even if the patient struggled, who would know?

4.  In Oregon, other (conventional) suicides have increased significantly with the legalization of physician-assisted suicide.  In Oregon, conventional suicides are a $41 million problem due to hospitalization costs, etc.  See http://www.choiceillusion.org/2014/03/the-high-financial-cost-of-regular.html  Legalization, regardless, sends the wrong message to young people that suicide is an acceptable solution to life's problems.

For a short article about Washington's similar law, please go here: https://www.kcba.org/newsevents/barbulletin/BView.aspx?month=05&Year=2009&AID=article5.htm

Attorney slams California suicide bill

FOR IMMEDIATE RELEASE

Dore: “Even if you like the concept of assisted suicide, SB 128 is the wrong bill.”

Contact: Margaret Dore (206) 697-1217

Seattle, WA -- Attorney Margaret Dore, president of Choice is an Illusion, which has fought assisted suicide legalization efforts in many states and now California, made the following statement after the California Senate Appropriations Committee passed SB 128 on May 28, sending the assisted suicide bill to the Senate floor.

"SB 128 is sold as giving people an 'end of life option,’” Dore said. “The fact is this bill is about ending the lives of people who aren’t necessarily dying anytime soon, and giving other people the ‘option’ to hurry them along."

Dore, an attorney in Washington State where assisted suicide is legal, explained, “In my law practice, I started out working in guardianships, wills and probate, and saw abuse of all kinds, especially where there was money involved (where there's a will, there are heirs). Then, in 2008, I got dragged to a meeting about our assisted suicide law and saw the perfect crime: your heir could help sign you up, and once the lethal dose was in the house, there was no oversight. Not even a witness is required. If you struggled, who would know?"

Great News! Scottish Assisted Suicide Bill Defeated 82 to 36

A Scottish assisted suicide bill has been defeated in its parliament: 82 - 36.[1]

http://www.thecourier.co.uk/news/scotland/critics-blast-assisted-suicide-bill-1.878651

The Bill would have allowed those with terminal or life-shortening illnesses to end their suffering with the assistance of another person, known as a "licensed facilitator".

It is being championed by Green MSP Patrick Harvie following the death of independent MSP Margo MacDonald in April 2014.

Alison Britton, convener of the Law Society's health and medical law committee, said the organisation was concerned that the Bill lacked clarity and would be difficult to enforce.

She said: "We have said throughout the passage of this Bill that legislation in this area needs to be absolutely clear and those seeking to end their lives, and those who assist them, need a robust and transparent process to be certain under which conditions it would be lawful for assistance to be provided.

"We remain concerned over the lack of definition of the key terms, such as 'assistance' and 'life-shortening' and the functions of the licensed facilitator are still uncertain.

"Lack of such clarity leads to ambiguity and leaves the legislation open to interpretation."

* * *

[1] Alex Schadenberg, at http://alexschadenberg.blogspot.com/

Assisted Suicide: How One Woman Chose to Die, Then Survived

http://dailysignal.com/2015/05/18/assisted-suicide-how-one-woman-chose-to-die-then-survived/

Kelsey Harkness / May 18, 2015

In 1994, Jeanne Hall, a resident of King City, Ore., voted in favor of Ballot Measure 16, which for the first time in the United States, would allow terminally ill patients to end their own lives through physician-assisted suicide.

“I thought, hey, I wouldn’t want anyone to suffer,” Hall told The Daily Signal. “So I checked it. Then it became legal.”

That day at the ballot box, Hall never could have predicted that more than 15 years later, she would be diagnosed with inoperable colon cancer.

Doctors gave Hall, who was 55 at the time, two options: She could get radiation and chemotherapy and attempt to fight the cancer, or she could take a lethal dose of barbiturates to end her life.

“I was calling it over,” she said. “I wasn’t going to do chemo. When I heard what might take place in radiation "I wasn’t going to do it. I looked for the easy way out.”

Without treatment, Hall was given six months to a year to live, and therefore qualified for physician-assisted suicide through Oregon’s Death With Dignity law.

“She was terminal because she was refusing treatment,” Dr. Kenneth Stevens, one of Hall’s two cancer doctors, told The Daily Signal. “It’s like a person could be considered terminal if they’re not taking [their] insulin or [other] medications.”

Final Exit Network, Inc. Guilty in Assisting With Suicide

​Dakota County Attorney James Backstrom announced that a Dakota County Jury has found Final Exit Network, Inc. guilty of Assisting Another to Commit Suicide and Interference with a Dead Body or Death Scene in connection with assisting Doreen Dunn in committing suicide on May 30, 2007 at her home in Apple Valley. The jury deliberated for less than two hours.  Judge Christian Wilton set the sentencing date for August 24, 2015 at 9:00 a.m. in Hastings.  

Additional facts pertaining to this case can be found online at: Criminal Complaint Search. To view prior news releases, go to: Attorney News Releases.

Backstrom commented:  “What Final Exit Network does in aiding individuals suffering from serious medical conditions who, like Doreen Dunn, are not terminally ill but are extremely vulnerable or depressed, in taking their own lives and then covering up the truth about what occurred to the victim’s family, the medical examiner and law enforcement, is not only legally wrong it is morally reprehensible.  We are pleased to have brought this organization to justice for these crimes.”

Backstrom thanked the Apple Valley Police Department and the Georgia Bureau of Investigation who aided in the investigation of this case.  Backstrom also thanked Assistant County Attorney Elizabeth Swank and Chief Deputy Phil Prokopowicz who prosecuted the case.

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.