Dore: "Legal assisted-suicide can be traumatic for patients and tear families apart”

Dear Assemblymembers:

I am a lawyer in Washington State where assisted-suicide is legal. Our law is similar to a law in Oregon. Both laws are similar to ABX2-15, scheduled for hearing tomorrow.

I had two clients whose fathers signed up for assisted-suicide. In the first case, one side of the family wanted the father to take the lethal dose, while the other did not. The father 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 client’s father refused to take the lethal dose when it was delivered (“You’re not killing me. I’m going to bed”), but then he took it the next night when he was high on alcohol.

Legal assisted-suicide can be traumatic for patients and tear families apart.

Kate Kelly: “Doctors are already abusing the power they have."

Dear Assemblymembers:

Please vote "No"on ABX2-15 (assisted suicide/euthanasia). Doctors are already abusing the power they have.  This bill, which will give doctors even more power to medically kill patients, can only make a bad situation worse.

In 2009, my mother died after a young doctor encouraged my brother, who held power of attorney, to begin “comfort care.”  My mother, who was NOT DYING, had had a mild stroke.  She had been trying to speak and had indicated that she would like some water.  Instead, on the order of this doctor, she was medically killed  (starved and dehydrated, with massive doses of morphine).

In that same year, I published my mother’s story . Since then, I have been contacted by other adult children in the US and Canada whose parents were  involuntarily killed via starvation, dehydration and overdose..

These involuntary deaths of people who were not dying are not isolated incidents.

Elizabeth Poiana to California Assembly: "“Older people are no longer valued.”

Dear Assemblymembers:

I am a college student in Washington State where assisted suicide is legal.

My mother is a caregiver.  I also  work as a caregiver for typically older people.

I am writing to tell you about how older people are now at risk in Washington State, 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.

Updated California Materials Against ABX2-15

To view new materials against ABX2-15, seeking to legalize physician-assisted suicide, click here.

If the document is "too big," click here and here for the memo and its appendix as separate documents.

Overview 

ABX2-15, the “End of Life Option Act,” seeking to legalize physician-assisted suicide in California is a recipe for elder abuse.  The bill is not limited to people who are dying.  Indeed, “eligible” persons can have years, even decades, to live.

In Oregon, which has a similar law, that state’s Medicaid program uses coverage incentives to steer people to suicide.  If ABX2-15 is enacted, California’s Medicaid program, as well as private insurers, will be able to engage in this same conduct.  Do you want this to happen to you or your family?

The bill has a myriad of other problems.  Please vote “No” on ABX2-15.

Prosecutor Press Release on FEN Sentencing in Minnesota; Charges Still Pending.

Final Exit Network, Inc. Sentenced in Assisting with Suicide.

8/24/15 

Dakota County Attorney James Backstrom announced that Final Exit Network, Inc. (FEN) was sentenced today by Judge Christian Wilton to a stay of execution of 21 months in prison (while a corporate entity cannot be sent to prison, under Minnesota law this sanction establishes that the offense is a felony) and 15 years of probation, and ordered to pay a fine of $30,000 and approximately $3,000 in restitution in connection with assisting Doreen Dunn in committing suicide on May 30, 2007, at her home in Apple Valley.  FEN will remain on probation until the fine and restitution is paid.  On May 14, 2015, a Dakota County Jury found Final Exit Network, Inc. guilty of Assisting Another to Commit Suicide and Interference with a Dead Body or Death Scene.

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

Final Exit Network Receives Maximum Sentence for Assisting Suicide

http://www.startribune.com/final-exit-network-fined-30-000-for-assisting-apple-valley-woman-s-suicide/322700141/

A Dakota County judge on Monday ordered Final Exit Network, a national right-to-die group, to pay a $30,000 fine and nearly $3,000 in funeral costs for assisting an Apple Valley woman’s 2007 suicide.

The sentence was the maximum Judge Christian S. Wilton could impose on the corporation for assisting a suicide.

Most States Have Rejected Assisted Suicide

In the last five years, four states have strengthened their laws against assisted suicide. These states are: Arizona, Idaho, Georgia and Louisiana.

In the last 30 days, courts in New Mexico and California have rejected assisted suicide. The  New Mexico Court of Appeals struck down a lower court ruling that had allowed physician-assisted suicide. A California trial court declined to legalize physician-assisted suicide, holding that California's law prohibiting physician-assisted suicide is constitution.

This year, there have been 25 plus proposals to legalize physician-assisted suicide in the United States, not one of which has passed.[1]

There are just three states were physician-assisted suicide is legal: Oregon; Washington; and Vermont.  In a fourth state, Montana, case law gives doctors who assist a suicide a defense to a homicide charge; the doctor can still be charged.  In both Montana and Vermont, there are active movements to eliminate assisted suicide.[2]

* * *
[1]  Death with Dignity National Center
[2]  In Montana, SB 202, which would have legalized physician-assisted suicide was defeated; HB 477, which would have reversed the court decision giving doctors a defense to a homicide charge, passed the House.  See http://www.montanansagainstassistedsuicide.org/2015/05/sb-202-dead.html and http://www.montanansagainstassistedsuicide.org/2015/03/hb-477-passes-house.html   See also www.truedignityvt.org

California's ABX2-15: Governor Not Impressed; Bill Is But A "New Number With the Same Song."

By Margaret Dore, Esq., MBA

Yesterday, the deceptively named Compassion & Choices unveiled its "new" deceptively named End of Life Option Act to great fanfare in a press credentialed only press conference.

Governor Jerry Brown has already weighed in that the present special session "is not the appropriate venue to consider the issue."

The new bill, ABX2-15, is in substance an old bill (SB 128) that was unable to make it out of committee.

AB 15 has some new provisions and puts some of the old bill's provisions in a different order. ABX2-15 is in substance the same bill as the old bill. Key points include:

• ABX2-15 applies to patients with a "terminal disease." In Oregon, which has a similar law, such persons include young adults with chronic conditions such as insulin dependent diabetes and chronic lower respiratory disease. People living with HIV/AIDS, who are dependent on their medication to live, also qualify as "terminal." Such persons can have years, even decades, to live. 

• Once a person is "labeled 'terminal,' an easy justification can be made that his or her treatment or coverage should be denied in favor of someone more deserving."[1] In Oregon, where assisted suicide is legal, patients are not only denied coverage for treatment, they are offered assisted suicide instead.[2] Well known cases are Barbara Wagner and Randy Stroup.[3]

• The bill remains a recipe for elder abuse in which the patient's heir, who will financially benefit from his or her death, is allowed to actively participate in signing the patient up for the lethal dose. This fact alone does not meet the "stink test." 

• Once the lethal dose is issued by the pharmacy, there is no oversight. Not even a witness is required at the death. If the patient struggled, who would know?

• The death certificate is required to be falsified to reflect a natural death. The significance is a lack of transparency and an inability to prosecute for murder even in a case of outright murder for the money.

ABX2-15 is but a new number with the same song. Don't be fooled.

To view a detailed legal/policy analysis of ABX2-15, please click on the following links: Executive summary and index; Memo; and Appendix/Attachments.

* * *

[1] Opinion Letter by Richard Wonderly MD and Attorney Theresa Schrempp, available at https://choiceisanillusion.files.wordpress.com/2012/07/schrempp_wonderly_opn_ltr1.pdf

[2] Id.
[3] Id.

Memo to the California State Assembly: "No" on SB 128

The original pdf version of this memo has an executive summary and index, which can be viewed here. The attachments can be viewed here.

I. INTRODUCTION.

I am an attorney in Washington State where assisted suicide is legal.[1] Our law is based on a similar law in Oregon. Both laws are similar to the proposed California bill, SB 128.[2] 

Enactment of SB 128 will create new paths of elder abuse. “Eligible” patients will include people with years, even decades, to live.  

I urge you to reject this measure. Do not make Washington’s and Oregon’s mistake.

New Mexico court strikes down ruling that allowed assisted suicide

http://www.washingtontimes.com/news/2015/aug/11/assisted-suicide-new-mexico-ruling-struck-higher-c/  By Valerie Richardson - The Washington Times - Tuesday, August 11, 2015

The New Mexico Court of Appeals handed a defeat to the right-to-die movement Tuesday by striking down a lower-court ruling establishing physician-assisted suicide.

The three-judge panel ruled 2-1 that the district court had erred when it determined that “aid in dying is a fundamental liberty interest.”

“We conclude that aid in dying is not a fundamental liberty interest under the New Mexico Constitution,” said Judge Timothy L. Garcia in the majority opinion.

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.”