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
Monday, February 10, 2014
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
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.
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.
Tuesday, January 28, 2014
Oregon's new assisted suicide report: chronic conditions; people with money and more
By Margaret Dore, Esq.
Updated February 19, 2014
Updated February 19, 2014
Per the report, most of the people who died from a lethal dose were white, aged 65 or older, and well-educated. See note [7]. People with these attributes are typically well off, i.e., the middle class and above. The report's introduction implies that their deaths were voluntary, stating that Oregon's act "allows" residents to obtain a lethal dose for self-administration. There is, however, nothing in the report stating that the specific deaths described in the report were self-administered and/or voluntary.[8] Older well-off people are, regardless, in a vulnerable demographic for abuse and exploitation. This includes murder. A 2009 MetLife Mature Market Institute Study states:
"Elders’ vulnerabilities and larger net worth make them a prime target for financial abuse . . . Victims may even be murdered by perpetrators who just want their funds and see them as an easy mark."[9]Oregon's act was passed in 1997.[10] Just three later, Oregon's suicide rate for other suicides was "increasing significantly."[11] Last year, an article in Oregon's largest paper reported:
"New figures show a sharp rise in suicides among middle-aged Americans, and an even bigger increase in Oregon. A Centers for Disease Control and Prevention report shows suicides among men and women aged 35-64 increased 49 percent in Oregon from 1999-2010, compared to 28 percent nationally."[12]This "significant increase" is consistent with a suicide contagion in which legalizing one type of suicide encouraged other suicides.[13]
The new Oregon report also lists "concerns" as to why the people who died requested the lethal dose.[14] The data for these concerns is originally generated by the prescribing doctor who uses a check-the-box form developed by suicide proponents.[15] One listed concern is "inadequate pain control or concern about it."[16] There is, however, no claim that anyone who ingested the lethal dose was actually in pain.[17]
A copy of Oregon's new report can be viewed at this link: http://choiceisanillusion.files.wordpress.com/2014/01/year16-2013.pdf For more information, please see the footnotes below.
Margaret Dore is an attorney in Washington State where assisted suicide is legal. She is President of Choice is an Illusion, a human rights organization opposed to assisted suicide and euthanasia. She is one of the attorneys of record in the Montana assisted suicide case, Montanans Against Assisted Suicide (MAAS) v. Montana Board of Medical Examiners. The case has already resulted in the removal of an official policy statement implying that assisted suicide is legal in Montana. For more information, please click here. Funds are needed for an upcoming appeal to the Montana Supreme Court. Please consider a generous donation to MAAS and/or Choice is an Illusion, by clicking here and/or here. Thank you.
[1] Oregon's Death with Dignity Act-2013, available at http://choiceisanillusion.files.wordpress.com/2014/01/year16-2013.pdf
[2] Id., Report, page 2, first paragraph and footnote 1.
[3] Id., Report, page 6 (underlying illness, listing chronic conditions such as "chronic lower respiratory disease" and "other illnesses"). See also page 7, footnote 6 (listing "diabetes mellitus").
[4] See e.g., Opinion letter of and Dr. Richard Wonderly and Attorney Theresa Schrempp (regarding a young adult with diabetes and other chronic conditions such as HIV/AIDS, "each of these patients could live for decades"), available at http://choiceisanillusion.files.wordpress.com/2012/07/schrempp_wonderly_opn_ltr1.pdf
[5] See Affidavit of Ken Stevens MD, available at: http://choiceisanillusion.files.wordpress.com/2013/07/signed-stevens-aff-9-18-12-as-filed.pdf See also, Affidavit of Jeanette Hall, available at: http://choiceisanillusion.files.wordpress.com/2013/05/jeanette-hall-affidavit.pdf
[6] Id.
[7] Report at note 1, page 2, last full paragraph.
[8] Id..As a further explanation, the report page 1 says that Oregon's Act (DWDA) "allows" terminally ill Oregonians to self-administer the lethal dose. Nothing says that administration "must" be by self-administration. Self-administration can also be non-voluntary, for example, if the patient was under a threat of harm to a pet, or incapacitated, say due to alcohol. The rest of the report, pages 2-7 talks about the patient's "ingestion" of the lethal dose, which could also be voluntary, non-voluntary or involuntary. For more information about the term "ingestion," see Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, at https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm. See also Margaret Dore, "'Death with Dignity': A Recipe for Elder Abuse and Homicide (Albeit not by Name)," Marquette Elder's Advisor, Vol. 11, No. 2, Spring 2010, pp. 391-2, available at http://choiceisanillusion.files.wordpress.com/2014/01/dore-marquette-law-review-article.pdf
[9] MetLife, "Broken Trust: Elders, Family and Finances," 2009, at https://www.metlife.com/mmi/research/broken-trust-elder-abuse.html#findings
[10] Oregon's Death with Dignity Act Report at note 1, supra, page 2, paragraph 2.
[11] News Release, "Rising suicide rate in Oregon reaches higher than national average," Christine Stone, Oregon Public Health Information Officer, Oregon Health Authority, September 9, 2010.
http://choiceisanillusion.files.wordpress.com/2014/01/rising-suicide-rate-in-oregon.pdf
[12] David Stabler, "Why Oregon's suicide rate is among highest in the country, " The Oregonian, May 15, 2013, at http://blog.oregonlive.com/living_impact/print.html?entry=/2013/05/why_oregons_suicide_rate_is_am.html
[13] http://en.wikipedia.org/wiki/Suicide_contagion
[14] Report at note 1, page 6 (middle of page)
[15] The check-the-box form is Question 15 of the Oregon Death with Dignity Act Attending Physician Follow-up Form, page 5, available at http://choiceisanillusion.files.wordpress.com/2014/01/attending-physician-follow-up-form.pdf
[16] Report at note 1, page 6 (middle of page).
[17] Id, entire report.
Monday, January 27, 2014
A Legislator's Question
By Margaret Dore, Esq.
Updated February 5, 2014
Updated February 5, 2014
A legislator considering an assisted suicide law asked me this question: "Is there a way to allow a person to end his life without making someone else a criminal?"
This was my (slightly edited) response:
People take their lives all the time. One of my cousins shot himself and another threw himself in front of a train. There was no criminality involved. Also, if people are in pain, palliative care laws allow medical personnel to give patients copious amounts of drugs, including up to sedation, which can hasten the patient's death. This is the principal of double effect. This is legal. For more information, read the Affidavit of Kenneth Stevens, MD, page 3, paragraph 13.
There is also palliative care abuse in which no one seems to be held accountable, except for maybe one case in California where doctors relied on a wealthy patient's daughters, who said that their father was really bad off and didn't want treatment, which was not the case. At least, that's what's claimed by the man's son. See William Dotinga, "Grim Complaint Against Kaiser Hospital," Court House News Service, February 6, 2012.
I've had like 15-20 contacts in the past year by people upset about their family member being suddenly off'd by medical personnel and/or having DNR's put on family members/friends without the patient's consent. My caregiver friends also talk about guarding their patients in the hospital. Here are some letters from Montana. http://www.montanansagainstassistedsuicide.org/2013/04/dont-give-doctors-more-power-to-abuse.html
Here's a letter from Washington State where assisted suicide is legal. The letter talks about doctors being quick with the morphine and also regarding the conduct of an adult son shortly after our assisted suicide law was passed ("an adult child of one of our clients asked about getting the pills [to kill the father]. It wasn't the father saying that he wanted to die"). http://www.montanansagainstassistedsuicide.org/2012/07/dear-montana-board-of-medical-examiners.html Here's a letter from a wife about how she was afraid to leave her husband alone after a doctor pitched assisted suicide to her husband. http://www.montanansagainstassistedsuicide.org/2013/01/i-was-afraid-to-leave-my-husband-alone.html
There is also the issue that people who say they want to die don't mean it, as with any suicide. See http://www.montanansagainstassistedsuicide.org/p/what-people-mean-when-they-say-they.html
I've had two clients whose fathers signed up for the Oregon/Washington assisted suicide acts. With the first case, one side of the family wanted the father to use the act and the other side didn't. He spent the last months of his life torn over whether of not he should kill himself. His daughter was also traumatized. He died a natural death. There is a Swiss study that you might be interested in, that 1 out of 5 family members were traumatized by witnessing the legal assisted suicide of a family member. See http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf
In my other case, the father had two suicide parties and it's not clear that it was voluntary. My client, his son, was told that his dad had said "You're not killing me, I'm going to bed"). Regarding the next day, my client was told that his dad was already high on alcohol when he drank the lethal dose. But then the person telling him this changed his story. In Montana, Senator Jeff Essman, made a relevant observation regarding this point:
I, however, doubt that a person in Oregon could be prosecuted. If you read the act carefully, there is no requirement of patient consent to administration of the lethal dose, and to the extent that's ambiguous, there's the rule of lenity. In Washington State, prosecutors are required to report assisted suicide deaths as "Natural" - no matter what - at least, that's what the regulation says: http://www.doh.wa.gov/portals/1/Documents/5300/DWDAMedCoroner.pdf How can you prosecute someone for homicide if the death is required to be reported as "Natural?"
Here in Washington, we have already had some informal proposals to expand the scope of our assisted suicide act. One in particular disturbed me. A Seattle Times column suggested euthanasia as a solution for people unable to support themselves, which would be involuntary euthanasia. See Jerry Large, "Planning for old age at a premium," March 8, 2012, which states:
As a Democrat, I see us as looking out for the little guy, not passing laws to protect perpetrators, healthcare systems, etc. from legitimate claims. I hope that you will vote against any effort to legalize assisted suicide/euthanasia.
Thank you for writing me back.
Margaret Dore
People take their lives all the time. One of my cousins shot himself and another threw himself in front of a train. There was no criminality involved. Also, if people are in pain, palliative care laws allow medical personnel to give patients copious amounts of drugs, including up to sedation, which can hasten the patient's death. This is the principal of double effect. This is legal. For more information, read the Affidavit of Kenneth Stevens, MD, page 3, paragraph 13.
There is also palliative care abuse in which no one seems to be held accountable, except for maybe one case in California where doctors relied on a wealthy patient's daughters, who said that their father was really bad off and didn't want treatment, which was not the case. At least, that's what's claimed by the man's son. See William Dotinga, "Grim Complaint Against Kaiser Hospital," Court House News Service, February 6, 2012.
I've had like 15-20 contacts in the past year by people upset about their family member being suddenly off'd by medical personnel and/or having DNR's put on family members/friends without the patient's consent. My caregiver friends also talk about guarding their patients in the hospital. Here are some letters from Montana. http://www.montanansagainstassistedsuicide.org/2013/04/dont-give-doctors-more-power-to-abuse.html
Here's a letter from Washington State where assisted suicide is legal. The letter talks about doctors being quick with the morphine and also regarding the conduct of an adult son shortly after our assisted suicide law was passed ("an adult child of one of our clients asked about getting the pills [to kill the father]. It wasn't the father saying that he wanted to die"). http://www.montanansagainstassistedsuicide.org/2012/07/dear-montana-board-of-medical-examiners.html Here's a letter from a wife about how she was afraid to leave her husband alone after a doctor pitched assisted suicide to her husband. http://www.montanansagainstassistedsuicide.org/2013/01/i-was-afraid-to-leave-my-husband-alone.html
There is also the issue that people who say they want to die don't mean it, as with any suicide. See http://www.montanansagainstassistedsuicide.org/p/what-people-mean-when-they-say-they.html
I've had two clients whose fathers signed up for the Oregon/Washington assisted suicide acts. With the first case, one side of the family wanted the father to use the act and the other side didn't. He spent the last months of his life torn over whether of not he should kill himself. His daughter was also traumatized. He died a natural death. There is a Swiss study that you might be interested in, that 1 out of 5 family members were traumatized by witnessing the legal assisted suicide of a family member. See http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf
In my other case, the father had two suicide parties and it's not clear that it was voluntary. My client, his son, was told that his dad had said "You're not killing me, I'm going to bed"). Regarding the next day, my client was told that his dad was already high on alcohol when he drank the lethal dose. But then the person telling him this changed his story. In Montana, Senator Jeff Essman, made a relevant observation regarding this point:
"[All] the protections [in Oregon's law] end after the prescription is written. [The proponents] admitted that the provisions in the Oregon law would permit one person to be alone in that room with the patient. And in that situation, there is no guarantee that that medication is self-administered.
So frankly, any of the studies that come out of the state of Oregon's experience are invalid because no one who administers that drug . . . to that patient is going to be turning themselves in for the commission of a homicide."Senate Judiciary Hearing on SB 167 on February 10, 2011
I, however, doubt that a person in Oregon could be prosecuted. If you read the act carefully, there is no requirement of patient consent to administration of the lethal dose, and to the extent that's ambiguous, there's the rule of lenity. In Washington State, prosecutors are required to report assisted suicide deaths as "Natural" - no matter what - at least, that's what the regulation says: http://www.doh.wa.gov/portals/1/Documents/5300/DWDAMedCoroner.pdf How can you prosecute someone for homicide if the death is required to be reported as "Natural?"
Here in Washington, we have already had some informal proposals to expand the scope of our assisted suicide act. One in particular disturbed me. A Seattle Times column suggested euthanasia as a solution for people unable to support themselves, which would be involuntary euthanasia. See Jerry Large, "Planning for old age at a premium," March 8, 2012, which states:
"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)So, if you worked hard and paid taxes all your life and then your company pension plan goes belly up, this is how you want society to pay you back?
As a Democrat, I see us as looking out for the little guy, not passing laws to protect perpetrators, healthcare systems, etc. from legitimate claims. I hope that you will vote against any effort to legalize assisted suicide/euthanasia.
Thank you for writing me back.
Margaret Dore
Sunday, January 26, 2014
A response to the press: The wife would still be a victim. In Oregon, murder-suicide follows "the national pattern."
I am an attorney in Washington State where physician-assisted suicide is legal. I was disturbed by your article suggesting that legal assisted suicide would somehow prevent murder-suicides.
A ccording to Donna Cohen, a professor of psychiatry and behavioral sciences, the typical murder-suicide case involves a depressed controlling husband who shoots his ill wife. "The wife does not want to die and is often shot in her sleep. If she was awake at the time, there are usually signs that she tried to defend herself."
The typical wife in these cases does not "choose" her death. She is a victim of spousal abuse. Legal assisted suicide, regardless, fails to guarantee "choice." These laws instead empower doctors, family members and new "best friends" to legally pressure people to take their lives. See Margaret K. Dore, "'Death with Dignity,' What Do we Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009.
In Oregon where assisted-suicide has been legal since 1997, murder-suicide has not been eliminated.[1] Indeed, murder-suicide follows "the national pattern."[2] The suggestion that legal assisted suicide prevents murder-suicide is without factual support.
For information about problems with legalization, please see this link: http://www.choiceillusion.org/2013/11/quick-facts-about-assisted-suicide_11.html
Thank you for your consideration. (the cited footnotes are below my signature block)
Margaret Dore, Esq. and President
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, 44th Floor
Seattle, WA 98154
***
[1] See Don Colburn, "Recent murder-suicides follow the national pattern," The Oregonian, November 17, 2009 ("In the span of one week this month in the Portland area, three murder-suicides resulted in the deaths of six adults and two children"), available at http://www.oregonlive.com/health/index.ssf/2009/11/recent_murder-suicides_follow.html ; "Murder-suicide suspected in deaths of Grants Pass [Oregon] couple," Mail Tribune News, July 2, 2000 (regarding husband, age 77, and wife, age 76) at http://archive.mailtribune.com/archive/2000/july/070200n6.htm; and Colleen Stewart, "Hillsboro [Oregon] police investigating couple's homicide and suicide," The Oregonian, July 23, 2010 ("Wayne Eugene Coghill, 67, shot and killed his wife, Nyla Jean Coghill, 65, before taking his own life in their apartment"), at http://www.oregonlive.com/hillsboro/index.ssf/2010/07/hillsboro_police_investigating_homicide_and_suicide.html.
[2] See Don Colburn above.
The typical wife in these cases does not "choose" her death. She is a victim of spousal abuse. Legal assisted suicide, regardless, fails to guarantee "choice." These laws instead empower doctors, family members and new "best friends" to legally pressure people to take their lives. See Margaret K. Dore, "'Death with Dignity,' What Do we Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009.
Thank you for your consideration. (the cited footnotes are below my signature block)
Margaret Dore, Esq. and President
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, 44th Floor
Seattle, WA 98154
***
[1] See Don Colburn, "Recent murder-suicides follow the national pattern," The Oregonian, November 17, 2009 ("In the span of one week this month in the Portland area, three murder-suicides resulted in the deaths of six adults and two children"), available at http://www.oregonlive.com/health/index.ssf/2009/11/recent_murder-suicides_follow.html ; "Murder-suicide suspected in deaths of Grants Pass [Oregon] couple," Mail Tribune News, July 2, 2000 (regarding husband, age 77, and wife, age 76) at http://archive.mailtribune.com/archive/2000/july/070200n6.htm; and Colleen Stewart, "Hillsboro [Oregon] police investigating couple's homicide and suicide," The Oregonian, July 23, 2010 ("Wayne Eugene Coghill, 67, shot and killed his wife, Nyla Jean Coghill, 65, before taking his own life in their apartment"), at http://www.oregonlive.com/hillsboro/index.ssf/2010/07/hillsboro_police_investigating_homicide_and_suicide.html.
[2] See Don Colburn above.
Saturday, January 25, 2014
Montana board forced to remove position statement. Help us make it permanent & overturn Baxter
For the last three years, Montanans Against Assisted Suicide (MAAS) has been an integral player in keeping assisted suicide from becoming legal in Montana. Most recently, MAAS has been prosecuting a lawsuit against the Montana Board of Medical Examiners. The suit has already caused the Board to remove a position statement implying that assisted suicide "may" be legal in Montana.
The lawsuit, however, has also been dismissed due to the Board's removal of the position statement. See court order here. If MAAS does not appeal by February 11, 2014 , there will be nothing to stop the Board from re-issuing its statement, or a worse statement, the very next day. Appeal will also allow MAAS to challenge the Baxter decision, which proponents claim legalized assisted suicide in Montana. A MTN News article describes the situation, as follows:
Problems with legal assisted suicide include that it encourages people with years to live, to throw away their lives. Legalization also creates new opportunities for elder abuse, for example, when there is an inheritance involved. In Oregon, legalization has enabled Oregon's Medicaid program to offer the "treatment" of suicide in lieu of desired treatments (to improve the quality of life, to extend life or to cure).
For more information, please click here.
MAAS's attorney, Margaret Dore, who is also President of Choice is an Illusion, is donating her time. Choice is an Illusion has also provided financial support for the MAAS lawsuit. Ongoing funds are, however, needed to pay for the rest of MAAS's legal team including the Charlton Law Firm and for out of pocket expenses such as transcripts, computer research and court fees. We are asking for your support as your finances allow. Any amount is appreciated.
Choice is an Illusion is proud to have been part of MAAS' victory to force this action by the Board. Please donate directly to MAAS, or to Choice is an Illusion as set forth below:
Please make checks payable to: MAAS, 610 North 1st St. Suite 5-285, Hamilton, MT 59840, or to Choice is an Illusion, 1001 4th Avenue, 44th Floor, Seattle, WA 98154
Please donate online by clicking here or here.
Thank you for your support.
The lawsuit, however, has also been dismissed due to the Board's removal of the position statement. See court order here. If MAAS does not appeal by February 11, 2014 , there will be nothing to stop the Board from re-issuing its statement, or a worse statement, the very next day. Appeal will also allow MAAS to challenge the Baxter decision, which proponents claim legalized assisted suicide in Montana. A MTN News article describes the situation, as follows:
[The] position paper - in response to the lawsuit - has since been rescinded by the Board and scrubbed from its website. But [MAAS's attorney, Margaret] Dore said court action was still needed to prevent the Board from reinstating such a position.
She repeatedly asked District Judge Mike Menahan to weigh in on a Montana Supreme Court ruling known as Baxter, that envisions potential defenses to doctors charged with homicide for assisting with suicide.Sanjay Talwani, "Montana judge hears assisted suicide arguments," MTN News, December 11, 2013.
Problems with legal assisted suicide include that it encourages people with years to live, to throw away their lives. Legalization also creates new opportunities for elder abuse, for example, when there is an inheritance involved. In Oregon, legalization has enabled Oregon's Medicaid program to offer the "treatment" of suicide in lieu of desired treatments (to improve the quality of life, to extend life or to cure).
For more information, please click here.
MAAS's attorney, Margaret Dore, who is also President of Choice is an Illusion, is donating her time. Choice is an Illusion has also provided financial support for the MAAS lawsuit. Ongoing funds are, however, needed to pay for the rest of MAAS's legal team including the Charlton Law Firm and for out of pocket expenses such as transcripts, computer research and court fees. We are asking for your support as your finances allow. Any amount is appreciated.
Choice is an Illusion is proud to have been part of MAAS' victory to force this action by the Board. Please donate directly to MAAS, or to Choice is an Illusion as set forth below:
Please make checks payable to: MAAS, 610 North 1st St. Suite 5-285, Hamilton, MT 59840, or to Choice is an Illusion, 1001 4th Avenue, 44th Floor, Seattle, WA 98154
Please donate online by clicking here or here.
Thank you for your support.
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