Persons Living With HIV/AIDS: Is This What You Want? To be Just Like Us?

By Margaret Dore, Esq.

Some HIV/AIDS groups have endorsed Ballot Question 2, which seeks to legalize assisted suicide in Massachusetts via a proposed act.  This post suggests that these groups and/or persons living with HIV/AIDS should give the issue a second look. 

1.  "Terminal" Does Not Mean "Dying" 

The proposed act applies to persons with a "terminal disease," defined in terms of less than six months to live.[1]  In Oregon, where there is a similar act, the six months to live is determined without requiring treatment.[2] 

In other words, a person living with HIV/AIDS, who is doing well, but who is dependent on treatment to live, is "terminal" for the purpose of assisted suicide eligibility. 

2.  The Significance of a Terminal Label

Once someone is labeled "terminal," an easy justification can be made that his or her treatment should be denied in favor of someone more deserving.  In Oregon, "terminal" patients are not only denied treatment, they are offered assisted suicide instead.  In a recent affidavit, Oregon doctor Ken Stevens states:

"9.  Under the Oregon Health Plan, there is . . .  a financial incentive towards suicide because the Plan will not necessarily pay for a patient’s treatment.  For example, patients with cancer are denied treatment if they have a "less than 24 months median survival with treatment" and fit other criteria. . . . 

12. All such persons . . .  will . . . be denied treatment. Their suicides under Oregon’s assisted suicide act will be covered."[3]

Dr. Stevens concludes:

"14. The Oregon Health Plan is a government health plan administered by the State of Oregon. If assisted suicide is legalized in [your jurisdiction], your government health plan could follow a similar pattern. If so, the plan will pay for a patient to die, but not to live."[4]

3.  Barbara Wagner and Randy Stroup

In Oregon, the most well known persons denied treatment and offered suicide are Barbara Wagner and Randy Stroup.[5]  Neither saw this event as a celebration of their "choice."  Wagner said: "I'm not ready to die."[6]  Stroup said: "This is my life they’re playing with."[7] 

4.  Proposals for Expansion

I live in Washington State, where assisted suicide is legal under an act passed in 2008.[8]  Four years later, there have already been proposals to expand our act to non-terminal people.[9]  Moreover, this year, there was a Seattle Times column suggesting euthanasia as a solution for people unable to afford care, which would be involuntary euthanasia for those persons who want to live.[10]

Prior to our law's being passed, I never heard anyone talk like this.

Is this what you want?

To be just like us?

Legal assisted suicide puts anyone with a significant health condition at risk of being steered to suicide.  For other reasons to vote against assisted suicide, please click here for talking points.  I hope that AIDS groups and people living with AIDS reconsider any support of Ballot Question No. 2.  Thank you.

* * *

Margaret Dore is a lawyer in Washington State where assisted suicide is legal. She is also President of Choice is an Illusion, a non-profit corporation opposed to assisted suicide and euthanasia.  Ms. Dore has been licensed to practice law since 1986. She is a former Law Clerk to the Washington State Supreme Court. She has several published court cases and many published scholarly articles. Her viewpoint is that people should be in control of their own fates, but that assisted suicide laws do not deliver. This year, she had an editorial published in the NY Times: "Assisted Suicide: A Recipe for Elder Abuse." For more information see www.margaretdore.com and www.choiceillusion.org

The Oregon Health Plan Steers Patients to Suicide

Yesterday, the Canadian Department of Justice filed evidence in Leblanc v. Canada, including the affidavit of Oregon doctor Ken Stevens.  Therein, Dr. Stevens talks about his patient, Jeanette Hall.  He also describes how with legal assisted suicide, the Oregon Health Plan steers patients to suicide.  His affidavit concludes:

"The Oregon Health Plan is a government health plan administered by the State of Oregon. If assisted suicide is legalized in Canada, your government health plan could follow a similar pattern. If so, the plan will pay for a patient to die, but not to live."

Please find the full text of his affidavit below.  To view a hard copy of his affidavit with supporting documentation, click here.  

New England Journal of Medicine Article Misleading

Dear Editor:

I am a lawyer in Washington State, one of two states where assisted-suicide is legal.  The other state is Oregon, which has a similar law.  Lisa Lehmann's article, "Redefining Physicians' Role in Assisted Dying," is misleading regarding how these laws work.

First, the Oregon and Washington laws are not limited to people in their "final months" of life.[1,2]  Consider for example, Jeanette Hall, who in 2000 was persuaded by her doctor to be treated rather than use Oregon's law.  She is alive today, twelve years later.[3]

Second, these laws are not "safe" for patients.[4][5]  For example, neither law requires a witness at the death.  Without disinterested witnesses, the opportunity is created for the patient's heir, or someone else who will benefit from the patient's death, to administer the lethal dose to the patient without his consent.  Even if he struggled, who would know?  

Third, the fact that persons using Oregon's law are "more financially secure" than the general population is consistent with elder financial abuse, not patient safety.  Do not be deceived. 

* * *

[1]  Margaret K. Dore, "Aid in Dying: Not Legal in Idaho; Not About Choice," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 18-20, September 2010, available at http://www.margaretdore.com/pdf/Not_Legal_in_Idaho.pdf.
[2]  Kenneth Stevens, MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 16-17, September 2010, available athttp://www.margaretdore.com/info/September_Letters.pdf 
[3]  Ms. Hall corresponded with me on July 13, 2012.
[4]  See article at note 1.  See also Margaret Dore, "Death with Dignity": A Recipe for Elder Abuse and Homicide (Albeit Not by Name)," at 11 Marquette Elder's Advisor 387 (Spring 2010), original and updated version available at http://www.choiceillusion.org/p/the-oregon-washington-assisted-suicide.html 
[5]  Blum, B. and Eth, S.  "Forensic Issues: Geriatric Psychiatry." InKaplan and Sadock's Comprehensive Textbook of Psychiatry, Seventh Edition, B. Sadock and V. Sadock editors.  Baltimore, MD: Lippincott, Williams and Wilkins, pp. 3150-3158, 2000. 

Ken Stevens MD: "legalizing assisted suicide can result in decreased patient choice"

Assisted Suicide
http://www.sltrib.com/sltrib/opinion/53280042-82/suicide-patients-assisted-oregon.html.csp

Updated Jan 19, 2012 01:01AM

Patty Henetz' "Do Utahns have the right to choose how they die?" (Tribune, Jan. 8) refers to the legalization of assisted suicide in Oregon. Utahns should understand that legalizing assisted suicide can result in decreased patient choice.

I have been a cancer doctor in Oregon for more than 40 years. The combination of assisted-suicide legalization and prioritized medical care based on prognosis has created a danger for my patients on the Oregon Health Plan (Medicaid).

The plan limits medical care and treatment for patients with a 5 percent or less likelihood of surviving five years. Patients in that category who have a good chance of living another three years and who want to live cannot receive surgery, chemotherapy or radiation therapy. However, the plan will cover the patient's suicide.

Oregon law says only patients with no more than six months to live are eligible for voluntary suicide, but the plan nonetheless offers suicide to patients in this category.

The mere presence of legal assisted suicide steers patients toward suicide. One patient was adamant to use the law. I convinced her to be treated. Eleven years later she is thrilled to be alive.

Kenneth Stevens, M.D.

Sherwood, Ore.