'Death with Dignity' Imperils the Poor

Reprint from 2004

http://realchangenews.org/index.php/site/archives/9122

Last week’s article by an assisted suicide/euthanasia advocate struck me as a bizarre article  

for Real Change, which advocates for the dignity and self-determination of the poor. (“Terminally ill patients face shortage of right-to-die drug amid controversy over capital punishment,” Real Change, June 18, 2014)

Massachusetts Assisted Suicide Bill Dies in Committee!

From Second Thoughts, Massachusetts, People with Disabilities Opposing the Legalization of Assisted Suicide:

Today, the Joint Committee on Public Health, of the Massachusetts Legislature, "declined to advance H.1999 the latest assisted suicide bill, H 1991, euphemistically titled 'An act affirming a terminally ill patient's right to compassionate aid in dying.' Disability rights advocates, along with representatives from medicine and members of the public, testified and lobbied against the bill."

The written testimony of Margaret Dore, president of Choice is an Illusion, is summarized below:

H.1991 is similar to Ballot Question 2, which was defeated by a vote of the people in 2012. This memo and its attachments discuss why H.1991 is a recipe for elder abuse. Passage will also cause family trauma, and encourage people with years to live to throw away their lives....  Even if you are for the concept of assisted suicide, H.1991 is the wrong bill.

Thank you to everyone who helped make this defeat possible!

Please consider a generous donation to Second Thoughts, Choice is an Illusion or your local group fighting against the legalization of assisted suicide and euthanasia.

We are need your support!

Choice is an Illusion

South Africa: Dore Expert Witness Affidavit

Below, an excerpt from the expert witness affidavit of Attorney Margaret K. Dore, filed in the Supreme Court of Appeal of South Africa, SCA Case No: 531/2015. 

The affidavit, including attachments, can be viewed by clicking here.

The Oregon and Washington Acts

12.  The Oregon and Washington "Death with Dignity Acts" legalize physician-assisted suicide and euthanasia as those terms are traditionally defined. See memo, pp. 2-3 (regarding definitions)  at "MD."

Media Release: Carter has been proved wrong; new law needed to prohibit assisted suicide & euthanasia

FRIDAY, MAY 20, 2016

FOR IMMEDIATE RELEASE

Canada’s Bill C-14, which seeks to codify assisted suicide and euthanasia, is a recipe for elder abuse. Recommendations by the Senate Legal & Constitutional Affairs Committee do not solve the bill’s problems. The bill violates the Canadian Supreme Court case, Carter v Canada.  

Recent news stories have proven Carter wrong. This justifies a new look at the issue, including time for more study or a new law prohibiting euthanasia and assisted suicide. 

Margaret Dore Speaking to Australian Delegation

Margaret Dore, Esq., MBA, speaking
 to the Delegation

On April 7, 2016, Margaret Dore, attorney and president of Choice is an Illusion, accompanied by her assistant, Brenda Ray, met with a five member delegation from the Legal and Social Issues Committee, Parliament of Victoria, Australia.

The topic was assisted suicide and euthanasia. The place was the Picnic House Restaurant in Portland Oregon where Dore spoke over lunch in opposition to legalization. Despite the serious nature of the topic, a good time was had by all.

Dore's written materials can be viewed by clicking here and here.

Rhode Island: Press Release

https://choiceisanillusion.files.wordpress.com/2016/03/press-release-03-22-161.pdf

Dore:   “The bill is sold as assuring patient choice and control.  The bill is instead stacked against the patient and a recipe for elder abuse.” 

Contact: Margaret Dore

(206) 697-1217

Providence, RI – Attorney Margaret Dore, president of Choice is an Illusion, which has fought assisted suicide/euthanasia legalization efforts in many states and now Rhode Island, made the following statement in connection with tomorrow's legislative hearing on a bill seeking to legalize assisted suicide and euthanasia in that state.  (H 7659, hearing Wednesday, 3/23/16, Rise of the House).

"There is a bill pending before the Rhode Island House of Representatives, which seeks to legalize physician-assisted suicide, assisted suicide and euthanasia as those terms are traditionally defined," said Dore.  "The bill describes these practices as 'hastening death,' but there is no requirement that a person be near death.  Indeed, ‘eligible’ persons may have years, even decades, to live.”

Dore said, "The bill is sold as assuring patient choice and control.  The bill is instead stacked against the patient and a recipe for elder abuse.”  Dore elaborated, “The patient's heir, who will financially benefit from the patient's death, is allowed to actively participate in signing the patient up for the lethal dose.  After that, no doctor, not even a witness, is required to be present at the death.  Even if the patient struggled, who would know?”  Dore concluded, “The bill creates the perfect crime.”

Assisted Suicide Proponents Wilt After Tough Questioning by Committee

 http://stopassistedsuicidemd.org/assisted-suicide-proponents-wilt-after-tough-questioning-by-committee/

From Stop Assisted Suicide Maryland

Margaret Dore, Esq.

Posted on February 26, 2016

(Annopolis MD) Proponents of physician-assisted suicide struggled to answer the tough questions thrown at them at yesterday’s Senate Judicial Proceedings Committee hearing on SB 418. The Committee met late into the night with Senators raising significant concerns with the bill and its lack of protections.

The message from proponents, led by national group Compassion & Choices, was that any protections in the law would stall a patient’s ability to get a lethal prescription from their physician. And questions surrounding these increased protections continuously baffled witnesses. There is nothing in this bill that would require a mental health screening, or ensure a physician is present at the time the lethal dose is taken. Proponents’ response to these concerns is that the Maryland healthcare system can’t support these types of mandates.  This is a weak excuse when it comes to protecting our most vulnerable populations who will be at risk if this bill is passed.

In fact, across the board proponents neglect to mention the issues in this legislation that would put our most vulnerable populations at risk. One witness in support of the bill, even referred to the disabled community’s concerns surrounding abuse and coercion of the vulnerable as irresponsible. ... This is a community that has consistently faced discrimination in healthcare laws. To not consider the threat to this community is irresponsible.

Powerful testimony was presented by an elder law attorney [Margaret Dore] who raised the significant potential for elder abuse surrounding this legislation.* She stated that in her experience, it is very common that family members are coercing elderly relatives for financial reasons. In confusing answers, proponents pushed back against protections that would disqualify witnesses who would benefit financially from a death, using the unacceptable excuse that it would leave family out of this process.

The Senate Committee brought some important questions to the table and it was clear that proponents were not prepared to answer. Maybe it’s because they know the physician assisted suicide bill in Maryland is indefensible.   

* To view Ms. Dore's written testimony, please see memo here; click here for the appendix. 

California: Contact the Governor now to stop assisted suicide/euthanasia.

Outright Lies to Trusting Legislators Gets California Bill to Governor's Desk.  Tell Jerry Brown to Veto ABX2-15 Now! 

• Call 916-445-2841!
• Fax 916-558-3160 
• Use this form to send an e-mail to Governor Brown:  https://govnews.ca.gov/gov39mail/mail.php  (US Mail will be too slow)

On Friday, September 11th, ABX2-15 passed the Senate just weeks after its initial introduction during a special session called for another purpose. During its short and expedited life, proponents ran roughshod on the facts to induce busy legislators to vote yes. This was evident during the final floor debate in the Senate where proponents repeatedly stated or implied the following, which are not true:

1.  That the bill is limited to people who are actively dying and in pain. The bill doesn't say this anywhere. The bill, instead, applies to people with a "terminal disease" defined as having a prediction of less than six months to live. (Memo, pp.9 -12). Such persons can, in fact, have years, even decades, to live.  (Id.) In Oregon, which has a nearly identical definition, "eligible" persons include young adults with chronic conditions such as insulin dependent diabetes. (Id).

2.  That the bill is "one of the strongest bills regarding patient protections." The bill, however, doesn't even require a witness when the lethal dose is administered.[1] If the patient protested or struggled, who would know?[2] In addition, the bill's various legal "requirements" are not actually "required." This is because participants are merely held to a "good faith" standard.[3] This standard is not defined in the bill, but common meanings include that participants need not comply with legal technicalities when they have honest intent.  See, for example, this legal dictionary definition:

[Good faith means] honest intent to act without taking an unfair advantage over another person or to fufill a promise to act, even when some legal technicality is not fulfilled.  (Emphasis added).[4] 

For these and other reasons, tell Jerry Brown to veto ABX2-15. For more information, see: Dore letter discussing why the Baker amendments did not fix the bill's problems; Dore memo why the financial cost of ABX2-15 could be "enormous"; and a formal memo regarding the bill generally, including "key points," an index, aformal memo and an appendix.

* * *
[1]  See ABX2-15 in its entirety.
[2]  Id.
[3]  ABX2-15, Sections 443.19(d), 443.14(b), 443.14(d)(1) and 443.15(c).
[4]  "Hill" citation at http://legal-dictionary.thefreedictionary.com/good+faith

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.

Utah: Problems with H.B. 391

By Margaret Dore, Esq., MBA

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

Problems include:

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

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

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

By Margaret K. Dore, Esq., MBA

The Voice of Experience, American Bar Association

Volume 25, No. 4, Winter 2014

To view the original version, click here and here

I graduated from law school in 1986. I first worked for the courts and then for the United States Department of Justice. After that, I worked for other lawyers, and then, in 1994, I officially started my own practice in Washington State. Like many lawyers with a new practice, I signed up for court-appointed work in the guardianship/probate context. This was mostly guardian ad litem work. Once in awhile, I was appointed as an attorney for a proposed ward, termed an “alleged incapacitated person.” In other states, a guardianship might be called a “conservatorship” or an “interdiction.” A guardian ad litem might be called a “court visitor.”

My Guardianship Cases

Most of my guardianship cases were straightforward. There would typically be a elderly person who could no longer handle his or her affairs. I would be the guardian ad litem. My job would be to determine whether the person needed a guardian, and if that were the case, to recommend a person or agency to fill that role.

My work also included private pay cases with moderate estates. With these cases, I would sometimes see financial abuse and exploitation. For example, there was an elderly woman whose nephew took her to the bank each week to obtain a large cash withdrawal. She had dementia, but she could pass as “competent” to get the money. In another case, “an old friend from 30 years ago” took “Jim,” a 90 year old man, to lunch. The friend invited Jim to live with him in exchange for making the friend sole beneficiary of his will. Jim agreed. The will was executed and he went to live with the friend in a nearby town. A guardianship was started and I was appointed guardian ad litem. I drove to the friend’s house, which was dilapidated. Jim did not seem to have his own room. I asked him if he would like to go home. He said “yes” and got in my car. He was not incompetent, but he had allowed someone else to take advantage of him. In another case, there was a disabled man whose caregiver had used his credit card to remodel her home. He too was competent, but he had been unable to protect himself.

In those first few years, I loved my guardianship cases. I had been close to my grandmother and enjoyed working with older people. I met guardians and other people who genuinely wanted to help others.

But then I got a case involving a competent man who had been railroaded into guardianship. The guardian, a company, refused to let him out. The guardian also appeared to be churning the case, i.e., causing conflict and then billing for work to respond to the conflict and/or to cause more conflict. I have an accounting background and also saw markers of embezzlement. I tried to tell the court, but the supervising commissioner didn’t know much about accounting. She allowed the guardian to hire its own CPA to investigate the situation, which predictably exonerated the guardian. The guardian had many cases and if what I said had been proved true, there would have been political fallout. There were also conflicts of interest among the lawyers.

At this point, the scales began to fall from my eyes. My focus started to shift from working within the system to seeing how the system itself sometimes facilitates abuse. This led me to write articles addressing some of the system’s flaws.  See e.g., Margaret K. Dore, Ten Reasons People Get Railroaded into Guardianship, 21 AM. J. FAM. L. 148 (2008); Margaret K. Dore, The Time is Now: Guardians Should be Licensed and Regulated Under the Executive Branch, Not the Courts, WASH. ST. B. ASS’N B. NEWS, Mar. 2007 at 27-9, available at http://maasdocuments.files.wordpress.com/2013/08/dore-the-time-is-now-ashx.pdf

The MetLife Studies 

In 2009, the MetLife Mature Market Institute released its landmark study on elder financial abuse. see https://www.giaging.org/documents/mmi-study-broken-trust-elders-family-finances.pdf The estimated financial loss by victims in the United States was $2.6 billion per year.

The study also explained that perpetrators are often family members, some of whom feel themselves “entitled” to the elder’s assets. The study states that perpetrators start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or coercing elders to sign over the deeds to their homes, change their wills or liquidate their assets.

In 2011, Met Life released another study available at https://www.giaging.org/documents/mmi-elder-financial-abuse.pdf, which described how financial abuse can be catalyst for other types of abuse and which was illustrated by the following example. “A woman barely came away with her life after her caretaker of four years stole money from her and pushed her wheelchair in front of a train. After the incident the woman said, “We were so good of friends . . . I’m so hurt that I can’t stop crying.”

Failure to Report

A big reason that elder abuse and exploitation are prevalent is that victims do not report. This failure to report can be for many reasons. A mother being abused by her son might not want him to go to jail. She might also be humiliated, ashamed or embarrassed about what’s happening. She might be legitimately afraid that if she reveals the abuse, she will be put under guardianship.

The statistics that I’ve seen on unreported cases vary, from only 2 in 4 cases being reported, to one in 20 cases. Elder abuse and exploitation are, regardless, a largely uncontrolled problem. 

A New Development: Legalized Assisted Suicide

Another development relevant to abuse and exploitation is the ongoing push to legalize assisted suicide and euthanasia in the United States. “Assisted suicide” means that someone provides the means and/or information for another person to commit suicide. If the assisting person is a physician who prescribes a lethal dose, a more precise term is “physician-assisted suicide.” “Euthanasia,” by contrast, is the direct administration of a lethal agent with the intent to cause another person’s death.

In the United States, physician-assisted suicide is legal in three states:  Oregon, Washington and Vermont. Eligible patients are required to be “terminal,” which means having less than six months to live. Such patients, however, are not necessarily dying.  One reason is because expectations of life expectancy can be wrong. Treatment can also lead to recovery. I have a friend who was talked out of using Oregon’s law in 2000. Her doctor, who did not believe in assisted suicide, convinced her to be treated instead.  She is alive today, 13 years later.

Oregon’s law was enacted by a ballot measure in 1997. Washington’s law was passed by another measure in 2008 and went into effect in 2009. Vermont’s law was enacted on May 20, 2013.  All three laws are a recipe for abuse. One reason is that they allow someone else to talk for the patient during the lethal dose request process. Moreover, once the lethal dose is issued by the pharmacy, there is no oversight over administration. Even if the patient struggled, who would know? [See e.g., http://www.choiceillusion.org/2013/11/quick-facts-about-assisted-suicide_11.html 

Here in Washington State, we have already had informal proposals to expand our law to non-terminal people. The first time I saw this was in a newspaper article in 2011. More recently, there was a newspaper column suggesting euthanasia “if you couldn’t save enough money to see yourself through your old age,” which would be involuntary [or non-voluntary] euthanasia. Prior to our law being passed, I never heard anyone talk like this.

I have written multiple articles discussing problems with legalization, including Margaret K. Dore, "Death with Dignity”: What Do We Advise Our Clients?," King Co. B. ASS’N, B. BuLL., May 2009, available atwww.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm; Margaret K. Dore, Aid in Dying: Not Legal in Idaho; Not About Choice, 52 THE ADVOCATE [the official publication of the Idaho State Bar] 9, 18-20 (Sept. 2013) 

My Cases Involving the Oregon and Washington Assisted Suicide Laws

I have had two clients whose parents signed up for the lethal dose. In the first case, one side of the family wanted the father to take the lethal dose, while the other did not.  He  spent the last months of his life caught in the middle and traumatized over whether or not he should kill himself. My client, his adult daughter, was also traumatized.  The father did not take the lethal dose and died a natural death.

In the other case, it's not clear that administration of the lethal dose was voluntary. A man who was present told my client that the father refused to take the lethal dose when it was  delivered (“You’re not killing me.  I’m going to bed”), but then took it the next night when he was high on alcohol. The man who told this to my client later recanted. My client did not want to pursue the matter further.

Conclusion

In my guardianship cases, people were financially abused and sometimes treated terribly, but nobody died and sometimes we were able to make their lives much better. With legal assisted suicide, the abuse is final.  Don’t make Washington's mistake.

Margaret K. Dore (margaretdore@margaretdore.com) JD, MBA, is an attorney in private practice in Washington State where assisted suicide is legal. She is a former Law Clerk to the Washington State Supreme Court and the Washington State Court of Appeals. She worked for a year with the U.S. Department of Justice and is president of Choice is an Illusion, www.choiceillusion.org, a nonprofit corporation opposed to assisted suicide and euthanasia.

Autistic Self Advocacy Network (ASAN) Condemns Exclusion of Disabled People at NJ Hearing on Assisted Suicide Bill

http://www.notdeadyet.org/2014/12/autistic-self-advocacy-network-asan-condemns-exclusion-of-disabled-people-at-nj-hearing-on-assisted-suicide-bill.html

The Autistic Self Advocacy Network  (ASAN) has issued a statement condemning the exclusion of disabled people from testifying at yesterday’s (Dec.7) hearing on a proposed assisted suicide bill in front of the New Jersey Senate Health, Human Services and Senior Citizens Committee:
(Excerpt)

The Autistic Self Advocacy Network is deeply concerned about the omission of disabled people and representatives from disability rights organizations at yesterday’s hearing. Given that more than half of the groups in the New Jersey coalition opposing the bill are disability rights organizations and centers for independent living, it is unconscionable that the committee deliberately excluded witnesses from the disability community. Even after our community submitted a formal request for inclusion among the witnesses, the committee declined to invite a disability community representative.

Read the entire statement here.

* * *

Margaret Dore, President of Choice is an Illusion, was also excluded despite multiple requests to participate.  So the proponents' deceptively named advocacy group,  Compassion & Choices, was allowed to present unopposed by its opposition counter-part, Choice is an Illusion.  To view a legal/policy memo opposing the proposed bill to legalize assisted suicide and euthanasia in New Jersey, please go here:  https://choiceisanillusion.files.wordpress.com/2014/12/a-2270-3r-memo-12-02-14.pdf

Whose Choice Will It Be? Telling the truth about assisted suicide. Excerpts from an NRO Interview

http://www.nationalreview.com/article/392444/whose-choice-will-it-be-interview  . . . .

Margaret Dore is a lawyer in Washington State, where assisted suicide is also legal. Dore is a former law clerk to the Washington state supreme court and president of Choice Is an Illusion, a 501(c)(4) nonprofit corporation opposed to assisted suicide and euthanasia. She talks with National Review Online about assisted suicide as it exists now and how we might make a change. — Kathryn Jean Lopez 

. . . .
Lopez: What is the absolute first thing that you would like anyone who was moved by Brittany Maynard’s life and death to know?

Dore: I would want them to know that “eligibility” for legal assisted suicide is not limited to people who are near death. This is true for the following reasons:

Under the Oregon and Washington assisted-suicide laws, assisted suicide is legal for “terminal” patients, meaning those predicted to have less than six months to live. But such predictions can be wrong. Moreover, treatment can lead to recovery. Consider Jeanette Hall, who was diagnosed with cancer in Oregon in 2000 and was adamant that she would “do” Oregon’s law. Her doctor, who didn’t believe in assisted suicide, stalled her and convinced her to be treated instead. Today, 14 years later, she is thrilled to be alive. You can see her doctor’s affidavit here.

Once assisted suicide is legal, there is pressure to expand. For example, here in Washington State, we have already had “trial balloon” proposals to expand our law to euthanasia for non-terminal people. For me, the most disturbing proposal was a discussion in our largest paper suggesting euthanasia for people who didn’t have enough money for their old age. So, if you worked hard all your life, paid taxes, and then your pension plan went broke, this is how society will pay you back? With non-voluntary or involuntary euthanasia? (The newspaper column can be read here.)

In other words, with legal assisted suicide, people with years to live are encouraged to throw away their lives. Moreover, and contrary to the media hype, legal assisted suicide (or euthanasia) may not be voluntary. . . .

Lopez: Why is the “death with dignity” language misleading?

Dore: Because it’s a euphemism, which doesn’t readily disclose that we are talking about assisted suicide and euthanasia for people who may or may not be dying anytime soon, and that such death may not be voluntary.

Lopez: Who is Compassion & Choices? Is its name misleading?

Dore: Compassion & Choices is a successor organization to the Hemlock Society, originally formed by Derek Humphry. In March 2011, Humphry was in the news as a promoter of mail-order suicide kits from a company now shut down by the FBI. This was after a 29-year-old man had used one of the kits to commit suicide. Seven months later, on October 22, 2011, Humphry was the keynote speaker at Compassion & Choices’ annual meeting here in Washington State.

Compassion & Choices’ name is misleading because it does not disclose its true nature as a suicide/euthanasia advocacy group. The name is also misleading because Compassion & Choices’ true mission is to reduce choice in health care and to change public policy so as to reduce patient cures.

Lopez: Speaking of names: How did your group arrive at Choice Is an Illusion?   

Dore: The name, Choice Is an Illusion, is a commentary on Compassion & Choices because the laws it promotes do not assure patient choice. . . .

Lopez: What might you want to leave readers with in closing?

Dore: Problems with legal assisted suicide include:

• The encouragement of people with years to live to throw away their lives.
• New paths of elder abuse, for example, in the context of inheritance.
• A push to expand euthanasia to non-terminal individuals.

Don’t make Washington State’s mistake.

To read the entire article, please go here:  http://www.nationalreview.com/article/392444/whose-choice-will-it-be-interview

"This is how society will pay you back? With non-voluntary or involuntary euthanasia?"

http://missoulian.com/news/opinion/mailbag/assisted-suicide-discussion-veering-into-talk-of-terminating-lives-of/article_87332fc0-4fe8-11e4-94f5-632029a45aed.html

I am a lawyer in Washington State, where assisted suicide is legal. Our law was passed by a deceptive ballot measure spearheaded by Compassion & Choices. Voters were promised that only the patient would be allowed to administer the lethal dose, which is false. Our law does say that the patient may self-administer the lethal dose, but there is no language saying that administration must be by self-administration. For more information, please go here:  https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm

Once assisted suicide is legal, there is pressure to expand. For example, here in Washington State, we have had “trial balloon” proposals to expand our law to non-terminal people. For me, the most disturbing one was a casual discussion in our largest paper suggesting euthanasia for people who didn’t save enough money for their old age. So, if you worked hard all your life, paid your taxes, and your pension plan went broke, this is how society will pay you back? With non-voluntary or involuntary euthanasia?

To view a copy of the newspaper column, please go here: https://choiceisanillusion.files.wordpress.com/2014/10/jerry-large_001.pdf.

Protect yourselves and your families. Don’t let assisted suicide become legal in Montana.

Margaret Dore, president,
Choice is an Illusion,
Seattle, Washington

Margaret Dore published in the Baltimore Sun

The letter below, published in the Baltimore Sun, describes the positive statistical correlation between legalizing physician-assisted suicide and the significant increase in other "regular" suicides in Oregon.  This is at great financial cost to that state.

For more detail and links to supporting documentation, please see: Letter from Margaret Dore to Members of the New Hampshire House of Representatives, March 4, 2014, titled:  "The High Financial Cost of (Regular) Suicide."

* * *

The published letter:  Margaret Dore," Legalizing assisted suicide is a bad idea."

Alexa Fraser's recent commentary promotes the idea of legalizing physician-assisted suicide. . . .

The term "physician-assisted suicide" means that a physician provides the means or information to enable a patient to perform a life-ending act, such as through a lethal prescription.

The premise of Ms. Fraser's commentary is that legalization of physician-assisted suicide will eliminate other types of suicides, such as those resulting from self-inflicted gunshot wounds.

This premise is not, however, supported by statistics from Oregon, which is the only state in which physician-assisted suicide has been legal long enough to have valid statistics over time.

The Oregon statistics support the conclusion that, if anything, "ordinary" suicides will actually increase if physician-assisted suicide were legalized in Maryland.

A suggestion that Bishop Tutu confuses assisted suicide with “switching off life support.” If so, perhaps we are to blame.

By Margaret Dore, Esq., MBA*

www.margaretdore.com

www.choiceillusion.org

An assisted suicide bill is coming up for a vote in the UK House of Lords.  The bill, HL Bill 6, is based on similar laws in Oregon and Washington State, USA.

Assisted Suicide and HL Bill 6

HL Bill 6, like the Oregon and Washington laws on which it is based, applies to patients who have been given 6 months or less to live.  Such patients may, in fact, have years to live.  One reason is that doctors’ predictions of life expectancy can be wrong.  See Margaret Dore, “Falconer Assisted Suicide Bill: ‘Eligible’ Patients May Have Years, Even Decades, to Live,” Choice is an Illusion, July 12, 2014.

Bishop Tutu’s Remarks

I don't know Bishop Tutu, but I have seen him speak and I admire him very much.  He has now, however, voiced his support for “assisted dying”, with reference to the death of Nelson Mandela.

According to a New Zealand blog post, Bishop Tutu may be confusing the withdrawal of life support with assisted suicide.  The post says in part:

Interesting that Bishop Tutu now admits publicly that Mandela was indeed on life support and that “prolonging his life was an affront to his dignity”, according to an article on BBC.com.

Switching off life support is, regardless, different from euthanasia and assisted suicide.  When life support is switched off the patient doesn't necessarily die. Consider, for example, this case from Washington State reported in the Seattle Weekly:

[I]nstead of dying as expected, the man slowly began to get better. [Dr. J. Randall Curtis] doesn't know exactly why, but guesses that for that patient, "being off the ventilator was probably better than being on it.  He was more comfortable, less stressed." Curtis says the man lived for at least a year afterwards. 

With assisted suicide and euthanasia, the patient deliberately kills himself or is killed by another person.  See e.g., AMA Code of Medical Ethics, Opinion 2.21 (defining euthanasia).  Moreover, that patient could have had years to live.

The Blame is on us

Perhaps the blame for the confusion should be placed on us and the language of the debate in which both sides have been referring to assisted suicide and euthanasia as “assisted dying.”  Perhaps it’s time for those of us who oppose legalization to call a spade a spade and eliminate the misleading term, “assisted dying” from our vocabulary. Our very lives may depend on it.

*  Margaret Dore is an attorney in Washington State USA where assisted suicide is legal.  She is also President of Choice is an Illusion, a human rights organization opposed to assisted suicide and euthanasia. Her publications include Margaret K. Dore, "''Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009 (regarding Washington's law).  See also Margaret Dore, Quick Facts About Assisted Suicide, at http://www.choiceillusion.org/2013/11/quick-facts-about-assisted-suicide_11.html

Washington’s ‘Death with Dignity’ law imperils the poor

http://realchangenews.org/index.php/site/archives/9122

Last week’s article by an assisted suicide/euthanasia advocate struck me as a bizarre article for Real Change, which advocates for the dignity and self-determination of the poor. (“Terminally ill patients face shortage of right-to-die drug amid controversy over capital punishment,” Real Change, June 18)

Washington’s assisted suicide law was passed in 2008 and went into effect in 2009. This was after a deceptive initiative campaign promised us that “only” the patient would be allowed to take the lethal dose. Our law does not say that anywhere. See Margaret K. Dore, “’Death with Dignity,” What Do We Advise Our Clients?,” King County Bar Association, Bar Bulletin, May 2009, available at https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm.

In Oregon, which has a similar law, there are documented cases of that state’s Medicaid program using the law to steer patients to suicide. In other words, indigent patients are offered suicide in lieu of desired treatments to cure or to extend life. The most well-known cases are Barbara Wagner and Randy Stroup.  See: Susan Donaldson James, “Death Drugs Cause Uproar in Oregon,” ABC News, August 6, 2008, at http://abcnews.go.com/Health/story?id=5517492&page=1; and “Letter noting assisted suicide raises questions,” KATU TV, July 30, 2008, at http://www.katu.com/news/specialreports/26119539.html  See also the Affidavit of Kenneth Stevens, MD, filed by the Canadian government in Leblanc v. Canada, available at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf.

Finally, consider this quote from a March 8, 2012 Jerry Large column in the Seattle Times. He says that at least a couple of his readers suggested euthanasia “if you couldn’t save enough money to see you through your old age.” http://seattletimes.com/text/2017693023.html  For the poor, this would be non-voluntary or involuntary euthanasia. 

So much for the dignity and self-determination of the poor.

Margaret Dore, Esq., MBA *

Seattle

* www.margaretdore.com & www.choiceillusion.org 

Legal/Policy Analysis Against New Jersey Bill, A2270 (Assisted Suicide & Euthanasia)

By Margaret Dore, Esq., MBA

A legal/policy analysis against New Jersey's proposed assisted suicide/euthanasia bill, A2270, can be viewed by clicking here.

If the analysis is "too big" for your computer, you can view it in pieces, by clicking the following links to: the cover sheet and index; the memo; and the appendices.

There are three main points:

1.  A2270 is titled "Aid in Dying for the Terminally Ill Act."  "Aid in Dying" is a euphemism for assisted suicide and euthanasia.  The title is, regardless, deceptive because it implies that A2270 is limited to people who are dying, which is untrue.  A2270 applies to people who may have years, even decades, to live.  See memo, pp. 5-8.

2. The bill is a recipe for elder abuse with the most obvious reason being a complete lack of oversight when the lethal dose is administered to the patient.  Even if he struggled, who would know? See memo, pp. 8-17.

3. The bill lacks transparency and accountability.  Id., pp. 17-19.

The last part of the memo is a discussion of the "Oregon and Washington Experience," with supporting documentation attached.

Please contact me with any questions or concerns at contact@choiceillusion.org or margaretdore@margaretdore.com.

Margaret Dore, President
Choice is an Illusion, a human rights organization
Law Offices of Margaret K. Dore, P.S.
www.choiceillusion.org
www.margaretdore.com
1001 4th Avenue, 44th Floor
Seattle, WA 98154

Margaret Dore writes the New Hampshire Judiciary Committee: Vote "No" on HB 1325

Madame Chair and Members of the Committee,

During the recent hearing on assisted suicide, I mentioned that there had been a significant increase in other suicides in Oregon after assisted suicide legalization.  This is consistent with a suicide contagion (legalizing and thereby normalizing one type of suicide encouraged other suicides). 

Of course, a correlation does not prove causation. 

However, as set forth below, there is a significant statistical correlation between the two events.  Moreover, the financial cost to Oregon from the other suicides is enormous.  Please see the data below:

Oregon's assisted suicide act went into effect in 1997. See top line at this link: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx

By 2000, Oregon's regular suicide rate was "increasing significantly"  See http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000")

In 2010, Oregon's other suicide rate was 35% above the national average.  http://maasdocuments.files.wordpress.com/2013/02/oregon-suicide-info_001.pdf

In 2012, the most recent report, Oregon's other suicide rate was 41% above the national average.  http://choiceisanillusion.files.wordpress.com/2014/02/oregon-suicide-report-2012-through-2010-pdf.pdf  Moreover, this report, page 3, states:

"Suicide is the second leading cause of death among Oregonians ages 15-34, and the 8th leading cause of death among all ages in Oregon.  The cost of suicide is enormous.  In 2010 alone, self-inflicted injury hospitalization changes exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars.  The loss to families and communities broadens the impact of each death."

The report, itself, does not address the possible influence of assisted suicide legalization.  But, again, the significant statistical correlation is there.  The cost to the state is enormous.

Please feel free to contact me for any further information.

Thank you.

Margaret Dore
Law Offices of Margaret K. Dore, P.S.
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, 44th Floor
Seattle, WA  98154
206 389 1754 main line

Oregon's new assisted suicide report: chronic conditions; people with money and more

By Margaret Dore, Esq.
Updated February 19, 2014

Oregon's assisted suicide report for 2013 has been released to the public.[1]  Per the report, the number of deaths from ingesting a lethal dose is low when compared to overall deaths, just 71 out of 32,475 total.[2] The report is nonetheless significant for the following reasons.

Per the report, some people who died from a lethal dose under Oregon's assisted suicide act had chronic conditions such as diabetes.[3] People with these conditions, and other conditions such as cancer, can have years to live.[4]  Jeanette Hall, the woman in the photo, had cancer and was talked out of assisted suicide 13 years ago.[5]  Her doctor convinced her to be treated instead.[6] Legalization, regardless, encourages people with years to live to throw away their lives.

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.