Massachusetts: Legal Challenge to Ballot Measure

Disability Rights Group Challenges Language for Assisted Suicide Ballot Measure as "Misleading, Inaccurate, and Euphemistic"

CONTACT  John Kelly 617-536-5140 

(Boston, MA) – On Thursday, May 17, 2012, Massachusetts voters including members of the disability rights group Second Thoughts filed a challenge before the Supreme Judicial Court regarding the proposed ballot language for the measure that, if approved, would legalize assisted suicide in the state.

"The ballot language is clearly misleading," said Second Thoughts director John Kelly of Boston. "We want the voters ofMassachusetts to know exactly what they are voting on this November," he said.

The petition asks the Supreme Judicial Court to remand the language to Massachusetts Attorney General Martha Coakley and Secretary of State William Galvin with the requirement that they amend the language for clarity and accuracy.

"The ballot language repeats the problems of the bill itself," said Second Thoughts member Paul Spooner of Taunton. "The title is euphemistic, with the word ‘medication’ twisted beyond recognition. People will be led to believe that the measure is about palliative care, when it is about taking a lethal overdose -- in other words, poison. Why not just call the act by its common and legal name, 'physician-assisted suicide?'"

"The way 'terminally-ill' is used in the description is clearly misleading ," said Kelly, "people will be encouraged to assume that being 'terminally ill' is a biological fact, rather than a human guess."

"People with disabilities are very familiar with so-called terminal diagnoses," said Second Thoughts member John Norton of Florence. "Everyone knows someone who has outlived their terminal diagnosis -- I was diagnosed with Lou Gehrig's Disease as a teenager; I'm alive and well fifty years later.  The ballot language misleads by implying that a 'terminally-ill' diagnosis actually leads to death within six months.  Instead, it should say ‘diagnosed as terminal’ or something similar in terms of accuracy."

"And what about choice?," asked Spooner. "There are no safeguards to protect patients from having the poison given to them by an heir or abusive caretaker. No witnesses are required under the law, so if someone else were to administer the drugs, who would know?"

The language submitted by the Attorney General Martha Coakley and Secretary of State is:

Title: Prescribing Medication to End Life [11-12] - Petition G

A YES VOTE would enact the proposed law allowing a physician licensed in Massachusetts to prescribe medication, at the request of a terminally-ill patient meeting certain conditions, to end that person’s life.

Second Thoughts has taken a leading role in opposing the ballot measure, and has been featured in the Boston Sunday Globe Magazine, the Wall Street Journal, and on local TV and radio.

Massachusetts Assisted-Suicide Initiative Fact Check: The Baloney Meter is Running High

Margaret Dore, Esq.

March 1, 2012

 

1.  Legalization will Empower the Government

Proponents claim that legalizing assisted suicide will keep the government out of people's lives.  The opposite is true.

Fact check:  In Oregon, where assisted suicide is legal, legalization has allowed the Oregon Health Plan, a government entity, to steer people to suicide.  The most well known cases involve Barbara Wagner and Randy Stroup.  Each wanted treatment.  The Plan denied coverage and steered them to suicide by offering to cover the cost of their suicides instead.  See  See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008; and "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008.

2.  The Initiative Allows Someone Else to Administer the Lethal Dose

Proponents claim that only the patient may administer the lethal dose.  This is not true.

Fact check:  The initiative (H.3884) states that patients "may" self-administer the lethal dose. There is no language stating that administration “must” be by self-administration.  "Self-administer" is also a specially defined term that allows someone else to administer the lethal dose to the patient.  See here.

3.  An Heir is Allowed to Witness the Lethal Dose Request

Proponents claim that the lethal dose request form must be "independently witnessed" by two people.  This is not true. 

Fact check:  The initiative, Sections 3 and 21, provides that one of two witnesses on the lethal dose request form cannot be a patient’s heir or other person who will benefit financially from the patient's death; the other witness can be an heir or other person who will benefit financially from the death.

4.  Substantial Compliance

Proponents claim that the initiative has "strict safeguards" to protect patients.  The initiative, however, only requires "substantial compliance" with its provisions.  Section 18(1)(a) states:  "A person who substantially complies in good faith with provisions of this chapter shall be deemed to be in compliance with this chapter." 

5.  Assisted Suicide is a Recipe for Elder Abuse

Proponents claim that the initiative is safe, which is not true.

Fact check: The initiative does not require witnesses at the death.  Without disinterested witnesses, the opportunity is created for an heir, or someone else who will benefit financially from the death, to administer the lethal dose to the patient without the patient's consent.  Even if he struggled, who would know?  

6.  Patients are not Necessarily Dying

Proponents imply that the initiative only applies to people in their "final days."  This is untrue.

Fact check:  See Nina Shapiro, "Terminal Uncertainty — Washington's new 'Death with Dignity' law allows doctors to help people commit suicide — once they've determined that the patient has only six months to live. But what if they're wrong?," Seattle Weekly, January 14, 2009; and Jeanette Hall, "She pushed for legal right to die, and - thankfully - was rebuffed," Boston Globe, October 4, 2011.

 

7.  Assisted Suicide is a Wedge Issue

Proponents deny that assisted suicide is a "wedge issue" to legalize direct euthanasia of non-terminal people.

Fact check:  In Washington state, where assisted suicide has been legal since 2009, there has been a proposal to expand Washington's law to direct euthanasia for non-terminal people.  See Brian Faller, "Perhaps it's time to expand Washington's Death with Dignity Act," The Olympian, November 16, 2011.

8.  Legal Assisted Suicide Threatens People with Disabilities 

Proponents claim that people with disabilities are not at risk from legalization of assisted suicide, which is untrue.

Fact check:  Disability rights groups such as Not Dead Yet oppose assisted suicide as a threat to their lives.  In Oregon and Washington, official government forms for assisted suicide acts in those states promote disability as a reason to commit suicide.[1]  People with disabilities are thereby devalued.  In 2009, there was a proposed assisted suicide bill in New Hampshire that squarely applied to people with disabilities.[2]  If the initiative were to be passed now, people with disabilities see themselves as potentially next in line under a future expansion of that law.  As noted above, there has already been a proposal in Washington state to expand its law to direct euthanasia for non-terminal people. 

* * * 

[1]  See e.g. "Oregon Death with Dignity Act Attending Physician Follow-up Form," question 15, providing seven suggested answers as to why there was a lethal dose request.  Some of the answers are written in terms of disability being an acceptable reason to kill yourself.  These answers include:  "[A] concern about . . . the loss of control of bodily functions."

[2]  Stephen Drake and Not Dead Yet, "New Hampshire Poised to Redefine "Terminally Ill" - to PWDs and others for Assisted Suicide Eligibility," January 30, 2009 (regarding New Hampshire's 2009 assisted suicide bill, HB 304, which applied to people with disabilities, people with HIV/AIDS and other non-dying people).

Massachusetts voters, reject Petition 11-12

http://www.washingtontimes.com/news/2012/jan/11/massachusetts-voters-reject-petition-1112/

If adopted this November, a ballot initiative in Massachusetts will legalize physician-assisted suicide for patients whose conditions are predicted to produce death within six months. Initiative Petition 11-12 claims to ensure that the patient's decision to commit suicide is voluntary. That claim, however, is misleading.

The initiative petition requires that two persons witness the patient's written request for a lethal prescription. One witness, however, can have a financial interest in the patient's death. That person can be the only witness present when the lethal drug is taken. Thus, an interested heir could pressure the patient, and no one would know because no objective witness is required when the drug is taken. Also, the petition would require the death certificate fraudulently to list the patient's underlying condition, rather than the lethal drug, as the cause of death.

Initiative Petition 11-12 uses terms like life-ending "medication" and death in a "humane and dignified manner." But there is nothing medicinal about poison and nothing dignified about the prospects for the abuse the initiative petition would allow. It is a bad law that the voters of Massachusetts should reject decisively.

STEPHEN L. MIKOCHIK
Professor emeritus
Temple Law School

Press Release: Mass Against Assisted Suicide

FOR IMMEDIATE RELEASE 

Massachusetts Assisted Suicide Initiative a Recipe for Elder Abuse

Choice is an Illusion, a nonprofit corporation opposed to assisted suicide, has launched a new website agianst the Massachusetts "death with dignity" initiative.  The website's name is "Mass Against Assisted Suicide." 

Margaret Dore, President of Choice is an Illusion and an elder law attorney, states: "The initiative's introduction declares that the process will be 'entirely voluntary' for the patient.  The act, as written, does not deliver on this promise.  The act is instead a recipe for elder abuse."

The proposed act has an application process to obtain a lethal dose for the purpose of causing the patient's death.  The act allows the patient's heir, who will benefit financially from the death, to actively help the patient sign up for the lethal dose.  Dore states:  "The act allows an heir to participate as one of two witnesses on the lethal dose request form.  The act also allows someone else to speak for the patient." 

"This does not meet the stink test," said Dore. "Signing away your life under the proposed act has less protection than signing a will."

Dore explained that when signing a will, similar conduct can create a presumption of fraud and undue influence.

Dore also pointed out that there is no oversight once the lethal dose of has been filled under the proposed act.

"The death is not required to be witnessed by disinterested persons," Dore said.  "Indeed, no one is required to be present." 

"Without disinterested witnesses, the opportunity is created for an heir, or someone else who will benefit from the death, to administer the lethal dose to the patient without his consent.  Who would know?"

This year in New Hampshire, a similar "death with dignity" act was defeated in the House of Representatives by a vote of 234 to 99. 

Former New Hampshire State Representative Nancy Elliott said: "Assisted suicide laws empower heirs and others to pressure and abuse older people to cut short their lives.  This is especially an issue when the older person has money.  There is no assisted suicide bill that you can write to correct this huge problem."

* * *

To view the new website, go here:  http://www.massagainstassistedsuicide.org  To learn more about "Choice" is an Illusion, visit:  www.choiceillusion.org  To learn about the New Hampshire bill that failed, go here:  http://www.choiceillusionnewhampshire.org/2011/05/new-hampshire-defeats-assisted-suicide.html

* * *

Margaret Dore is President of Choice is an Illusion and an elder law attorney. Contact her at 206-389-1754 or margaretdore@margaretdore.com.  See also http://www.margaretdore.org/  Contact Former New Hampshire State RepresentativeNancy Elliott at mmknhrep@gmail.com  

Massachusetts: MMS Physicians Reaffirm Opposition to Physician-Assisted Suicide

MMS Press Release

December 3, 2011
http://www.massmed.org/AM/Template.cfm?Section=Online_Newsroom&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=65342

Contact: Richard P. Gulla
Phone: (781) 434-7101 Email: rgulla@mms.org

Waltham, Mass. -- December 3, 2010 – The Massachusetts Medical Society, the statewide association of physicians with more than 23,000 members, today voted to reaffirm its opposition to physician-assisted suicide, with its House of Delegates voting by a wide margin to maintain a policy the Society has had in effect since 1996.

Opposition to physician-assisted suicide was part of a larger policy statement that includes recognition of patient dignity at the end of life and the physician’s role in caring for terminally-ill patients. The policy was approved by more than 75 percent of the Society’s delegates.

Lynda Young, M.D., president of the Society, said that “Physicians of our Society have clearly declared that physician-assisted suicide  is inconsistent with the physician’s role as healer and health care provider. At the same time we recognize the importance of patient dignity and the critical role that physicians have in end-of-life care.”

Dr. Young said the policy goes beyond a single statement of opposition to physician-assisted suicide to include “support for patient dignity and the alleviation of pain and suffering at the end of life.” Additionally, it includes the Society’s commitment to “provide physicians treating terminally-ill patients with the ethical, medical, social, and legal education, training, and resources to enable them to contribute to the comfort and dignity of the patient and the patient’s family.”

The policy was one of several reaffirmed and adopted at the Society’s 2011 Interim Meeting, which brings hundreds of physicians from across the state to examine and consider specific resolutions on public health policy, health care delivery, and organizational administration by the Society’s House of Delegates, its policy-making body. Resolutions adopted by the delegates become policies of the organization. . . .

The Massachusetts Medical Society, with more than 23,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information, visit www.massmed.org, www.nejm.org, or www.jwatch.org.

Massachusetts: "Oregon doctor disputes state's assisted suicide"

http://www.gloucestertimes.com/opinion/x553404669/Letter-Oregon-doctor-disputes-states-assisted-suicide 
The Gloucester Daily Times Wed Oct 19, 2011, 11:25 PM EDT

To the editor:

Cynthia Fisk's letter (The Times, Wednesday, Oct. 12) supports assisted suicide to avoid disabling and unyielding pain.

In Oregon, where I practice medicine and where assisted-suicide has been legal since 1997, there has never been a documented case of assisted-suicide used because of actual untreatable pain.

In statewide television ads in 1994, a woman named Patty Rosen claimed to have killed her daughter with an oral overdose of barbiturates because of intractable cancer pain. This claim was later challenged and shown to be false.

Giving patients a lethal dose to kill themselves is easier than evaluating them, caring for them and/or treating them. In short, legalization encourages lazy doctoring.

A few years ago, a patient contacted me concerned that an oncologist might be one of the "death doctors." She questioned his motives,­ particularly when she obtained a more favorable opinion from another oncologist. Such fears were never an issue before assisted-suicide was legalized.

Don't make Oregon's mistake.

William L. Toffler MD
Professor of Family Medicine
Oregon Health & Science University

Massachusetts: "Don't be fooled by assisted-suicide bill"

http://www.lowellsun.com/editorials/ci_19137188
The Lowell Sun
Updated: 10/18/2011 09:27:53 AM EDT

This letter responds to Marie Donovan's article about the proposed Massachusetts death-with-dignity act, which seeks to legalize assisted suicide in your state (" 'Death with Dignity Act' renews end-of-life debate"). I am an attorney in Washington state, one of just two states where physician-assisted suicide is legal. The other state is Oregon. I am also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide as an issue of public safety (www.choiceillusion.org).

In both Washington and Oregon, assisted-suicide laws were passed via highly financed sound-bite, ballot-initiative campaigns. No such law has made it through the scrutiny of a legislature -- despite more than 100 attempts. This year, a bill was defeated in the New Hampshire House, 234 to 99.

The proposed Massachusetts act is a recipe for elder abuse. Key provisions include that an heir, who will benefit financially from a patient's death, is allowed to actively help sign the patient up for the lethal dose. See e.g., Section 21 allowing one of two witnesses on the lethal-dose request form to be an heir (http://www.mass.gov/Cago/docs/Government/2011-Petitions/11-12.pdf  ).

Once the lethal dose is issued by the pharmacy, there is no oversight over administration. The proposed act does not require that a doctor or anyone else be present at the time of death. This creates the opportunity for an heir, or another person who will benefit from the death, to administer the lethal dose to the patient without the patient's consent. Even if he struggled, who would know?

Donovan's article prominently features a discussion of religion. In Washington state, proponents used similar discussions and even religious slurs to distract voters from the pitfalls of legalization. What the proposed law said and did was all but forgotten.

Do not be deceived.

MARGARET DORE
Choice is an Illusion
Seattle, Wash.

Massachusetts: Assisted Suicide is a Recipe for Elder Abuse; Do not be Deceived

By Margaret Dore

A ballot initiative to legalize physician-assisted suicide via a "death with dignity" act is now in the signature-gathering stage in Massachusetts.[1]

Physician-assisted suicide is legal in just two states: Oregon and Washington.[2]  In both states, acts to legalize the practice were enacted via sound-bite ballot initiative campaigns.[3]  No such law has made it through the scrutiny of a legislature.  Just this year, bills to legalize assisted suicide were defeated in Montana, New Hampshire and Hawaii.[4] Just this year, Idaho enacted a statute to strengthen its law against assisted suicide.[5]

The proposed Massachusetts act is a recipe for elder abuse.  Key provisions include that an heir, who will benefit financially from a patient's death, is allowed to participate as a witness to help sign the patient up for the lethal dose.  See Section 21 of the act, allowing one of two witnesses on the lethal dose request form to be an heir, available here.  This situation invites undue influence and coercion.

Once the lethal dose is issued by the pharmacy, there is no oversight.  See entire proposed act, available here.  The act does not require witnesses when the lethal dose is administered.  See act here.  Without disinterested witnesses, an opportunity is created for an heir, or another person who will benefit from the patient's death, to administer the lethal dose to him without his consent.  Even if he struggled who would know?

In Massachusetts, proponents are framing the issue as religious.  In Washington state, proponents used a similar tactic and even religious slurs to distract voters from the pitfalls of legalization.  What the proposed law said and did was all but forgotten.

        

        Do not be deceived.

* * *

Margaret Dore is an attorney in Washington State where assisted suicide is legal.  She is also President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide.  Her publications include Margaret K. Dore, "Physician-Assisted Suicide: A Recipe for Elder Abuse and the Illusion of Personal Choice," The Vermont Bar Journal, Winter 2011.

* * *

[1]  To view the proposed Massachusetts initiative, click here:  http://www.mass.gov/Cago/docs/Government/2011-Petitions/11-12.pdf
[2]  In Montana, there is a court decision that gives doctors who cause or aid a suicide, a potential defense to criminal prosecution for homicide.  The decision does not legalize assisted suicide by giving doctors or anyone else immunity from criminal prosecution and civil liability.  To learn more, go here:  http://www.montanansagainstassistedsuicide.org/p/baxter-case-analysis.html  The assisted suicide promotion group, Compassion & Choices, has a new campaign claiming that assisted suicide is "already legal" in Hawaii.  This is an odd claim given that bills to legalize assisted suicide in Hawaii have repeatedly failed, most recently this year.  See here for the most recent bill: http://capitol.hawaii.gov/Archives/measure_indiv_Archives.aspx?billtype=SB&billnumber=803&year=2011
[3]  Oregon's physician-assisted suicide act was enacted via Ballot Measure 16.  Washington's act was enacted via Initiative 1000.
[4]  In Montana, SB 167 was tabled in Committee and subsequently died on April 28, 2011.  In New Hampshire, HB 513 was defeated on March 16, 2011.  In Hawaii, SB 803 was defeated on February 7, 2011 .
[5]  On July 1 2011, Idaho's new statute strengthening Idaho law against assisted suicide went into effect:   http://www.choiceillusionidaho.org/2011/07/idaho-strengthens-law.html

Boston Globe: She pushed for legal right to die, and - thankfully - was rebuffed

http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/she_pushed_for_legal_right_to_die_and___thankfully___was_rebuffed/

I DISAGREE with Scot Lehigh’s Sept. 23 column, which characterizes assisted suicide as only involving people who are going to die in “a few months or weeks’’ (“Death with dignity in Mass.,’’ Op-ed). I am a retired person living in Oregon, where assisted suicide is legal. Our law was enacted through a ballot initiative that I voted for. In 2000, I was diagnosed with cancer and told that I had six months to a year to live.

I knew that our law had passed, but I didn’t know exactly how to go about making use of it. I tried to ask my doctor, but he didn’t really answer me. I didn’t want to suffer. I wanted to do what our law allowed, and I wanted my doctor to help me. Instead, he encouraged me not to give up, and ultimately I decided to fight the disease. I had both chemotherapy and radiation.

I am so happy to be alive! It is now 11 years later.

If my doctor had believed in assisted suicide, I would be dead. I thank him and all my doctors for helping me to choose “life with dignity.’’
 
Assisted suicide should not be legal. I hope Massachusetts does not make this terrible mistake.

Jeanette Hall

King City, Ore.

Massachusetts: Oregon doctor finds fault with state's law

http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/oregon_doctor_finds_fault_with_states_law/ 

 – +

I am a doctor practicing medicine in Oregon and Washington, where physician-assisted suicide is legal. I disagree with Scot Lehigh that these suicides are not like other suicides in which “a healthy person [takes] his life for reasons of despair, depression, or hopelessness’’ (“Death with dignity in Mass.,’’ Op-ed, Sept. 23).

First, doctors can be wrong. So, what looks like a few months to live can be years. For a good article on this subject, see Nina Shapiro’s January 2009 "Terminal Uncertainty" in the Seattle Weekly.

Second, despair, depression, and hopelessness are a part of assisted suicide. A few years ago, a patient of mine who was undergoing cancer treatment with a specialist became depressed, and expressed a wish for assisted suicide.

In most jurisdictions, suicidal ideation is interpreted as a cry for help. In Oregon, the only help my patient got was a lethal prescription intended to kill him.  Don’t make our mistake. Keep assisted suicide out of Massachusetts.

Dr. Charles J. Bentz

Portland, Ore.

The writer is an associate professor of medicine in the division of general medicine and geriatrics at Oregon Health & Science University.

Massachusetts Assisted Suicide Petition Certified

By Margaret Dore

The Massachusetts' Attorney General's office has completed its certification review of 31 initiative petitions.  The petitions approved include a petition to legalize physician-assisted suicide.

"Physician-assisted suicide occurs when a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act." (AMA Code of Medical Ethics, Opinion 2.211). For example, a "physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide." Id.  

Proponents claim that legalization of assisted suicide will give patients "control" of their end of life care.  The proposed law, however, has no required witnesses at the death.  This creates the opportunity for an heir, or other person who will benefit from the death, to administer the lethal dose to the patient without his consent.  Even if he struggled, who would know?

* * * 

According to the Attorney General's press release:

1.  "Today’s decisions by the Attorney General’s Office are based on a strict constitutional review and do not represent the office’s support or opposition to the merits of the petitions."

2.  "Proponents of each certified initiative petition must now gather and file the signatures of 68,911 registered voters by December 7, 2011.  Once the requisite signatures are obtained, the proposal is sent to the state Legislature to enact before the first Wednesday in May 2012.  If the Legislature fails to enact the proposal, its proponents must gather another 11,485 signatures from registered voters by early July 2012 to place the initiative on the November 2012 ballot.  An initiative petition, if ultimately passed by the voters, becomes the equivalent of a statute."