"Assisted suicide in Washington and Oregon is a recipe for elder abuse and cloaked in secrecy"

http://missoulian.com/news/opinion/mailbag/oregon-washington-assisted-suicide-laws-include-no-protections-for-patients/article_074c4378-507b-11e2-8348-001a4bcf887a.html

By, Margaret Dore, Esq.  Supporting documentation follows letter, below.

Re: Susan Hancock, “Death with Dignity is about giving people choices" (Dec. 20, guest column):

I disagree with Susan Hancock’s description of how the Washington and Oregon assisted suicide laws work. I disagree that assisted suicide cannot be forced upon an unwilling person.

The Oregon and Washington assisted suicide acts have a formal application process. The acts allow an heir, who will benefit from the patient’s death, to actively participate in this process.

Once the lethal dose is issued by the pharmacy, there is no oversight. For example, there is no witness required at the death. Without disinterested witnesses, the opportunity is created for an heir, or for another person who will benefit from the patient’s death, to administer the lethal dose to the patient without his consent. One method would be by injection when the patient is sleeping. The drugs used in Oregon and Washington are water soluble and therefore injectable. If the patient woke up and struggled, who would know?

The Washington and Oregon acts require the state health departments to collect statistical information for the purpose of annual reports. According to these reports, users of assisted-suicide are overwhelmingly white and generally well-educated. Many have private insurance. Most are age 65 and older. Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.

The forms used to collect the statistical information do not ask about abuse. Moreover, not even law enforcement is allowed to access information about a particular case. Alicia Parkman a mortality research analyst at the Center for Health Statistics, Oregon Health Authority, wrote me: “We have been contacted by law enforcement and legal representatives in the past, but have not provided identifying information of any type.“

Assisted suicide in Washington and Oregon is a recipe for elder abuse and cloaked in secrecy. Don’t make our mistake.

Supporting documentation below.

Margaret Dore,

Seattle, Wash.

Mass: Inclusion Key in anti suicide drive

http://www.washingtontimes.com/news/2012/nov/14/inclusion-key-in-anti-suicide-drive/#disqus_thread

By Valerie Richardson, The Washington Times, November 14, 2012

The anti-euthanasia movement found new life last week after voters in Massachusetts defied the conventional wisdom by rejecting a physician-assisted suicide initiative.

In a setback for the “aid in dying” movement, Question 2, known as the Death With Dignity initiative, lost by a margin of 51 percent to 49 percent after leading by 68-to-20 in a poll released in early September by the Boston Globe.

The turnaround came after the “No on 2” camp fractured the liberal coalition that approved similar measures in Oregon and Washington by building a diverse campaign of religious leaders, medical professionals and advocates for the disabled along with a few prominent Democrats and a member of the Kennedy clan.

Massachusetts: Support withered for assisted-suicide ballot question

http://www.lowellsun.com/todaysheadlines/ci_22157064/support-withered-assisted-suicide-ballot-question#ixzz2Egbgwy23

 

By Chris Camire, ccamire@lowellsun.comlowellsun.com

Updated:   12/09/2012 07:15:07 AM EST

In late September, polls showed a ballot initiative that would make physician-assisted suicide legal for terminally ill patients had support from 68 percent of Massachusetts voters. 

Over the next month, that support steadily eroded, and on Election Day the measure failed by a razor-thin 51-49 percent margin. 

How did a proposal that seemed sure to pass just five weeks before the election come up short? 

Joseph Baerlein, president of Rasky Baerlein Strategic Communications, who handled public relations for the Committee Against Physician Assisted Suicide, said the measure's opponents had to convince voters who supported the idea of assisted suicide that the bill before them was flawed. 

"We focused our campaign strategy on looking at those weaknesses," said Baerlein. "For us to have a chance to win, we would have to have some amount of voters who felt it was their right take another look, so they would see that this wasn't the right way to do it."

The Death with Dignity Act, or Question 2, mirrored legislation passed in Oregon and Washington state.

Winning in Massachusetts: Inclusion was Key

http://www.washingtontimes.com/news/2012/nov/14/inclusion-key-in-anti-suicide-drive/#disqus_thread

By Valerie Richardson, The Washington Times, November 14, 2012

The anti-euthanasia movement found new life last week after voters in Massachusetts defied the conventional wisdom by rejecting a physician-assisted suicide initiative.

In a setback for the “aid in dying” movement, Question 2, known as the Death With Dignity initiative, lost by a margin of 51 percent to 49 percent after leading by 68-to-20 in a poll released in early September by the Boston Globe.

The turnaround came after the “No on 2” camp fractured the liberal coalition that approved similar measures in Oregon and Washington by building a diverse campaign of religious leaders, medical professionals and advocates for the disabled along with a few prominent Democrats and a member of the Kennedy clan.

Those who are not dying can be lured to assisted suicide

http://bostonglobe.com/opinion/letters/2012/11/02/those-who-are-not-dying-can-lured-assisted-suicide/mYhNV8k6hWseAFwSxdCnIL/story.html

I am a cancer doctor in Oregon, where physician-assisted suicide is legal. Oregon's assisted-suicide law applies to patients predicted to have less than six months to live. This does not necessarily mean that such patients are dying.

In 2000, I had a cancer patient named Jeanette Hall. Another doctor had given her a terminal diagnosis of six months to a year to live.  This was based on her not being treated for cancer. At our first meeting, she told me that she did not want to be treated, and that she wanted to opt for what our law allowed - to kill herself with a lethal dose of barbiturates.

I did not and do not believe in assisted suicide. I informed her that her cancer was treatable and that her prospects were good. But she wanted "the pills."  She had made up her mind, but she continued to see me. On the third or fourth visit, I asked her about her family and learned that she had a son. I asked her how he would feel if she went through with her plan. Shortly after that, she agreed to be treated, and her cancer was cured. 

Several years later she saw me in a restaurant and said, "Dr. Stevens, you saved my life."

For her, the mere presence of legal assisted suicide had steered her to suicide.

I urge the citizens of Massachusetts to vote no on Question 2.

Dr. Kenneth Stevens

Sherwood, Ore

Assisted Suicide Users are Older People with Money

By Margaret Dore, Esq., Updated October 29, 2012

Users of assisted suicide in Oregon and Washington are overwhelmingly white and generally well-educated.[1]  Many have private insurance.[2]  Most are age 65 and older.[3]  Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.[4] 

In the United States, elder financial abuse costs elders an estimated $2.9 billion per year.[5] Perpetrators include strangers, family members and friends.[6]. The goals of financial abuse perpetrators are achieved "through deceit, threats, and emotional manipulation of the elder."[7]

The Oregon and Washington assisted suicide acts, and the similar Massachusetts proposal, do not protect users from this abuse. Indeed, the terms of these acts encourage abuse. These acts allow heirs and other persons who will benefit from an elder's death to actively participate in his or her lethal dose request.[8] There is also no oversight when the lethal dose is administered, not even a witness is required.[9] This creates the opportunity for an heir, or someone else who will benefit from the person's death, to administer the lethal dose to that person without his consent.[10]  Even if he struggled, who would know?

This is not to say that all persons who use the Oregon and Washington acts are subject to abuse or that their actions are not voluntary.  Rather, the Oregon and Washington acts do not protect such persons from abuse.  Neither will the Massachusetts proposal.

For more information about problems with the Massachusetts' proposal, click here and here. For a "fact check" on the proposal, click here.

[1] See the most current official report from Washington State, "Washington State Department of Health 2011 Death with Dignity Act Report, Executive Summary ("Of the 94 participants in 2011 who died, . . . 94% were white, non-Hispanic . . .75 percent had at least some college education"), available at http://www.doh.wa.gov/portals/1/Documents/5300/DWDA2011.pdf  See also the most current official report from Oregon, also for 2011 ("most [users] were white (95.6%) [and] well-educated (48.5% had at least a baccalaureate degree) . . .", available at http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf
[2] See Washington's report in note 1, page 5, table 2 (46% had private insurance only, or a combination of private and Medicaid/Medicare).  See Oregon's report in note 1("patients who had private insurance (50.8%) was lower in 2011 than in previous years (68.0%). . ."
[3] See Washington's report in note 1, page 5, Table 2 (74% were aged 65 or older).  See Oregon's report in note 1, page 2 ("Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70 years").
[4]  Educated persons are generally financially better off than non-educated persons; persons with private insurance have funding to pay for it; seniors generally are well off.  See "Broken Trust:  Elders, Family, and Finances, a Study on Elder Financial Abuse Prevention, by the MetLife Mature Market Institute, the National Committee for the Prevention of Elder Abuse, and the Center for Gerontology at Virginia Polytechnic Institute, March 2009, Executive Summary, page 4 ("Elders’ vulnerabilities and larger net worth make them a prime target for financial abuse").
[5]  The Met Life Study of Elder Financial Abuse, " Crimes of Occasion, Desperation, and Predation Against America's Elders," June 2011, page 2, key findings ("The annual financial loss by victims of elder financial abuse is estimated to be at least $2.9 billion dollars, a 12% increase from the $2.6 billion estimated in 2008"). 
[6] Id.
[7] Id., page 3.
[8] See e.g. Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009; and Margaret K. Dore, Memo to Joint Judiciary Committee (regarding Bill H.3884, now Ballot Question No. 2), Section III
[9] Id.  See also entire proposed Massachusetts Act at http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf
[10]  The drugs used, Secobarbital and Pentobarbital, are water and alcohol soluable, such that they can be injected without consent, for example, to a sleeping individual.  See "Secobarbital Sodium Capsules, Drugs.Com, at  http://www.drugs.com/pro/seconal-sodium.html  If the person wakes up and trys to fight, who would know? 

Legalization And Violent Deaths

By Margaret Dore

Assisted suicide proponents claim that legal assisted suicide will prevent violent deaths such as those by murder-suicide and suicide involving a handgun.[1] In Oregon where assisted-suicide has been legal since 1997, murder-suicide has not been eliminated.[2]  Indeed, murder-suicides follow "the national pattern."[3]  As discussed below, suicides involving a handgun have also not been eliminated.  Oregon's suicide rate has instead increased with legalization of assisted suicide.

Oregon’s overall suicide rate, which excludes suicides under Oregon’s assisted suicide act, is 35% above the national average.[4] This rate has been "increasing significantly since 2000."[5]  Just three years prior, in 1997, Oregon legalized physician-assisted suicide.[6] Other suicides thus increased, not decreased, with legalization of assisted suicide.  Moreover, many of these deaths are violent.  For 2007, which is the most recent year reported, "[f]irearms were the dominant mechanism of suicide among men."[7] The claim that legalization will prevent violent deaths is without factual support.

* * *

[1]  See e.g. Lindsey Anderson, Associated Press, "Mass. Voters Consider Physician-Assisted Suicide," October 20, 2012, at http://www.wbur.org/2012/10/20/physician-assisted-suicide ("Dr. Marcia Angell ... believes [her father] would've lived longer and not turned to a pistol had assisted suicide been available").
[2]  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); Baldr Odinson, "Fourth Murder-Suicide for the Eugene Area," New Trajectory:  A blog for Ceasefire Oregon, March 2, 2011, ("Harry Hanus, age 74, shot and killed his wife, Barbara, before taking his own life")

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. 

Users of Assisted Suicide are Seniors with Money

By Margaret Dore, Esq.

Users of assisteds suicide are "overwhelmingly white, well educated and financially comfortable."[1]  They are also age 65 and older.[2]  In other words, users are older people with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.[3]  

In the United States, elder financial abuse costs elders an estimated $2.9 billion per year.[4]  Perpetrators include strangers, family members and friends.[5].  The goals of financial abuse perpetrators are achieved "through deceit, threats, and emotional manipulation of the elder."[6]

The Oregon and Washington assisted suicide acts, and the similar Massachusetts proposal, do not protect users from this abuse. Indeed, the terms of these acts encourage abuse.  These acts allow heirs and other persons who will benefit from an elder's death to actively participate in his or her lethal dose request.[7]  There is also no oversight when the lethal dose is administered, not even a witness is required.[8]  This creates the opportunity for an heir, or someone else who will benefit from the person's death, to administer the lethal dose to that person without his consent.  Even if he struggled, who would know?

For more information about problems with the Massachusetts' proposal, click here and here.  For a "fact check" on the proposal, click here.

* * * [1]  Katie Hafner, "In Ill Doctor, a Surprise Reflection of Who Picks Assisted Suicide," New York Times, August 11, 2012.
[2]  See e.g., the most current official report from Oregon, "Oregon Death with Dignity Act--2011" ("Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70 years"), available at http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf
[3]  The MetLife Study of Elder Financial Abuse, "Crimes of Occasion, Desperation, and Predation Against America's Elders," June 2011 (a follow up to MetLife's 2009 "Broken Trust: Elders, Family, and Finances"), available at http://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf
[4]  Id., page 2, key findings  
[5]  Id.
[6]  Id., page 3.
[7]  See Memo to Joint Judiciary Committee (regarding Bill H.3884, now ballot measure No. 2), Section III.A.2. ("Someone else is allowed to speak for the patient"), available at http://www.massagainstassistedsuicide.org/p/memo-to-joint-judiciary-committee.html
[8]  See above memo at Section III.A.1("No witnesses at the death").  See also entire proposed Massachusetts Act at http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf

In Oregon, other suicides have increased with legalization of physician-assisted suicide

Scott Helman's article about legalizing assisted suicide in Massachusetts implies that doing so will eliminate violent suicides.  I am physician in Oregon where assisted suicide is legal.  Official statistics from the state of Oregon do not support this claim.

Based on an Oregon Public Health report released in 2010, Oregon's overall suicide rate, which excludes suicide under Oregon's assisted suicide act, is 35% above the national average. The report documents that the rate has been "increasing significantly since 2000." 

Just three years prior, in 1997, Oregon legalized assisted suicide.  Suicide has thus increased, not decreased, with legalization of assisted suicide.  Moreover, many of these deaths are violent.  For 2007, which is the most recent year reported on Oregon's website, "[f]irearms were the dominant mechanism of suicide among men."  The claim that legalization prevents violent deaths is without factual support.

Factual support for the above statistics:

Oregon Health Authority News Release September 9, 2010 athttp://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf and,

"Suicides in Oregon, Trends and Risk Factors," Executive Summary, p.4, at

http://public.health.oregon.gov/DiseasesConditions/InjuryFatalityData/Documents/Suicide%20in%20Oregon%20Trends%20and%20risk%20factors.pdf  

William L. Toffler MD

Professor of Family Medicine

Oregon Health & Science University

Posrtland OR

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).

Vermont: "Assisted suicide law sends contradictory message"

Editor’s note: This op-ed is by Guy Page, a parent and resident of Cambridge.

http://vtdigger.org/2012/02/01/page-assisted-suicide-law-sends-contradictory-message/

In the Jan. 19 mail I received a letter from Lamoille Union High School, where my daughter is enrolled. It begins with the following sentence: “Over the last few years Vermont has seen an increase in suicide among young people.” It went on to describe a school initiative to hopefully address this awful development. I hope they are successful. All of my children have friends, or friends of friends, who have taken their own lives.

My eldest son, Tim, was a constant suicide risk through his teens. Through the wise, compassionate help of state social workers, Tim escaped his teen years alive. I can tell you that he was personally shaken by the implications, to him, of the proposed assisted suicide law several years ago. When he heard about it, my brilliant, troubled son began to shake in anger and almost despair. “Those hypocrites,” he said. “They’ve been telling me all this time that suicide is never OK.” It didn’t matter when I said the law is meant to address another set of problems – his teenaged hypocrisy-o-meter had already pegged assisted suicide as another example of “do as I say, not as I do, it’s all right for adults, not OK for kids.”

Recently I researched teen suicide in Oregon, where assisted suicide became legal in 1998. According to the Oregon health department website, there were more teen suicides after the law passed than before — 1999: 29 suicides. 2000: 44 suicides. 2001: 31. 2002: 37. 2003: 46. 2004: 52. The last two years were the highest two-year period in their survey. Furthermore, 94 percent of teen suicide attempts leading to hospitalization were caused by ingesting drugs – the only form of assisted suicide permitted by Oregon state law. Kids learn from their elders.  [See:  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5635a2.htm]

Does this “prove” a link between the Oregon physician-assisted suicide law and teen suicide? No. But the burden of proof is on those who say, “Don’t worry, it will all be OK, none of our teens will think that.” As a parent of an at-risk child, I think this law may unintentionally tell other troubled teens “when it gets too hard it’s okay to end it all.” As the letter from my daughter’s high school says, the real world is a very hard place for some teens right now, and I think this law will just make it harder.

There are plenty of other reasons to oppose this bill. Before my wife passed in February 2011, she was appalled and upset at end-of-life questions asked of her in the ICU that to her seemed motivated by hospital cost-control. It drove a (thankfully temporary) wedge of distrust between her and her caregivers. So Vermont Insurance Commissioner Steve Kimball’s newspaper comments connecting this end-of-life issue with the high cost of health care were chilling. By contrast, Orange County Sen. Mark MacDonald’s daughter was one of Diane’s nurses and provided skilled, affirming care that should be the goal of the state’s health policy. But for me the teen suicide connection is reason enough for the Senate to drop this bill before it does irreversible harm.

---

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The Leblanc Case: A Recipe for Elder Abuse and a Threat to the Individual

By Margaret Dore

January 26, 2012

"Those who believe that legal assisted
suicide/euthanasia will assure their

autonomy and choice are naive."

William Reichel, MD

Montreal Gazette,

May 30, 2010[1]

A.  Introduction

Leblanc vs. Attorney General of Canada brings a constitutional challenge to Canada's law prohibiting aiding or abetting a suicide.  Leblance also seeks to legalize assisted suicide and euthanasia as a medical treatment.  In 2010, a bill in the Canadian Parliament seeking a similar result was overwhelmingly defeated. 

Legalization of assisted suicide and/or euthanasia under Leblanc will create new paths of elder abuse.  This is contrary to Canadian public policy.  Legalization will also empower the health care system to the detriment of individual patients. 

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.

Canada: The Danger of Euthanasia: "If euthanasia were legal, the wife, not wanting to die, would still be a victim"

http://www.ottawacitizen.com/opinion/Danger+euthanasia/5935217/story.html

 

By Alex Schadenberg, Ottawa Citizen January 2, 2012
 

Re: Time to rethink euthanasia, Dec. 29.

Marcel Lavoie implies that legalizing euthanasia would stop violent deaths in the elderly, such as the death of Doreen Flann by stabbing.

In many of these deaths, the perpetrator-husband also kills himself for a murder-suicide.

 

In Oregon, where assisted-suicide has been legal since 1997, murdersuicide has not been eliminated. Indeed, murder-suicide follows the national pattern.

Moreover, according to Donna Cohen, an expert on murder-suicide, the typical 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."

If euthanasia were legal, the wife, not wanting to die, would still be a victim.

Our laws against assisted suicide and euthanasia are in place to protect vulnerable people. Assisted suicide and/or euthanasia should not be legalized in Canada.

[For more indepth information, see Dominique Bourget, MD, Pierre Gagne, MD, Laurie Whitehouse, PhD, "Domestic Homicide and Homicide-Suicide:  The Older Offender," Journal of the American Academy of Psychiatry and the Law, September 2010 (Canadian study);  Don Colburn, "Recent murder-suicides follow the national pattern," The Oregonian, November 17, 2009; and “Murder-suicides in Elderly Rise: Husbands commit most murder-suicides – without wives’ consent” ]

Alex Schadenberg,

London Ont., Canada
Executive Director,

Euthanasia Prevention Coalition

Helium Hood Seller Pleads Guilty to Tax Fraud

http://www.latimes.com/news/local/la-me-suicide-lady-20111203,0,3503245.story

San Diego-area suicide kit seller agrees to stop sale of devices

El Cajon woman came under scrutiny when one of her products was found on a dead 29-year-old in Oregon.

By Richard Marosi, Los Angeles Times

December 3, 2011

Reporting from San Diego -- A former schoolteacher who sold suicide kits that she once touted as leaving people "eternally sleepy" pleaded guilty Friday to a tax evasion charge and agreed to stop encouraging people to commit suicide.

Sharlotte Hydorn mailed more than 1,300 of the so-called helium hood suicide kits to people around the world, concealing the true nature of the product by describing the boxes as "orchid humidifiers" or "beauty bonnets" or "plastic rain hoods" on U.S. customs forms, according to federal prosecutors.

The $60 kits actually contained a clear plastic bag, medical grade tubing and a how-to diagram. A customer would place the bag over his head, connect the tubing from the bag to a helium tank and turn the valve. Death would be caused by helium asphyxiation.

Hydorn, 91, who was once an elementary school science teacher, marketed the product to terminally ill people as a compassionate alternative. She admitted to federal agents, however, that she didn't verify the physical condition, age or identity of the people who ordered her product.

She drew scrutiny last year after one of her devices was found over the head of a dead 29-year-old man from Eugene, Ore. In May, federal agents raided her home in El Cajon, east of San Diego, where she assembled the kits with her son.

Investigators determined that the kits had been sold to at least 50 people in San Diego County since 2007. In 2010, four San Diego residents — none of them terminally ill — committed suicide using the kits, according to prosecutors.

Hydorn said she became interested in assisted suicide after watching her once-healthy husband die after a long battle with colon cancer 30 years ago. He died in a hospital bed, and she regrets not being able to respect his wishes to die in the comfort of his home.

Her product, Hydorn said, ends lives peacefully, leaving people "eternally sleepy."

In Oregon, where assisted suicide is legal under certain conditions, lawmakers have introduced a bill that would outlaw any device sold with the intent that another person use it to commit suicide.

Hydorn had failed to file federal income tax returns since 2007 and agreed to pay about $26,000 in outstanding taxes, prosecutors said. She faces a maximum penalty of one year in prison and is scheduled to be sentenced Feb. 26.

richard.marosi@latimes.com

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.

Vermont: Don't Make Oregon's Mistake

http://www.benningtonbanner.com/opinion/ci_19077890

Posted: 10/09/2011 09:32:49 PM EDT, Sunday October 9, 2011 

 

I am a doctor in Oregon where physician-assisted suicide is legal. Dr. Richard Guerrero's letter justifies his support of assisted suicide with a discussion of physical pain (Sept. 30).

 
In Oregon, there has never been a documented case of assisted suicide used because there was actual untreatable pain.
 
One of the first times I discussed assisted suicide with a patient was with a man in a wheelchair with a progressive form of multiple sclerosis who asked me for assistance with his suicide. I told him that I could readily understand his fear and his frustration and even his belief that assisted suicide might be a good path for him.
 
At the same time, I told him that should he become sicker or weaker, I would work to give him the best care and support available. I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his suicide. He simply said: "Thank you."
 
How we respond to someone requesting suicide can either reflect the person's inherent worth or can cause the person even deeper desperation. Patients can even feel pressured to proceed simply due to how we respond. For this reason alone, the deaths may not be voluntary. Don't make Oregon's mistake.
 
WILLIAM L. TOFFLER, MD