Showing posts with label Washington. Show all posts
Showing posts with label Washington. Show all posts

Saturday, November 2, 2019

Speaking in Washington State USA

Margaret Dore
This evening, Margaret Dore, a lawyer and president of Choice is an Illusion, was the featured speaker at St. Louise Parish Hall in Bellevue, Washington State.

Her main topics included problems with assisted suicide in Washington and how to win in the future against legalization. She also discussed suicide contagion in Oregon.

To learn more about assisted suicide in Washington State, click herehere and here.

Special thanks to Debby Ummel who organized the event.

Thursday, June 16, 2016

New York Memo Opposing Bills A. 10059 and S. 7579 - Web Version

https://choiceisanillusion.files.wordpress.com/2016/06/ny-memo-05-31-16_001.pdf

I. INTRODUCTION

I am a lawyer in Washington State where physician-assisted suicide and euthanasia are legal.[1] Our law is based on a similar law in Oregon.  Both laws are similar to the proposed bills, A. 10059 and S. 7579.[2]

The bills are titled “Medical Aid in Dying.”  There is, however, no requirement that patients be dying. “Eligible” patients may have years, even decades, to live. The bills are also sold as a promotion of patient choice and control. The bills are instead stacked against the patient and a recipe for elder abuse. Finally, the bills are deceptively written; they are not what they appear to be. I urge you to vote “No.”

Sunday, May 22, 2016

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."

Wednesday, May 11, 2016

New Power of Attorney Act Expressly Excludes "Death with Dignity"


Washington State's new uniform power of attorney act specifically says that “no rights under Washington’s death with dignity act, chapter 70.245 RCW may be exercised through a power of attorney.”  Session Law 5635, Section 219.

Sunday, December 13, 2015

Quick Facts About Assisted Suicide

By Margaret Dore, Esq., MBA
For a pdf version, please click here

1.  Assisted Suicide

Assisted suicide means that someone provides the means and/or information for another person to commit suicide. When a physician is involved, the practice is physician-assisted suicide.

2. The Oregon and Washington Laws

In Oregon, physician-assisted suicide was legalized in 1997 via a ballot measure. In Washington State, a similar law was passed by another ballot measure in 2008 and went into effect in 2009.

3.  Problems With Legalization

The Oregon and Washington laws are a recipe for elder abuse and encourage people with years to live to throw away their lives. In Oregon, there are documented cases of the Oregon Heath Plan (Medicaid) steering patients to physician-assisted suicide via coverage incentives. Oregon’s conventional suicide rate has increased with legalization of assisted suicide, which is consistent with a suicide contagion. Patients and families are traumatized.

The Oregon and Washington laws require the death certificate to be falsified to reflect a natural death via a terminal disease, as opposed to the actual cause of death, a lethal dose. The significance is a lack of transparency and an inability to take legal action against overreaching parties.

Sunday, May 31, 2015

Attorney slams California suicide bill

FOR IMMEDIATE RELEASE


Dore: “Even if you like the concept of assisted suicide, SB 128 is the wrong bill.”

Contact: Margaret Dore (206) 697-1217


Seattle, WA -- Attorney Margaret Dore, president of Choice is an Illusion, which has fought assisted suicide legalization efforts in many states and now California, made the following statement after the California Senate Appropriations Committee passed SB 128 on May 28, sending the assisted suicide bill to the Senate floor.

"SB 128 is sold as giving people an 'end of life option,’” Dore said. “The fact is this bill is about ending the lives of people who aren’t necessarily dying anytime soon, and giving other people the ‘option’ to hurry them along."

Dore, an attorney in Washington State where assisted suicide is legal, explained, “In my law practice, I started out working in guardianships, wills and probate, and saw abuse of all kinds, especially where there was money involved (where there's a will, there are heirs). Then, in 2008, I got dragged to a meeting about our assisted suicide law and saw the perfect crime: your heir could help sign you up, and once the lethal dose was in the house, there was no oversight. Not even a witness is required. If you struggled, who would know?"

Thursday, February 19, 2015

Washington State: SB 5919 on the move!

Last night, SB 5919, which clarifies that a person considering assisted suicide has the right to be told of options for cure or to extend life, has passed out of the Law & Justice Committee.

The vote was bipartisan.  The seven member committee voted as follows:  6 "do pass" and 1 "without recommendation."  See here

Marlene Deakins, RN, Supporting SB 5919

"I hope that  with the proposed bill, doctors will get the message that they need to back off , to make sure that patients are freely choosing what’s best for them, as chosen by them."

* * * 

Dear Senator Padden, Members of the Law and Justice Committee and Senator Angel:

I am a Registered Nurse.  I am writing this letter in support of SB 5919, which would make it clear that persons asking about assisted suicide remain eligible to be told about options for cure or to extend life.  I hope that this law will provide protection for people like my brother, Wes Olfert, who died a few years ago (2011) in Washington State.

When he was first admitted to the hospital, he made the mistake of asking about assisted suicide.  I say a mistake, because this set off a chain of events that interfered with his care and caused him unnecessary stress in what turned out to be the last months of his life.

By asking the question, he was given a "palliative care" consult by a doctor who heavily and continually pressured him to give up on treatment before he was ready to do so.  It got so bad that Wes became fearful of this doctor and asked me and a friend to not leave him alone with her.

I hope that  with the proposed bill, doctors will get the message that they need to back off, to make sure that patients are freely choosing what’s best for them, as chosen by them.

Please vote “yes” on SB 5919

Marlene Deakins, RN
Tuscon Arizona


Saturday, February 14, 2015

Senator Jan Angel, Supporting SB 5919

This bill . . . is about choice and common sense. Patients should know all their options before having to make a life-or-death decision.

The bill does not impose any limitations on a person's ability to choose what is best for him or her. It could even be called a technical amendment as it just expands the list of information that is provided to patients before they make their decision.

Kenneth Stevens, MD, supporting SB 5919.

My name is Dr. Kenneth Stevens. I live in Sherwood, Oregon. I'm testifying in favor of Senate Bill 5919, which amends Washington's Death with Dignity Act.

I'm a cancer doctor in Oregon, where we've had the similar act since 1997. I'm also a professor emeritus at Oregon Health and Science University. I previously served as Chair of the Department of Radiation Oncology. I have treated thousands of patients with cancer.

Jeanette Hall
I practice in both Washington state as well as Oregon. I've read the proposed bill, which amends Washington's act to make it clear that patients who request a lethal dose under the act have the right to be told of treatment options for cure and to extend life.

I strongly support this bill, especially due to my experience with a patient named Jeanette Hall. The Oregon and Washington acts apply to patients predicted to have less than six months to live.  This does not necessarily mean that the patients are dying. This is true for two reasons:

WA State: Vote "YES" on SB 5919.

This is a simple bill, which clarifies that patients considering assisted suicide have a right to be told of their options for cure or to extend life. Passing the bill will be consistent with how Washington's assisted suicide act was marketed to the voters, as providing choice for patients. I urge you to vote "Yes.”
* * *
Below please find my updated memo supporting SB 5919, currently pending in the Washington State Senate. To see a print version, please click here.

Margaret Dore, Esq., MBA

Thursday, November 13, 2014

If New Jersey's Assisted Suicide Bill Is Enacted, There Will be Pressure to Expand its Reach to Broader Groups of People.

By Margaret Dore, Esq., MBA

Today, the New Jersey Assembly passed a proposed assisted suicide/euthanasia bill, which goes next to the New Jersey Senate. The bill is the "third reprint" of A2270, which has a six months to live eligibility criteria for assisted suicide and euthanasia.

If enacted, there will be pressure to expand “eligibility” to broader groups of people who are not close to death.  I say this due to what’s been happening with hospice and our experience here in Washington State regarding our similar law.  See also this legal/policy analysis of the third reprint.

Hospice

Hospice has a six months to live eligibility criteria.  In August, the Washington Post reported that there “appears to be a surge in hospices enrolling patients who aren’t close to death.”[1]  This practice is resulting in the overdose deaths of non-dying people.[2]

This is consistent with what I've been hearing from people in both the US and Canada regarding the deaths of their family members.[3]

Washington State

In Washington State, our law went into effect in 2009.  Since then, we have had informal “trial balloon” proposals to expand our law to non-terminal people.  For example, there was a column in the Seattle Times, which is our largest paper, containing this suggestion for euthanasia of people who didn't save enough for their old age. The column stated:
A few [readers] suggested that if you couldn't save enough money to see you through your old age, you shouldn't expect society to bail you out.
At least a couple mentioned euthanasia as a solution.[4] 
So, you work hard all your life, pay taxes and then your pension plan goes broke, this is how society would pay you back, with non-voluntary or involuntary euthanasia?

Prior to passing our law, I never heard anyone talk like this.

Don't make Washington's mistake.

Margaret Dore is an attorney in Washington State and President of Choice is an Illusion.  For more information about problems with New Jersey's bill, please see Ms. Dore' legal/policy memo regarding that law, which can be viewed here: https://choiceisanillusion.files.wordpress.com/2014/11/nj-no-on-a2270-no-assisted-suicide-11-12-14.pdf

[1] Peter Whoriskey, “As More Hospices Enroll Patients Who Aren’t Dying, Questions About Lethal Doses Arise,” Washington Post. August 21, 2014, http://www.washingtonpost.com/news/storyline/wp/2014/08/21/as-more-hospices-enroll-patients-who-arent-dying-questions-about-lethal-doses-arise/?
[2] Id.
[3] See e.g. Carol Mungas, "I support House Bill 505, which clearly states that assisted suicide is not legal" (My husband, Dr. James E. Mungas "was effectively euthanized against his will"),  http://www.montanansagainstassistedsuicide.org/2013/03/i-support-house-bill-505-which-clearly.html; Daniela, "Euthanasia without patient consent and over the family's objection," ("Our family . . . is having emotional problems because of what we witnessed.... [N]ow I hear my grandma cry for water every night") http://www.margaretdore.org/2014/11/euthanasia-without-patient-consent-and.html and Kate Kelly, "Mild stroke led to mother's forced starvation,"("I cried much of the time, but softly, so she would not know.  I didn't want to add to her agony.")   http://www.choiceillusion.org/p/mild-stroke-led-to-mothers-forced.html
[4] To view a copy of the newspaper column, please go here: https://choiceisanillusion.files.wordpress.com/2014/10/jerry-large_001.pdf.



Thursday, October 9, 2014

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

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

Saturday, August 30, 2014

Washington Post Puts the Spotlight on Hospice/Palliative Care Abuse

By Margaret Dore, Esq., MBA
Choice is an Illusion, President

Below and finally, a comprehensive article in a major paper describing what a lot of us know already, that non-consenting, non-dying people are being killed with morphine and other drugs under the guise of hospice/palliative care.  The article, excerpted below from the Washington Post, describes cases in the US. There are similar cases in Canada and the UK (e.g, the former "Liverpool Pathway").

There are a myriad of reasons why these cases occur, including mistakes and negligence, which is described in the Post article.  The wishes of heirs interested in a speedy inheritance and/or to get dad out of the way before he changes his will, can also be at play.  For a particularly egregious example, see William Dotinga, "Grim Complaint Against Kaiser Hospital," at http://www.courthousenews.com/2012/02/06/43641.htm


With hospice, eligibility is determined by a prediction of less than six months to live.  This is the same eligibility cutoff used for legal assisted suicide in Oregon and Washington State.  This is, however, just a prediction and there are many people deemed eligible who live longer than that and/or who are not dying.  See, e.g., the Washington Post article excerpted below and this article from the Seattle Weekly: "Terminal Uncertainty."  See also this affidavit from Oregon doctor Kenneth Stevens, MD and this affidavit from John Norton.

This hospice/palliative care abuse issue is important for itself, as well, as for its implications in the larger debate over assisted suicide/euthanasia legalization.  Consider, for example, the letter below from Washington State.  The author, the owner of a care facility, describes how since passage of Washington's assisted suicide law, doctors more readily resort to morphine, sometimes without consent.  He states:
Since [Washington's assisted suicide law] passed, we have . . .  noticed that some members of the medical profession are quick to bring out the morphine to begin comfort care without considering treatment. Sometimes they do this on their own without telling the client and/or the family member in charge of the client's care. http://www.choiceillusion.org/2013/12/it-wasnt-father-saying-that-he-wanted.html
He also describes a general devaluation of older people, as follows:
Since our [assisted suicide] law was passed, I have also observed that some medical professionals are quick to write off older people as having no quality of life whereas in years past, most of the professionals we dealt with found joy in caring for them. Our clients reciprocated that joy and respect.  (Id.).
He concludes by asking readers to not make Washington's mistake of legalizing assisted suicide. He states:
Someday, we too will be old. I, personally, want to be cared for and have my choices respected. I, for one, am quite uncomfortable with these developments. Don't make our mistake.  (Id.).
* * *
Below, the excerpt from the Washington Post article.

As More Hospices Enroll Patients who Aren't Dying, Questions About Lethal Doses Arise

http://www.washingtonpost.com/news/storyline/wp/2014/08/21/as-more-hospices-enroll-patients-who-arent-dying-questions-about-lethal-doses-arise/?

By Peter Whoriskey at peter.whoriskey@washpost.com

Saturday, July 12, 2014

UK: Falconer Assisted Suicide Bill: "Eligible" Patients May Have Years, Even Decades, to Live

By Margaret Dore, Esq., MBA

In the UK, HL Bill 6 is an assisted suicide law proposed by Lord Falconer, which is based on the Oregon and Washington assisted suicide laws.  Bill 6 would legalize assisted suicide for persons with a "terminal illness," defined in terms of a prediction of less than six months to live.[1]  The Oregon and Washington laws have a similar six months to live criteria.[2]

Under all three laws, "eligible" patients may have years, even decades, to live.  This is true for the following the following reasons: 

1.      Predictions of life expectancy can be wrong.  

Patients may have years or even decades to live because predicting life expectancy is not an exact science.  Consider John Norton who was diagnosed with ALS.  He was told that he would get progressively worse (be paralyzed) and die in three to five years.  Instead, the disease progression stopped on its own.  In a 2012 affidavit, at age 74, he states:
If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.  http://www.massagainstassistedsuicide.org/2012/09/john-norton-cautionary-tale.html [3]
2.      The six months to live is determined without treatment. 

Consider Oregon resident, Jeanette Hall, who was diagnosed with cancer and decided to "do" Oregon's law.  Her doctor, Kenneth Stevens, didn't believe in assisted suicide and encouraged her to be treated instead.  It is now 14 years later and she is "thrilled" to be alive.  This is Dr. Steven's affidavit filed by the Canadian government in Leblanc v. Canada, now dismissed, discussing Jeanette.  http://choiceisanillusion.files.wordpress.com/2013/07/signed-stevens-aff-9-18-12-as-filed.pdf   This is Jeanette's affidavit, also filed by the Canadian government:  http://choiceisanillusion.files.wordpress.com/2013/05/jeanette-hall-affidavit.pdf  

3.      In Oregon, the six months to live criteria is now being interpreted to include chronic conditions such as diabetes.  

Oregon doctor, William Toffler, explains: 
Our law applies to “terminal” patients who are predicted to have less than six months to live. In practice, this idea of terminal has recently become stretched to include people with chronic conditions such as chronic lower respiratory disease and diabetes. Persons with these conditions are considered terminal if they are dependent on their medications, such as insulin, to live. They are unlikely to die in less than six months unless they don’t receive their medications. Such persons, with treatment, could otherwise have years or even decades to live.[4]  
* * *
[1]  See HL Bill 6, Sections 2, at http://services.parliament.uk/bills/2014-15/assisteddying.html (defining "terminal illness" as an "inevitably progressive condition which cannot be reversed by treatment," and for which the patient "is reasonably expected to die in six months.").
[2]  See ORS 127.800 s.1.01(12) and RCW 70.245.010(13) at    http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx and http://apps.leg.wa.gov/RCW/default.aspx?cite=70.245.010  (both stating:  "'Terminal disease' means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.").
[3]  See also:  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? The Seattle Weekly, January 14, 2009 http://choiceisanillusion.files.wordpress.com/2013/10/terminal-uncertainty.pdf and http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty
[4]  Letter from William Toffler, MD, to the New Haven Register, published February 26, 2014, 2nd letter at http://www.nhregister.com/opinion/20140226/letters-to-the-editor-dying-deserve-right-to-choice  See also, Dore Memo at pp 6-7, at http://choiceisanillusion.files.wordpress.com/2014/06/nj-a2270-legal-analysis_001.pdf and Margaret Dore, “Oregon's new assisted suicide report: chronic conditions;  people with money and more,” February 19, 2014, at http://www.choiceillusion.org/2014/01/oregons-new-assisted-suicide-report.html 

Wednesday, June 18, 2014

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

Wednesday, March 5, 2014

"Older people are no longer valued as they were before."

http://www.nhregister.com/opinion/20140304/letters-to-the-editor-time-to-rethink-who-our-leaders-are (second letter)

Dear Editor:  

I am a high school student in Washington state, where assisted suicide is legal. I want to become a doctor. My mother is a caregiver. Sometimes, I help her with her clients.
I am writing to tell you about how older people are at risk in Washington, from doctors and hospitals. I will also talk about how attitudes about older people have changed for the worse. This is especially true since our assisted-suicide law was passed in 2008.
I grew up in an adult family home. An adult family home is a small elder care facility located in a residential home. The caregivers live in the home with the clients.
My parents and two of my brothers lived in the home. With the clients there, it was like having six grandparents at once. It was a very happy environment.
This was true for the clients, too, no matter what their condition was or how long they had to live. My mom could make them happy even when they were dying. The clients’ family members were supportive and seemed happy, too, and never suggested that one of the clients should die.
Today, in 2014, we no longer live in an adult family home. My mother is a caregiver for private clients. She also now fears for her clients, especially in the hospital. She is afraid that the hospital will begin “comfort care” (that’s morphine) and her patient will suddenly die. This has already happened. She tries to never leave her patients alone in the hospital. Either she or a family member will be there.
She has also had one client where a family member wanted the client to do the assisted-suicide.
In short, older people are no longer valued as they were before.
I hope that you will not follow our path.
— Elizabeth Poianna 

Wednesday, February 5, 2014

Preventing Abuse and Exploitation: A Personal Shift in Focus. An article about guardianship, elder abuse and assisted suicide.

http://www.americanbar.org/publications/voice_of_experience/2014/winter/preventing_abuse_and_exploitationa_personal_shift_focus.html

http://choiceisanillusion.files.wordpress.com/2014/02/dore-preventing-abuse-and-exploitation-aba.pdf

By Margaret K. Dore, Esq., MBA
The Voice of Experience, American Bar Association
Volume 25, No. 4, Winter 2014

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

My Guardianship Cases

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

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

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

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

At this point, the scales began to fall from my eyes.  My focus started to shift from working within the system to seeing how the system itself sometimes facilitates abuse.  This led me to write articles addressing some of the system’s flaws.  See e.g., Margaret K. Dore, Ten Reasons People Get Railroaded into Guardianship, 21 AM. J. FAM. L. 148 (2008), available at www.margaretdore.com/pdf/Dore_AJFL_Winter08.pdf; Margaret K. Dore, The Time is Now: Guardians Should be Licensed and Regulated Under the Executive Branch, Not the Courts, WASH. ST. B. ASS’N B. NEWS, Mar. 2007 at 27-9, available at http://maasdocuments.files.wordpress.com/2013/08/dore-the-time-is-now-ashx.pdf

The MetLife Studies 

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

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

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

Failure to Report

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

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

A New Development: Legalized Assisted Suicide

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

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

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

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

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

My Cases Involving the Oregon and Washington Assisted Suicide Laws

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

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

Conclusion

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

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

Sunday, January 5, 2014

"He made the mistake of asking for information about assisted suicide"

http://missoulian.com/news/opinion/mailbag/legalizing-assisted-suicide-allows-physicians-to-pressure-patients/article_5726f258-84fb-11e2-9707-001a4bcf887a.html

Last year, my brother, Wes Olfert, died in Washington state, where assisted suicide is legal.

When he was first admitted to the hospital, he made the mistake of asking for information about assisted suicide. I say a mistake, because this set off a chain of events that interfered with his care and caused him unnecessary stress in what turned out to be the last months of his life.

By asking the question, he was given a “palliative care” consult by a doctor who heavily and continually pressured him to give up on treatment before he was ready to do so. It got so bad that Wes actually became fearful of this doctor and asked me and a friend to not leave him alone with her. Justified or not, Wes was afraid that the doctor would do something to him or have him sign something if she would find him alone.

In fact, even though he was on heavy doses of narcotic pain medications and not in a clear state of mind to sign documents without someone to advocate for him, this palliative care MD actually did try to get him to sign a DNR or “Do Not Resuscitate” form without his Durable POA or any family member present. Fortunately, his close friend/POA arrived at that moment to stop this from happening. Some of the other doctors and staff members seemed to also write Wes off once they learned that he had asked about assisted suicide.

I am writing to urge your readers to prevent assisted suicide in Montana. I do this on behalf of myself and my other brother, Ron Olfert, of Sanders County, who also died last year. He was strongly opposed to assisted suicide.

Please contact your legislators and ask them to vote “yes” on House Bill 505.

Marlene Deakins, RN
Tuscon, Arizona


Friday, January 3, 2014

Washington's Assisted Suicide Act

Originally published as "'Death with Dignity':  What Do We Advise Our Clients?," King County Bar Bulletin, May 2009.  See here.

Margaret Dore, Esq.

A client wants to know about the new Death with Dignity Act, which legalizes physician-assisted suicide in Washington.1 Do you take the politically correct path and agree that it's the best thing since sliced bread? Or do you do your job as a lawyer and tell him that the Act has problems and that he may want to take steps to protect himself?

Patient "Control" is an Illusion

The new act was passed by the voters as Initiative 1000 and has now been codified as Chapter 70.245 RCW.  During the election, proponents touted it as providing "choice" for end-of-life decisions. A glossy brochure declared, "Only the patient — and no one else — may administer the [lethal dose]."2 The Act, however, does not say this — anywhere. The Act also contains coercive provisions. For example, it allows an heir who will benefit from the patient's death to help the patient sign up for the lethal dose.

How the Act Works

The Act requires an application process to obtain the lethal dose, which includes a written request form with two required witnesses.The Act allows one of these witnesses to be the patient's heir.4 The Act also allows someone else to talk for the patient during the lethal-dose request process, for example, the patient's heir.5 This does not promote patient choice; it invites coercion.

Interested witness

By comparison, when a will is signed, having an heir as one of witnesses creates a presumption of undue influence. The probate statute provides that when one of the two required witnesses is a taker under the will, there is a rebuttable presumption that the taker/witness "procured the gift by duress, menace, fraud, or undue influence."6

Once the lethal dose is issued by the pharmacy, there is no oversight. The death is not required to be witnessed by disinterested persons. Indeed, no one is required to be present. The Act does not state that "only" the patient may administer the lethal dose; it provides that the patient "self-administer" the dose.

"Self-administer"

In an Orwellian twist, the term "self-administer" does not mean that administration will necessarily be by the patient. "Self-administer" is instead defined as the act of ingesting. The Act states, "'Self-administer' means a qualified patient's act of ingesting medication to end his or her life."7

In other words, someone else putting the lethal dose in the patient's mouth qualifies as "self-administration." Someone else putting the lethal dose in a feeding tube or IV nutrition bag also would qualify. "Self-administer" means that someone else can administer the lethal dose to the patient.

No witnesses at the death

If, for the purpose of argument, "self-administer" means that only the patient can administer the lethal dose himself, the patient still is vulnerable to the actions of other people, due to the lack of required witnesses at the death.

With no witnesses present, someone else can administer the lethal dose without the patient's consent. Indeed, someone could use an alternate method, such as suffocation. Even if the patient struggled, who would know? The lethal dose request would provide an alibi.

This situation is especially significant for patients with money. A California case states, "Financial reasons [are] an all too common motivation for killing someone."8 Without disinterested witnesses, the patient's control over the "time, place and manner" of his death, is not guaranteed.

If one of your clients is considering a "Death with Dignity" decision, it is prudent to be sure that they are aware of the Act's gaps.

What to Tell Clients

1. Signing the form will lead to a loss of control

By signing the form, the client is taking an official position that if he dies suddenly, no questions should be asked. The client will be unprotected against others in the event he changes his mind after the lethal prescription is filled and decides that he wants to live. This would seem especially important for clients with money. There is, regardless, a loss of control.

2. Reality check

The Act applies to adults determined by an "attending physician" and a "consulting physician" to have a disease expected to produce death within six months.9 But what if the doctors are wrong? This is the point of a recent article in The Seattle Weekly: Even patients with cancer can live years beyond expectations10. The article states:
Since the day [the patient] was given two to four months to live, [she] has gone with her children on a series of vacations . . . .
"We almost lost her because she was having too much fun, not from cancer," [her son chuckles].11 
Conclusion

As lawyers, we often advise our clients of worst-case scenarios. This is our obligation regardless of whether it is politically correct to do so. The Death with Dignity Act is not necessarily about dignity or choice. It also can enable people to pressure others to an early death or even cause it. The Act also may encourage patients with years to live to give up hope. We should advise our clients accordingly.

Margaret Dore is a Seattle attorney admitted to practice in 1986. She is the immediate past chair of the Elder Law Committee of the ABA Family Law Section. She is a former chair of what is now the King County Bar Association Guardianship and Elder Law Section. For more information, visit her website at www.margaretdore.com.

1 The Act was passed by the voters in November as Initiative 1000 and has now been codified as RCW chapter 70.245 [available at http://apps.leg.wa.gov/RCW/default.aspx?cite=70.245 ]
2 I-1000 color pamphlet, "Paid for by Yes! on 1000."
3 RCW 70.245.030 and .220 state that one of two required witnesses to the lethal-dose request form cannot be the patient's heir or other person who will benefit from the patient's death; the other may be.  [See http://www.margaretdore.com/pdf/C-SECTION-3_001.pdf]
4 id.
5 RCW 70.245.010(3) allows someone else to talk for the patient during the lethal-dose request process; for example, there is no prohibition against this person being the patient's heir or other person who will benefit from the patient's death. The only requirement is that the person doing the talking be "familiar with the patient's manner of communicating."
7 RCW 70.245.010(12).
8 People v. Stuart, 67 Cal. Rptr. 3rd 129, 143 (2007).
9 RCW 70.245.010(11) & (13).
10 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? The Seattle Weekly, January 14, 2009. http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty [or formatted versions here and here - the second version is more clear, but has an advertisement that may be objectionable to some viewers]
11 id.