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.

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? 

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.  

Montana Board Denies Hearing; New Legal Challenge Anticipated

On May 7, 2012, the Montana Board of Medical Examiners voted to postpone consideration of whether Position Statement No. 20 should be vacated.[1]  Position Statement No. 20 concerns "aid in dying," a euphemism for assisted suicide and euthanasia.[2]  The reasons given for the delay included "to allow additional time for public input."[3]


On July 6, 2012, Montanans Against Assisted Suicide filed additional "public input" including a letter and a legal memorandum titled:  "Summary of Legal Arguments Requiring Position Statement No. 20 to be Vacated as a Matter of Law."[4]  The letter requested twenty minutes oral argument.[5]


On July 20, 2012, the Board held the postponed hearing.  The Board acknowledged that it had received the above documents and also acknowledged the presence of Cory Swanson, attorney for Montanans Against Assisted Suicide.  The Board did not allow Mr. Swanson to speak.

Montanans Against Assisted Suicide Pushes Legal Challenge Forward

By Margaret Dore

July 6, 2012, Montanans Against Assisted Suicide (MAAS) filed documents with the Montana Medical Examiner Board for the purpose of vacating Position Statement No. 20, titled "Physician Aid in Dying."  The documents filed included: "Summary of Legal Arguments Requiring Position Statement No. 20 to be Vacated as a Matter of Law," which states: 

"Position Statement No. 20 puts physicians and/or the public at risk by encouraging them to engage in illegal and tortious conduct that could result in their being charged with a crime and/or sued.  Statement No. 20 also puts vulnerable people at risk of being killed or steered to suicide by their heirs or  predators.  With these circumstances, the Board’s enactment of Statement No. 20 violates its duty to protect the public (and puts the Board itself at risk of liability)."

To view the above document in its entirety, read the text below or click here to read the hard copy filed with the Board.  Other documents filed with the Board included a cover letter and a proposed order. 

The Text: 

1.  On March 16, 2012, the Board adopted a revised version of  Position Statement No. 20, which refers to “aid in dying” as a “medical procedure or intervention.”[1]

2.  The term, “aid in dying,” means assisted suicide and euthanasia.[2]

3.  On December 31, 2009, the Montana Supreme Court issued Baxter v. State, 354 Mont. 234 (2009), which addressed a narrow form of “aid in dying.”  Baxter did not legalize “aid in dying,” although that fact is disputed by some proponents.[2]

4.  Position Statement No. 20 implies that “aid in dying” is confined to “end-of-life” matters.[4]  In Baxter, however, the plaintiffs sought to legalize assisted suicide for people who were not necessarily at the “end of life,” for example, an 18 year old who is insulin dependent.[5] 

5.  In the last [2011] legislative session, a bill seeking to legalize aid in dying, SB 167, was defeated.[6]

6.  The Medical Examiner Board derives its power from the Administrative Procedure Act, §§ 2-4-101 to 2-4-711, MCA, and other statutes such as § 37-1-307, MCA, which defines the authority of Boards in general.[7]  These statutes do not grant the Medical Examiner Board authority to interpret the meaning of a court decision such as Baxter.[8]  These statutes do not grant the Board the power to enact new legislation, for example, to legalize “aid in dying” as a medical procedure or intervention.

7.  Interpreting court decisions and enacting legislation are the province of the Judiciary and the Legislature, not the Board.  With these circumstances, the Board had no authority to adopt Position Statement No. 20, which effectively interpreted Baxter and/or effectively enacted new legislation to legalize “aid in dying.”  Position Statement 20 is null and void.

8.  The Board’s lack of authority is a lack of subject matter jurisdiction and requires Position Statement No. 20 to be vacated to the extent that it purports to legalize “aid in dying” and/or refers to “aid in dying” as an “end-of-life” matter.

9.  Position Statement No. 20 is also invalid and/or void in its entirety because it is a “rule” under the Administrative Procedure Act, which was adopted without attempting to comply with rulemaking procedures.[9]

10.  Position Statement No. 20 is also invalid and/or void in its entirety because there was no oral argument scheduled for members of the public to speak prior to its enactment.  § 2-4-302(4), MCA  states: “If the proposed rulemaking involves matters of significant interest to the public, the agency shallschedule an oral hearing.”  (Emphasis added).  A matter is of “significant interest to the public” if the agency knows it “to be of widespread citizen interest.”  In the case at hand, the record is overflowing with citizen input including more than 3000 signatures opposed to assisted suicide.[11]  The Board knew of “widespread citizen interest” as a matter of law.  The Board adopted Position Statement No. 20 without previously scheduling oral argument for the public.  For this reason also, the statement is null and void.  

11. Position Statement No. 20 is also null and void because it purports to expand a physician’s scope of practice to include “aid in dying.”  This is the function of the Legislature, not the Board.  Board of Optometry v. Florida Medical Association, 463 So.2d 1213, 1215 (1985).

12.  Position Statement No. 20 puts physicians and/or the public at risk by encouraging them to engage in illegal and tortious conduct that could result in their being charged with a crime and/or sued.  Statement No. 20 also puts vulnerable people at risk of being killed or steered to suicide by their heirs or  predators.  With these circumstances, the Board’s enactment of Statement No. 20 violates its duty to protect the public (and puts the Board itself at risk of liability).

13.  For the above reasons, Position Statement No. 20 is null and void as a matter of law.  It must be vacated and removed from the Board’s website." 

* * *

[1]  The revised statement [titled Physician Aid in Dying] says: "The Montana Board of Medical Examiners has been asked if it will discipline physicians for participating in  aid-in-dying.  This statement reflects the Board’s position on this controversial question. [paragraph break] The Board recognizes that its mission is to protect the citizens of Montana against the unprofessional, improper, unauthorized and unqualified practice of medicine by ensuring that its licensees are competent professionals.  37-3-101, MCA.  In all matters of medical practice, including end-of-life matters, physicians are held to professional standards.  If the Board receives a complaint related to physician aid-in-dying, it will evaluate the complaint on its individual merits and will consider, as it would any other medical procedure or intervention, whether the physician engaged in unprofessional conduct as defined by the Board’s laws and rules pertinent to the Board."  [To view the statement of the Board's website, click here.] 
[2]  Model Aid-in-Dying Act, § 1-102(3), atwww.uiowa.edu/~sfklaw/euthan.html  Note the letters “euthan” in the link. 
[3]  See Greg Jackson Esq. and Matt Bowman Esq., “Analysis of Implications of the Baxter Case on Potential Criminal Liability,” Spring 2010 (“the Court's narrow decision didn't even "legalize" assisted suicide”), available athttp://www.montanansagainstassistedsuicide.org/p/baxter-case-analysis.html; statement by Dr. Stephen Speckart conceding that assisted suicide is not legal under Baxter (“[M]ost physicians feel significant dis-ease with the limited safeguards and possible risk of criminal prosecution after the Baxter decision"), at [the following link with a similar statement by Senator Anders Blewett] http://maasdocuments.files.wordpress.com/2011/07/blewett_speckhart_trans_001.pdf; statement by Senator Anders Blewett conceding that a doctor who assisted a suicide could be prosecuted under the Baxter decision (“under current law, ... there’s nothing to protect the doctor from prosecution”), athttp://maasdocuments.files.wordpress.com/2011/07/blewett_speckhart_trans_001.pdf; and The Montana Lawyer, November 2011 (featuring pro-con articles by Senator Blewett and Senator Jim Shockley), available athttp://www.montanabar.org/associations/7121/November%202011%20mt%20lawyer.pdf.
[4]  Id.
[5]  See opinion letter from attorney Theresa Schrempp and Dr. Richard Wonderly to the Euthanasia Prevention Coalition, October 22, 2009 (attaching the plaintiffs’ interrogatory answers with a definition of “terminally ill adult patient” broad enough to include “an 18 year old who is insulin dependent”).  (Attached hereto at B-1 to B-3). [To view, click here]
[6] See Detailed bill information page, attached hereto at B-4. [To view, click here]
[7]  For more information about the Administrative Procedure Act and other statutes, see Memorandum dated May 2, 2012, pp. 1-2, pp. 8-10.  A copy of the Act and other statutes are attached thereto at A-1 through A-28
[8]  Id.
[9]  See Memorandum dated May 2, 2012, pp. 8-10. [To view citation, use link at note 7, above]
[10]  § 2-4-102(12)(a). 
[11]  Memorandum dated May 2, 2012, p. 3; attachments at A-37 to A-45.  [To view citations, use links at note 7, above]

False & Misleading "Aid in dying" Letter

Below, a letter to physicians responding to a prior "false and misleading" letter claiming that assisted suicide is legal in Montana. To see a hard copy of this letter as sent, click here.


Dear Physician:


I represent Montanans Against Assisted Suicide & For Living with Dignity.  You may have received a letter from Compassion & Choices, formerly known as the Hemlock Society, dated June 5, 2012.  The letter claims that assisted suicide, referred to as "aid in dying," is legal under the Baxter decision issued by the Montana Supreme Court on December 31, 2009.  This is untrue.  I urge you to read the materials below or contact your own counsel for advice regarding the court's decision in Baxter.

Vermont: Assisted Suicide Bill is Dead!

[For a legal analysis of the failed bill, S. 103, click here]

"Death with dignity debate tabled"

By Susie Steimie, March 16, 2012

http://www.wcax.com/story/17176558/vt-lawmakers-right-to-die-bill-wont-pass

MONTPELIER, Vt. -

The death with dignity debate has been tabled and a state senator is in the hospital. The vice chair of the Senate Judiciary Committee, Sen. Alice Nitka, is currently in the hospital after an accident at her home Thursday. The committee was expected to vote on the controversial end of life bill Friday.

The bill would give terminally ill patients the right to end their own life. But instead of voting Friday, the chair met with Gov. Peter Shumlin to say the bill will not move.

This session marks the first hearing of the end of life bill in a Vermont Senate committee. But lawmakers say most of the work was done behind closed doors.

Reporter Susie Steimle: How much would you say politics have come into play here?  Sen. Diane Snelling: Quite a bit.

"Oh yeah, there's been some strong pressure. But there's strong pressure on a lot of bills. But this is an emotional bill; it hits everyone," said Sen. Dick Sears, D-Bennington County.

 

Sears is holding his ground. He said the bill would not leave his committee this session. We now know that it won't.

As a seasoned senator with the president pro-tem on his side, much of the political pressure to keep this bill from moving came from him. On the other side it came from the governor, who supports the bill.

"When you're a good friend like I am with the governor, it's hard to tell when it's friendship and when it's pressure. But I know he's disappointed with the decision," Sears said.

The committee held extensive testimony this week, which drew hundreds of Vermonters from across the state.

Snelling, who supports the bill, says she fears this gave people false hope.

"I almost wish we hadn't taken testimony, which we did take, because in a sense that gets people to think something is going to happen," said Snelling, R-Chittenden County.

Snelling wanted to send this bill out of committee without recommendation, something Sears calls "wimpy."

"Saying we voted it out without recommendation is like saying we don't have the courage to stand up for what we believe," Sears said.

"I wish that this bill could come to the floor and I've heard from many people on both sides that it's a matter of conscience, in which case, let's vote on our conscience," Snelling said.

Snelling says at this point she's accepted defeat for this session, but that doesn't mean she's giving up.

"It's a difficult issue, I know it's a difficult issue, but I didn't come here to do easy things. So it's very important to stand on the strength of my convictions," Snelling said.

Both senators say it's likely some supporters of the end of life bill will try to attach it to the health care bill, which will be voted on later this session, but neither senator believes it will pass that way. Snelling says she expects it will be back next session.

Supporters don't know if there are enough votes to pass it in the Senate. It's extremely divided. I've heard the vote could be 16-14 either way, but part of the controversy here is this is truly a Senate battle; the House is ready to pass it and the governor supports it.

 

Hawaii: Attorney General Opinion Attached

Per Jim Hochberg, Hawaii State Senator Joshua Green, MD, has authorized release of the Attorney General's opinion rejecting C & C's claim that assisted suicide is "already legal" in Hawaii.  The opinion states in part:

"Dear Senator Green:

Re: Hawaii law on assistance with dying

You have asked (1) whether §453-1, Hawaii Revised Statutes (HRS), authorizes a physician to assist a terminally ill patient with dying when requested by or on behalf of the patient, and (2) whether any criminal laws prohibit aid in dying.

We are assuming that a physician’s assistance with dying would consist of prescribing a lethal dose of medication that a terminally ill patient could take to bring on a swifter and possibly more peaceful death than would otherwise ensue. Our analysis addresses only this method of assistance. Briefly, (1) we do not believe that §453-1 provides authority for a physician to assist with dying, and (2) a physician who provided such assistance could be charged under Hawaii’s manslaughter statute. . . ."

To view the entire opinion, click here.

Hawaii: Attorney General Rejects C & C Claim that Assisted Suicide is "Already Legal"

The Attorney General of Hawaii has issued a formal opinion rejecting Compassion & Choices' claim that physician-assisted suicide, termed "aid in dying," is legal in Hawaii.

A press release issued by the Alliance Defense Fund describes that Senator Josh Green, MD had requested the opinion from Attorney General David Louie.[1]  The press release states:

"[T]he attorney general's legal opinion states that state law "does not authorize physicians to assist terminally ill patients with dying" and "a physician who provided assistance with death could be charged under Hawaii's manslaughter statute."

The press release also quotes Honolulu attorney Jim Hochberg:  "[N]o one should believe the recent falsehoods that pro-death proponents have spread about [Hawaii] law."

* * * 

[1]  To view the ADF Press Release, click here