Killing with kindness: Why the Death With Dignity Act endangers people with disabilities

http://thephoenix.com/boston/news/146648-killing-with-kindness-why-the-death-with-dignity-/#ixzz2AvS5wlXH

 

By S.J. Rosenbaum

I think my opinions about doctor-assisted suicide crystallized the night Mike — my wheelchair-using, ventilator-breathing boyfriend — choked on pineapple juice, passed out, and died.

He was dead for several minutes, on a steel table in the ER. The doctor shocked the pulse back into his heart and dropped him into an induced coma, but it still wasn't clear whether he would make it. As I stood by his bedside, shaking, one of the nurses touched me on the shoulder.

"Maybe it's better this way," she murmured.

I'll never forget that moment. We'd been watching a movie together a few hours before. We had plans to go clubbing. Maybe it's better this way?

I'm not a violent person, but I wanted to punch that lady in the face.

When I started going out with Mike, I thought that prejudice against people with disabilities was something we'd left behind along with Jim Crow and sodomy laws. I was shocked, again and again, to find that I was wrong. So wrong. Everyone I met had ideas about what it must be like to date Mike — that we never went out, that we couldn't have sex, that I must have to take care of him all the time — that were so false as to be laughable. We did laugh at that stuff. We had to. But for every person who came up to us to congratulate Mike on his "bravery" in taking a trip to the mall, there was someone who actually thought he'd be better off dead.

Some of those people were doctors.

Not the young doctor who fought like a demon to restart his heart in the ER. But there were others: well-meaning doctors who saw Mike, and people like him, as pitiable — as "bad outcomes." In fact, that's the norm: study after study has shown that doctors, as a group, consistently underestimate the quality of life of their disabled patients. Those prejudices — unquestioned and unacknowledged — can have disastrous results.

I don't know anyone born with a serious disability whose doctors didn't tell their parents that they would never be able to live independently. A doctor at Mass General, who treats children with muscular dystrophy, told me about colleagues who had counseled their patients against using the ventilators that would prolong their lives by decades. Those doctors weren't trying to do harm. They simply saw their patients' lives as not worth living.

As disability activist Carol Gill writes: "Many of us have been harmed significantly by medical professionals who knew little about our lives, who thought incurable functional impairments were the worst things that could happen to a person, and who were confident they knew best."

All this, then, is why I'll be voting against referendum Question 2, the Death with Dignity Act, on November 6.


The language of the bill sounds reasonable: it would allow doctors to prescribe lethal doses of medication, upon request, to patients with terminal diseases. But it wouldn't actually have much benefit for the dying, who already have the same access to self-administered suicide as anyone else. Instead, it could present doctors with an option to offer the patients they think they can't help: the bill's definition of "terminal disease" is so vague as to encompass disabilities like Mike's, and it has no requirement that a person seeking the fatal dose see a counselor or be screened for depression.

So why would a person with a disability ask for a suicide pill? My ex never would. Disabled from birth, Mike has been fighting for his rights since he was in grade school. He's a badass with 60 tattoos, and he's not ready to die any time soon.

But for the late-disabled, it's different. People diagnosed with a progressive disease — MS, ALS, and other such dire acronyms — still carry the same prejudices they've held all their able-bodied lives. Often, they don't know anyone living a full, enjoyable life with disabilities, don't know such lives are possible. So if a doctor offers them an exit, they're all too likely to take it.

It's happened. One of the earliest right-to-die cases, in 1989, was that of David Rivlin, a spinal-cord-injury survivor. Isolated in a nursing home, cut off from meaningful work, unable to live independently on the meager assistance the state offered at the time, he demanded to die. "I don't want to live an empty life lying helplessly in a nursing home for another 30 years," he told a reporter.

No one offered him an alternative. "The nondisabled people around him assumed that when a person with such a disability said he would rather be dead, he was acting rationally," disability activist Paul K. Longmore wrote a few years after Rivlin's death. Neither Rivlin, nor other people with disabilities seeking "death with dignity," realized that they could have been fighting for the support to live, rather than the right to die. Longmore observed, "The only real aid the system offered any of them . . . was assistance in ending their lives."

It's not 1989 anymore. The disabled in Massachusetts have more access, and more agency, than those in almost any other state, and activists fought hard to make it that way. Disabled Bostonians are filmmakers, tattoo artists, psychologists, writers. They ride the T. They own houses and businesses. And like Mike and me, they fall in love.

But not everyone knows that those things are an option. And with Romney — a man who sees adequate health care as a privilege, not a right — on the same ballot as Question 2, all that progress is scarily close to rolling back. Now is the worst time to perpetuate the myth that death is better than disability.

Vote no on Question 2.

Read more: 

http://thephoenix.com/boston/news/146648-killing-with-kindness-why-the-death-with-dignity-/#ixzz2AvRHl7Jn

UK govt agrees to investigate "death pathway"

Article below regarding abuse of the Liverpool Pathway, from Michael Cook of Bio Edge.

A problem also in the US and Canada.  See, for example, Kate Kelly's article about her mother and "VSED" by clicking here

With some doctors abusing the power they already have with the Liverpool Pathway, etc., why would you give them more power to effect patient death, i.e., by legalizing assisted suicide and/or euthanasia?

The problem will only get worse.

* * *

http://www.bioedge.org/index.php/bioethics/bioethics_article/10293
by Michael Cook | Oct 27, 2012 |

Pressure from the British media has forced an investigation into the controversial Liverpool Care Pathway by National Health Service and the Association of Palliative Medicine.

The medical establishment appears very reluctant to question the LCP. Only a few days ago 22 organisations signed a consensus statement supporting it. It quoted the Parliamentary Under Secretary of State for Health, Earl Howe:

"The Liverpool Care Pathway has sometimes been accused of being a way of withholding treatment, including hydration and nutrition. That is not the case. It is used to prevent dying patients from having the distress of receiving treatment or tests that are not beneficial and that may in fact cause harm rather than good."

But the campaign by the Daily Mail and the Telegraph has been relentless. "When well over 100,000 are dying on the LCP each year, the suspicion inevitably arises that the pathway is being used to hasten death and free up beds," said the Daily Mail in an editorial.

Neurologist Patrick Pullicino contends that the LCP has made euthanasia a "standard way of dying on the NHS". He and his supporters were scathing about the consensus statement: 

"It is self-evident that stopping fluids whilst giving narcotics and sedatives hastens death... The median time to death on the Liverpool Care Pathway is now 29 hours. Statistics show that even patients with terminal cancer and a poor prognosis may survive months or more if not put on the LCP."

The investigation coordinated by the NHS will examine poor experiences under the LCP, which everyone acknowledges do happen. The NHS will talk to family members of people who have died on the pathway, investigate complaints and speak with clinicians. "Poor experiences must be explored, acknowledged and learnt from," says Professor Mayur Lakhani, Chair of the Dying Matters Coalition.

Will the investigation result in a thorough revision of the LCP? Even though the medical establishment admits that there are problems, it may not admit that they are due to the basic framework. The Consultant Nurses in Palliative Care Reference Group is already interpreting criticisms as dangerous and offensive. "Counter-productive comments", it says, are "deeply offensive to public servants who abide by clear codes of conduct and the law".

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")

Massachusetts: Bob Joyce on Elder Abuse, etc. - Vote No on Question 2

Dear Editor:

It's not clear why The Bulletin titled Joe Galeota's recent column as it did ["Terrible," October 11, 2012].

If it's because the column offered no information about the content of the physician-prescribed suicide referendum, I agree. That is terrible. . . .

Let's get serious, and consider just a few of the many reasons why voters should defeat this flawed bill.

The referendum shockingly increases the risk of abuse to elders, many of whom do not have loving families and/or have lost their circle of friends and/or have no one to advocate for them. We should consider that Massachusetts had 19,500 reported cases of elder abuse in 2011. There are insufficient elder abuse investigators to keep up with the 54 new cases reported each day. One study has suggested that there are 23.5 unreported cases for every one reported case.

The referendum does not even provide the level of protection required when a person signs a will in Massachusetts (i.e., two disinterested witnesses), and there is absolutely no oversight at the time the lethal drugs would be administered. 

The Massachusetts Medical Society, representing more than 24,000 physicians and medical students, opposes the bill. So does the American Medical Society.

Insurance companies, hospitals and governmental medical providers have a clear and compelling financial interest in denying us of adequate end-of-life care.

How much do you trust insurers, hospitals and governments? Unless you answer "with my life," you should oppose physician-prescribed suicide and vote NO on Question Two.

It would indeed be "terrible"  if we allow this referendum to pass!

Robert W. Joyce

Persons Living With HIV/AIDS: Is This What You Want? To be Just Like Us?

By Margaret Dore, Esq.

Some HIV/AIDS groups have endorsed Ballot Question 2, which seeks to legalize assisted suicide in Massachusetts via a proposed act.  This post suggests that these groups and/or persons living with HIV/AIDS should give the issue a second look. 

1.  "Terminal" Does Not Mean "Dying" 

The proposed act applies to persons with a "terminal disease," defined in terms of less than six months to live.[1]  In Oregon, where there is a similar act, the six months to live is determined without requiring treatment.[2] 

In other words, a person living with HIV/AIDS, who is doing well, but who is dependent on treatment to live, is "terminal" for the purpose of assisted suicide eligibility. 

2.  The Significance of a Terminal Label

Once someone is labeled "terminal," an easy justification can be made that his or her treatment should be denied in favor of someone more deserving.  In Oregon, "terminal" patients are not only denied treatment, they are offered assisted suicide instead.  In a recent affidavit, Oregon doctor Ken Stevens states:

"9.  Under the Oregon Health Plan, there is . . .  a financial incentive towards suicide because the Plan will not necessarily pay for a patient’s treatment.  For example, patients with cancer are denied treatment if they have a "less than 24 months median survival with treatment" and fit other criteria. . . . 

12. All such persons . . .  will . . . be denied treatment. Their suicides under Oregon’s assisted suicide act will be covered."[3]

Dr. Stevens concludes:

"14. The Oregon Health Plan is a government health plan administered by the State of Oregon. If assisted suicide is legalized in [your jurisdiction], your government health plan could follow a similar pattern. If so, the plan will pay for a patient to die, but not to live."[4]

3.  Barbara Wagner and Randy Stroup

In Oregon, the most well known persons denied treatment and offered suicide are Barbara Wagner and Randy Stroup.[5]  Neither saw this event as a celebration of their "choice."  Wagner said: "I'm not ready to die."[6]  Stroup said: "This is my life they’re playing with."[7] 

4.  Proposals for Expansion

I live in Washington State, where assisted suicide is legal under an act passed in 2008.[8]  Four years later, there have already been proposals to expand our act to non-terminal people.[9]  Moreover, this year, there was a Seattle Times column suggesting euthanasia as a solution for people unable to afford care, which would be involuntary euthanasia for those persons who want to live.[10]

Prior to our law's being passed, I never heard anyone talk like this.

Is this what you want?

To be just like us?

Legal assisted suicide puts anyone with a significant health condition at risk of being steered to suicide.  For other reasons to vote against assisted suicide, please click here for talking points.  I hope that AIDS groups and people living with AIDS reconsider any support of Ballot Question No. 2.  Thank you.

* * *

Margaret Dore is a lawyer in Washington State where assisted suicide is legal. She is also President of Choice is an Illusion, a non-profit corporation opposed to assisted suicide and euthanasia.  Ms. Dore has been licensed to practice law since 1986. She is a former Law Clerk to the Washington State Supreme Court. She has several published court cases and many published scholarly articles. Her viewpoint is that people should be in control of their own fates, but that assisted suicide laws do not deliver. This year, she had an editorial published in the NY Times: "Assisted Suicide: A Recipe for Elder Abuse." For more information see www.margaretdore.com and www.choiceillusion.org

What about the seriously ill or disabled people who want to live?

http://doughtyblog.dailymail.co.uk/2012/10/what-about-the-seriously-ill-or-disabled-people-who-want-to-live.html

The "Liverpool Pathway":  "It comes down to this: there are a lot of people who believe that, rather than trying to help their loved ones, hospitals have been keen to kill them off."

What about the seriously ill or disabled people who want to live?

By Stephen Doughty, 12 October 2012 6:56 PM

We have heard an awful lot about the suffering of people who bear terrible afflictions or disabilities and who wish to die. We have heard very little about the desperately sick who want to live, and the families who stand by them in hope.

It is looking like we have got this the wrong way round.

The highly organised campaign for assisted dying has brought together pressure groups, think tanks, celebrities like Sir Terry Pratchett, and some fairly prominent politicians, notably in recent years Tony Blair’s Lord Chancellor and one-time flatmate, Lord Falconer.

It has been based around a brilliantly conceived series of legal cases in which the judiciary have been presented with deeply affecting hard cases. Each one has asked for a modest legal concession, usually involving human rights and the 1961 law that makes helping with a suicide a serious crime.

The individuals who have brought these cases are sometimes merely sympathetic and at others pitiable, as in the recent instance of Tony Nicklinson, the 58-year-old victim of 'locked-in syndrome' who lost his call for help from his doctor to die in the High Court in August. Mr Nicklinson died a few days after his legal defeat.

Occasionally the legal campaigns have scored successes. The most notable was that of multiple sclerosis sufferer Debbie Purdy, who persuaded the Law Lords that the Director of Public Prosecutions should provide guidance on whether her husband might face prosecution for assisted suicide, were he to help her travel to the Dignitas clinic in Zurich to die.

As a result of the Purdy case, DPP Keir Starmer QC introduced rules on assisted dying prosecutions that mean no-one is likely to be prosecuted, with the risk of a 14-year-jail term, if they help in the death of someone who is a suffering relative or friend, and if they act out of compassion rather than malice or greed.

However you paint it, this is a major change in the law as set down by Parliament, a law which takes no account of the motives of the individual aiding and abetting the suicide.

Indeed, Mr Starmer has brought no prosecutions against anybody from the trail of stricken families who have helped members travel to Switzerland to die.

What is interesting is that, despite all the campaigning, all the high-profile court cases, all the BBC interviews, all the endless hand-wringing about the cruelty of keeping those who are suffering alive against their will, few people seem to want to take advantage of the new right to die.

We do not have very recent figures, but I would guess that no more than 200 British people have died at Dignitas since the clinic became well-known here in 2003.

It is a number small enough to raise the question of how big, really, is the demand for assisted dying?

The campaign for assisted dying has certainly been effective in influencing care of the incapacitated in the Health Service.

It was surely a factor in the successful passage of the Mental Capacity Act, pushed through by Lord Falconer in the teeth of a rebellion by backbench Labour MPs, which gave legal status to living wills. These mean people can leave orders for their doctors to kill them by withdrawing nourishment and fluid by tube if they become too sick to speak for themselves.

The assisted dying campaign formed the background to the introduction of the Liverpool Care Pathway into hospitals across the country. This, for those who have not noticed, is the system by which medical staff withdraw treatment from those judged to be close to death, in the cause of easing their passing. It often involves heavy sedation and the removal of nourishment and fluid tubes.

I do not wish to try to step into the shoes of those medical professionals and care workers who deal every day with people at the extreme end of life and in the depths of the worst illnesses. I have no qualifications or knowledge to second guess their decisions, and no intention of criticising those who work with great professionalism and compassion in jobs that are far beyond my capability.

But all the indications suggest there are many families who are unhappy with the way in which their relatives have died in hospitals, and that they are increasingly willing to complain about it.

Many of these people may be speaking out of misdirected grief. As one well-informed MP put it to me this week, very few expect a loved one who goes into hospital to die, but people do have the habit of dying. Some of those complaining may be troublemakers, some inspired by political or religious agendas.

Nevertheless there seem to be a lot of them. And they are not celebrities or legal grandees or Westminster faces. They are little people, people like you and me, not the kind you usually hear on the radio or see on the TV.

The courageous Professor Patrick Pullicino, the hospital consultant who defied the NHS consensus to speak out against the Liverpool Care Pathway this summer, reckoned it is used in around 130,000 deaths each year. That is a number that dwarfs the assisted dying lobby.

I think we are going to hear a lot more about the Liverpool Care Pathway, and I think the medical professions, the Department of Health, and a number of politicians are going to have to put some time into considering what has been happening.

It comes down to this: there are a lot of people who believe that, rather than trying to help their loved ones, hospitals have been keen to kill them off.

They believe that, while the assisted dying lobby has been parading in the courts and publicising itself on the BBC, assisted dying has quietly become a reality in our hospitals.

Massachusetts: Vote no on Question 2

"Ignoring any moral issues, the initiative is vulnerable to abuse and should not be passed into law."

By Anthony Speranza

http://www.salemnews.com/opinion/x1684126269/Column-Vote-no-on-Question-2

This year in Massachusetts, voters will decide on Question 2: an initiative petition to legalize physician-assisted suicide in the commonwealth. Ignoring any moral issues, the initiative is vulnerable to abuse and should not be passed into law.

Dignity 2012, a group in support of the issue referred to as "Death with Dignity," claims the proposed law "contains strict safeguards to ensure that the patient is making a voluntary and informed decision." The safeguards written into the law, however, are insufficient. First, nearly all responsibility rests in the hands of a patient's physician. Section 6 of the initiative states that no patient shall be prescribed the life-ending medication if either of two physicians deem that the patient suffers from a "psychiatric or psychological disorder or depression." While the theory behind this precaution is practical, it falls short of effective. Only 15 days separate the date of request from the date of prescription of the lethal dose. There is no clear definition of what tests must be run in this time to check a patient's mental capacity. According to Jennifer Popik, a medical ethics attorney, "There is no requirement that the patient be given a psychiatric evaluation... This means that a physician ... can prescribe suicide to that patient without even a specialist's evaluation." The "safeguard" concerning mental health is rendered useless because a psychiatric evaluation is not compulsory. A similar law in Oregon serves as a warning: According to a report by the Oregon Public Health Department, of the 71 patients who chose physician-assisted suicide last year, only one was referred for psychiatric evaluation.

Kate Kelly on the "Liverpool Pathway"

If you think the "Liverpool Pathway" is painless, gentle, and/or dignified, think again. My mother had a mild stroke in a Canadian care facility. The relative with power of attorney, along with a doctor who had never seen my mother before, decided she would have morphine only, although she was conscious, trying to speak, and indicating she wanted water. She moaned for days, had blisters inside her mouth, had to be given suppositories to prevent convulsions, and clamped her lips on a dampened cloth, which provided only the illusion of moisture. After 6 days without food or water, she finally died.

 
We already have abuse of authority by some doctors. Assisted suicide will give them even more power. The push for suicide as a "cure" indicates a society gone mad.


To read my mother's story, see http://www.choiceillusion.org/p/vsed.html

Massachusetts: Ballot Question 2, Whose Choice?

"[This] would be on an involuntary basis for those persons who want to live."

By Margaret Dore

I am an attorney in Washington State, where assisted suicide is legal.  Our law was passed by a ballot initiative in November 2008 and went into effect in March 2009.  Our law is similar to Ballot Question 2. 

In Washington State, my former clients own two adult family homes (small elder care facilities).  Four days after the election, the adult child of one of their residents asked about getting pills for the purpose of causing his father's death.  It wasn't the older gentleman asking for his "right to die."[1]

At that time, our law had not yet gone into effect; the man died before it did.  But if our law had been in effect, whose choice would it have been?  The choice of his son, or the choice of the older gentleman?

In Washington state, we have already had suggestions to expand our law to direct euthanasia for non-terminal people.[2].  More disturbing, there was this discussion in the Seattle Times suggesting euthanasia for people unable to afford care, which would be on an involuntary basis for those persons who want to live.  Columnist Jerry Large stated:

"After Monday's column, some readers were unsympathetic [to people unable to afford care], a few 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."[3]

I never saw anything like this prior to our law's being passed in 2008.  Be careful what you vote for.

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.  

Support of assisted suicide questioned

http://www.burlingtonfreepress.com/article/20120821/OPINION03/308210010/Letter-Support-assisted-suicide-questioned   Burlington Free Press , 4:03 PM, Aug 20, 2012   |

I would like to commend T.J. Donovan for recognizing the need to enforce the law against those committing physical and financial abuse against the elderly and other vulnerable people. However, according to the Burlington Free Press coverage of the attorney general candidates (Aug. 8), T.J. also supports passage of doctor-prescribed suicide legislation.

My question is this: If an elderly woman can be bullied into turning over her social security check, why doesn't Donovan understand that it is possible to pressure her into making a request for a lethal dose and bullying her into taking it?

BRENDA PEPIN

Montpelier

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

Canada: What about the right to cry for help?

http://www.montrealgazette.com/news/about+right+help/6907100/story.html

By Amy E. Hasbrouck

It has taken me a long time to read through the nearly 400 pages of the June 15 decision of the British Columbia Supreme Court on the issue of assisted suicide. I found reading it to be like a journey to a dark place, full of raw emotions.

The long and the short of the reasons for judgment issued by Justice Lynn Smith is that legal provisions in Canada prohibiting assisted suicide law are unconstitutional because they impede disabled people’s rights to life, liberty and security of the person.

The judge believes that having a disability or degenerative illness is a rational reason to want to die, and that those of us with disabilities should be helped to die if we can’t do it neatly or efficiently ourselves.

Justice Smith doesn’t appear to believe that people with disabilities and terminal illness are ever coerced, persuaded, bullied, tricked or otherwise induced to end our lives prematurely. She believes those researchers who contend there have been no problems in jurisdictions where assisted suicide is legal, and she rejects evidence suggesting there have been problems.
She writes: “It is unethical to refuse to relieve the suffering of a patient who requests and requires such relief, simply in order to protect other hypothetical patients from hypothetical harm.”

I’ll have to mention that to some of my hypothetical friends who say they have been pressured by doctors, nurses and social workers to hypothetically “pull the plug.”

The same goes for all those folks who succumbed to the pressure; I guess they’re only hypothetically dead.

Canada, Carter & Outrage!

"Canada will be known as the country where a Provincial Judge has more power than the Federal Government. "

* * *

Dear Ms. Kerry-Lynne Findlay MP,

I am angry and upset about Justice Lynn Smith's decision in the Carter case, giving Ms. Carter the "right" to assisted suicide/euthanasia. 

This erroneous and presumptuous decision by Justice Smith is a guarantee of elder abuse unto death. We already have a problem with elder abuse in Canada. I witnessed this firsthand with my mother, when, after a mild stroke, the relative holding power of attorney decided my mother would have no treatment. I sat by my mother's bedside in a Nova Scotia nursing home, unable to do anything except hold her hand while she suffered for six days, before finally succumbing to dehydration and starvation. If Justice Smith's decision is allowed to stand, there will be no need for inconvenienced or greedy relatives to wait for even this questionable medical procedure of withholding treatment.

It appears that Justice Smith holds herself above the Government of Canada. She has given our elected representatives, such as yourself, a year to comply with her decision to allow people to "help" kill other Canadians. This is the right to commit homicide. The Federal Government of Canada decided many years ago that Canada would not kill convicted murderers, even if they want to die, but now Justice Smith had deemed that anyone in Canada can kill another person who allegedly asks to be killed. 

MP Findlay, the "right" to kill someone is not a decision for a Provincial Court Justice to make. If Justice Smith's decision is upheld, Canada will be a place of supreme irony. We will have the distinction of protecting the lives of convicted murders, while allowing our vulnerable elders and others to be subject to human error or deliberate murder. We will also be, I believe, unique as a nation: Canada will be known as the country where a Provincial Judge has more power than the Federal Government. 

I look forward to your response on this matter.

Thank you.

Yours truly,

Kate Kelly, B.A., B. Ed.

The Carter Opinion: Unclear Legal Effect & Invalid Reasoning

By Margaret Dore

On June 15, 2012, Justice Lynn Smith of the BC Supreme Court issued an opinion purporting to legalize assisted suicide and euthanasia in Canada.[1]  As discussed below, the legal effect of this opinion is unclear.  The reasoning is also invalid. 

A.  Legal Effect 

The opinion was the result of a summary trial in which both the Attorney General of Canada and the Attorney General of British Columbia argued that the court had no power to do anything other than dismiss the case.  This was due to the Supreme Court of Canada's prior decision on similar facts (the Rodriguez case).  The opinion states:

"They [Canada and British Columbia] say that it is not open to this Court to do anything other than dismiss the plaintiffs' claim."[2]

If Canada and British Columbia are correct, the opinion is nothing more than an advisory document.  Unless and until this point is resolved, any person participating in a death under the opinion will remain at risk of criminal prosecution, civil lawsuits and/or professional discipline.

B.  Invalid Reasoning

The opinion is also written in double-speak, which means to say one thing and to mean another, sometimes the opposite.  Most centrally, the opinion bases the plaintiff's "right to die" on her "right to life" in the Canadian Charter of Rights and Freedoms.[3]  These are opposite concepts.[4] 

The opinion also argues that because Canadian law does not prohibit suicide as a crime, that commiting suicide is a right.[5]  This claim ignores other Canadian law  discouraging suicide. Indeed, a suicidal person can be committed against his or her will in order to prevent a suicide.[6]  With suicide actively discouraged under the law, it cannot be said that the law somehow grants a right to commit suicide.   Once again, the opinion's logic is flawed.

* * *

[1]  To view the opinion, click here.
[2]  Opinion, page 251, paragraph 891.
[3]  Id., pages 365-8.
[4]  See e.g., the opinion at 366, pargraph 1314, which states:  "Canada argues that the right to life does not include the right to choose death.  [Canada] submits that such an interpretation would directly contradict the plain and obvious meaning of a right to life and would mark a significant departure from existing Supreme Court of Canada jurisprudence."
[5]  See e.g., the opinion at 10, pargraph 15:  "The claim that the legislation infringes Ms. Taylor's equality rights begins with the fact that the law does not prohibit suicide.  However, persons who are physically disabled such that they cannot commit suicide without help are denied that option because s. 241(b) prohibits assisted suicide."
[6]  See BC Mental Health Act, Part 3, Section 22 (allowing involuntary admissions "to prevent the person's or patient's substantial mental or physical deterioration or for the protection of the person or patient or the protection of others").

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

Louisiana Assisted-Suicide Ban Strengthened

http://www.dailycomet.com/article/20120424/WIRE/120429820/1223?Title=La-assisted-suicide-ban-strengthened


The Associated Press


Published: Tuesday, April 24, 2012 at 8:37 a.m.

BATON ROUGE -- The House unanimously backed a proposal Monday to strengthen Louisiana’s ban on euthanasia and assisted suicide.

House Bill 1086 by Rep. Alan Seabaugh, R-Shreveport, would spell out that someone authorized to approve medical procedures for another person may not approve any procedure that would be considered assisted suicide. That prohibition also would be extended to include surgical or medical treatment for the developmentally disabled or nursing home residents who may be unable to make their own medical decisions.

Louisiana already has a prohibition in criminal law against euthanasia and assisted suicide. But Seabaugh said he wanted to make sure it was clear in the state’s medical consent law.

NY Times: Assisted Suicide: A Recipe for Elder Abuse

April 10, 2012
http://www.nytimes.com/roomfordebate/2012/04/10/why-do-americans-balk-at-euthanasia-laws/assisted-suicide-laws-are-a-recipe-for-elder-abuse

Margaret Dore, a lawyer in Washington State where assisted suicide is legal, is the president of Choice is an Illusion, a nonprofit organization opposed to assisted suicide.

Assisted suicide means that one person provides the means or information for another person to commit suicide. In Oregon and Washington, assisted-suicide laws were passed by ballot measures. No such law has made it through the scrutiny of a legislature despite more than 100 attempts.

The Oregon and Washington acts apply to "terminal" patients, defined as patients predicted to have no more than six months to live. Doctor prognoses, however, can be wrong. Moreover, treatment can lead to recovery. My friend Jeanette Hall was adamant that she would "do" Oregon's act. She had been diagnosed with cancer and was given six months to a year to live. Her doctor convinced her to be treated. That was nearly 12 years ago.

Proponents tout assisted suicide as providing "choice" over the timing of one's death. But choice under the Oregon and Washington acts cannot be assured. For example, neither act requires witnesses at the death. Without disinterested witnesses, the opportunity is created for an 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?

Assisted suicide is a concept contrary to public safety and a recipe for elder abuse.  Americans are right to be skeptical of these laws.

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.

 

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.