Margaret Dore published in the Baltimore Sun

The letter below, published in the Baltimore Sun, describes the positive statistical correlation between legalizing physician-assisted suicide and the significant increase in other "regular" suicides in Oregon.  This is at great financial cost to that state.

For more detail and links to supporting documentation, please see: Letter from Margaret Dore to Members of the New Hampshire House of Representatives, March 4, 2014, titled:  "The High Financial Cost of (Regular) Suicide."

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The published letter:  Margaret Dore," Legalizing assisted suicide is a bad idea."

Alexa Fraser's recent commentary promotes the idea of legalizing physician-assisted suicide. . . .

The term "physician-assisted suicide" means that a physician provides the means or information to enable a patient to perform a life-ending act, such as through a lethal prescription.

The premise of Ms. Fraser's commentary is that legalization of physician-assisted suicide will eliminate other types of suicides, such as those resulting from self-inflicted gunshot wounds.

This premise is not, however, supported by statistics from Oregon, which is the only state in which physician-assisted suicide has been legal long enough to have valid statistics over time.

The Oregon statistics support the conclusion that, if anything, "ordinary" suicides will actually increase if physician-assisted suicide were legalized in Maryland.

Connecticut Bill Dead!

Assisted suicide bill won't be voted on

[For a legal and policy analysis against the bill, please click here]

THE ASSOCIATED PRESS, March 25, 2014 - 7:32 pm EDT

http://www.therepublic.com/w/CT--Assisted-Suicide

HARTFORD, Connecticut — A bill that would allow Connecticut physicians to prescribe medication to help terminally ill patients end their lives won't be voted on during this year's legislative session, the co-chairman of the General Assembly's Public Health Committee said Tuesday.

Windham Rep. Susan Johnson said Tuesday there is not enough time to address various outstanding issues with the bill. This year's short legislative session ends May 7.

"We worked very hard on that bill and there's a lot of work left to do," Johnson said.

This marks the second year in a row that the Public Health Committee has held a public hearing on such legislation and committee members did not take a vote.

Johnson said the Judiciary Committee is better suited to tackle certain outstanding issues with the bill, such as determining a patient's competency, whether they're under any duress, and how they can be protected from people with criminal intentions.

"Those kinds of things need to be ironed out," she said.

Proponents vowed to return with another bill next year, when there will be a longer legislative session.

"I'm very sorry that we're not able to move the bill further this year," said Rep. Betsy Ritter, D-Waterford. "We heard from people who wanted it badly."

Ritter said she was pleased, however, by the attention paid to the issue this year, adding how "the discussion just exploded across the state." Tim Appleton, the state director of the advocacy group Compassion and Choices, said he expects support will grow more between now and next year's legislative session.

Opponents have questioned the level of support for the bill, claiming outside groups are pushing the issue in Connecticut. They've vowed to fight future bills.

"The collateral damage from legalizing assisted suicide — including massive elder abuse, the deadly mix with a cost-cutting health care system steering people to suicide, misdiagnosis and incorrect prognosis, suicide contagion, and disability discrimination in suicide prevention — is simply not fixable," said Stephen Mendelsohn, of Second Thoughts Connecticut.

The High Financial Cost of (Regular) Suicides.

Dear New Hampshire House Members:

I am an attorney in Washington State where physician-assisted suicide is legal.  Our law is based on a similar law in Oregon.  I previously sent you materials, which can be viewed here

I write to discuss another factor for your consideration: Government reports from Oregon, showing a positive correlation between the legalization of physician-assisted suicide and an increase in other (regular) suicides. Of course, a statistical correlation does not prove causation.  The statistical correlation described herein, is, however, consistent with a suicide contagion (legalizing and thereby normalizing one type of suicide encouraged other suicides).  Please consider the following.

Oregon's assisted suicide act went into effect in 1997.  See top line at this link: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx

By 2000, Oregon's regular suicide rate was "increasing significantly"  See second paragraph, http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000"). 

By 2007, Oregon's other (regular) suicide rate was 35% above the national average. See second page at "A-57) http://maasdocuments.files.wordpress.com/2013/02/oregon-suicide-info_001.pdf

In 2010, the most recent report, Oregon's other (regular) suicide rate was 41% above the national average. http://choiceisanillusion.files.wordpress.com/2014/02/oregon-suicide-report-2012-through-2010-pdf.pdf  Moreover and per this report, the financial cost of these other (regular) suicides is huge.  The report, page 3, elaborates:

In 2010, there were 685 Oregonians who died by suicide and more than 2,000 hospitalizations due to suicide attempts.  Suicide is the second leading cause of death among Oregonians ages 15-34, and the 8th leading cause of death among all ages in Oregon.  The cost of suicide is enormous.  In 2010 alone, self-inflicted injury hospitalization charges exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars.  The loss to families and communities broadens the impact of each death.  (Footnotes omitted).

Oregon is the only state where there has been legalization of physician-assisted suicide long enough to have valid statistics showing this positive statistical correlation between assisted suicide legalization and other (regular) suicides.

The enormous cost of increased (regular) suicides in Oregon, positively correlated to physician-assisted suicide legalization, is a significant factor for the House to consider in its vote on HB 1325, which seeks to legalize physician-assisted suicide.

For this and other reasons, I urge you to vote No in HB 1325.

Thank you.

Margaret Dore, Esq., MBA, President
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion, a nonprofit corporation
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, 44th Floor
Seattle, WA  98154
206 389 1754 main line
206 389 1562 direct line

Margaret Dore writes the New Hampshire Judiciary Committee: Vote "No" on HB 1325

Madame Chair and Members of the Committee,

During the recent hearing on assisted suicide, I mentioned that there had been a significant increase in other suicides in Oregon after assisted suicide legalization.  This is consistent with a suicide contagion (legalizing and thereby normalizing one type of suicide encouraged other suicides). 

Of course, a correlation does not prove causation. 

However, as set forth below, there is a significant statistical correlation between the two events.  Moreover, the financial cost to Oregon from the other suicides is enormous.  Please see the data below:

Oregon's assisted suicide act went into effect in 1997. See top line at this link: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/index.aspx

By 2000, Oregon's regular suicide rate was "increasing significantly"  See http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000")

In 2010, Oregon's other suicide rate was 35% above the national average.  http://maasdocuments.files.wordpress.com/2013/02/oregon-suicide-info_001.pdf

In 2012, the most recent report, Oregon's other suicide rate was 41% above the national average.  http://choiceisanillusion.files.wordpress.com/2014/02/oregon-suicide-report-2012-through-2010-pdf.pdf  Moreover, this report, page 3, states:

"Suicide is the second leading cause of death among Oregonians ages 15-34, and the 8th leading cause of death among all ages in Oregon.  The cost of suicide is enormous.  In 2010 alone, self-inflicted injury hospitalization changes exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars.  The loss to families and communities broadens the impact of each death."

The report, itself, does not address the possible influence of assisted suicide legalization.  But, again, the significant statistical correlation is there.  The cost to the state is enormous.

Please feel free to contact me for any further information.

Thank you.

Margaret Dore
Law Offices of Margaret K. Dore, P.S.
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, 44th Floor
Seattle, WA  98154
206 389 1754 main line

Suicide prevention plans at odds with right to die

This Canadian article is consistent with the Oregon experience in which legalization of physician-assisted suicide was followed by a significant increase in other suicides.  See footnote 1.

http://www.calgaryherald.com/opinion/op-ed/Martinuk+Suicide+prevention+plans+odds+with+right/9343852/story.html

By Susan Martinuk, Calgary Herald January 3, 2014 

Retired politician Bob Rae used the occasion of a friend's apparent suicide to call on Canada to establish a national suicide prevention plan.

Susan Martinuk

Chris Peloso was Rae's friend and well known in Ontario's political circles as the husband to George Smitherman, a former high-profile cabinet minister and politician. Media reports haven't utilized the term suicide, but the phrase "lost his battle with depression" seems to indicate that was the case.

Calls for such a strategy are made every time there is a high-profile suicide in this country (such as Amanda Todd and Rehtaeh Parsons, two girls who suffered unbearable bullying in school and on the Internet). Parliament passed a suicide prevention strategy one year ago, but few seem to be aware of its existence or its implementation, and society continues to call for somebody to do something to prevent such tragedies from occurring.

Prevention is usually a good policy. But I have questions about whether any suicide prevention policy can be successful with Canada's health-care system and be consistent with other societal messages.

The first question is how can we effectively prevent suicides by those who are depressed when our health-care system offers limited (at best) access to psychiatric care and treatment?

A depressed person can call a suicide hotline or speak with a counsellor, and a crisis may be prevented. Or maybe not. But, at some point, the only way to prevent suicide is to access medical treatment.

The Fraser Institute's 2013 report, Waiting Your Turn: Wait Times for Health Care in Canada, reveals that the national average wait time from referral by a general practitioner to the time of beginning non-urgent psychiatric treatment was 20.3 weeks. If you live in New Brunswick, that wait is 73.5 weeks. That's about 1.5 years to access treatment and includes a 46-week wait from the time of GP referral to seeing a psychiatric specialist.

If you live in Saskatchewan, the wait for treatment is one year. Even if the case is urgent, patients still face a five-week wait to get an appointment with a psychiatrist. Anyone familiar with depression or other mental illnesses knows that a lot can change in five weeks, let alone one year.

Rae thinks it's important to have public conversations about mental illness. But awareness has absolutely nothing to do with treatment and, based on the above statistics, it's difficult to imagine that any province could maintain an effective suicide prevention strategy.

My second question raises an issue that Canadians may not be familiar with, but will undoubtedly face in the coming months as Quebec (and eventually the rest of Canada) debates the legalization of euthanasia.

That is, how can we credibly promote suicide prevention strategies at the same time as a large portion of society is publicly claiming they have a right to die? After all, euthanasia is supposedly about the right to self-determination when individuals are forced to live in circumstances that are unbearable.

At least that's how the conversation goes. The reality of legalization is very different, as we've seen in Belgium, the Netherlands, Switzerland and Oregon. Each of these has relaxed their laws to the point that depressed people can easily access euthanasia. As one bioethicist claims, euthanasia in these districts expands the options for the mentally ill and "empowers" them when they make the choice.

A 2005 study in the Journal of Clinical Oncology showed that almost one half (44 per cent) of requests for euthanasia were made by patients with depression. These authors started with the premise that terminally ill people who requested euthanasia were more accepting of death and that depression would therefore not be a factor. In contrast, they found that depressed patients were four times more likely to request death.

A report in Current Oncology in 2011 summarized euthanasia in the Netherlands by saying that in 30 years, it "has moved from euthanasia of people who are terminally ill, to euthanasia of those who are chronically ill; from euthanasia for physical illness, to euthanasia for mental illness; from euthanasia for mental illness, to euthanasia for psychological distress of mental suffering," and now to euthanasia of those over 70 who are simply "tired of living."

How do we talk about such facts while promoting a national suicide prevention policy? A society that knows the slippery slope of euthanasia and still accepts its legalization has no credibility in talking about suicide prevention for those with mental illness.

Susan Martinuk is a columnist based in Western Canada. Her column appears every Friday.

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[1]   This quote is from  page 17 of Vote No on SB 220:

Oregon’s suicide rate, which excludes suicide under Oregon’s physician-assisted suicide act, is 35% higher than the national average.  This rate has been "increasing significantly since 2000." Just three years prior, Oregon legalized physician-assisted suicide.  This increased suicide rate is consistent with a suicide contagion (legalizing one type of suicide encourag[ing] other suicides).  There is, regardless, a statistical correlation between these two events.

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.

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[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")

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

Vermont: "Assisted suicide law sends contradictory message"

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

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

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

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

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

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

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

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Article printed from VTDigger: http://vtdigger.org/
URL to article: http://vtdigger.org/2012/02/01/page-assisted-suicide-law-sends-contradictory-message/
URLs in this post:

[1] : http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5635a2.htm

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

By Margaret Dore

January 26, 2012

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

autonomy and choice are naive."

William Reichel, MD

Montreal Gazette,

May 30, 2010[1]

A.  Introduction

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

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