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

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

By, Margaret Dore, Esq.

 

Supporting documentation follows letter, below.

I disagree with Susan Hancock’s description of how the Washington and Oregon assisted suicide laws work.   (Dec. 20, guest column)  I disagree that assisted suicide cannot be forced upon an unwilling person.

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

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

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

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

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

Supporting documentation below.

Margaret Dore, Esq.

Seattle, Wash.

MAAS files New Lawsuit Against Board

On Monday, December 17, 2012, MAAS filed a new lawsuit against the Montana Board of Medical Examiners.

The lawsuit is a response to the Board's order entered on November 16, 2012 refusing to vacate Position Statement No. 20.   The lawsuit's claims include that the statement is invalid because it was adopted "without statutory authorization, . . . outside the Board's subject matter jurisdiction and/or because it is an infringement on the role of the Legislature." 

The petition for the lawsuit can be viewed by clicking here.  The attachments to that petition can be viewed by clicking here and here.

Gazette opinion: Time to update Montana elder abuse law

http://billingsgazette.com/news/opinion/editorial/gazette-opinion/gazette-opinion-time-to-update-montana-elder-abuse-law/article_566c1b0a-9111-58e7-bc99-15b19e833f66.html?print=true&cid=print

The Montana Elder and Persons with Developmental Disabilities Act was intended to protect especially vulnerable citizens. But the statute isn’t used as often as it should be in criminal cases.

"Compassion & Choices is a successor organization to the Hemlock Society"

http://helenair.com/news/opinion/readers_alley/assisted-suicide-law-could-lead-to-patient-mistreatment/article_32bac11c-4985-11e2-9338-0019bb2963f4.html?print=true&cid=print

12/19/12

Theresa Schrempp Seattle, Wash.

I am a lawyer in Washington State where assisted-suicide is legal. 

Your readers should know that Compassion & Choices is a successor organization to the Hemlock Society, originally formed by Derek Humphry. In 2011, Humphry was the keynote speaker at Compassion & Choices’ annual meeting here in Washington State. In 2011, he was also in the news as a promoter of mail-order suicide kits from a company now shut down by the FBI. This was after a 29 year old man used one of the kits to commit suicide.

In 2007, Compassion & Choices was a plaintiff in Montana’s assisted-suicide case. Compassion & Choices requested legalization of assisted-suicide for “terminally ill adult patients.” The definition of this phrase was broad enough to include an otherwise healthy 18 year old who is insulin dependent or a young adult with stable HIV/AIDS. Such persons can live for decades with appropriate medical treatment.

Once someone is labeled “terminal,” an easy justification can be made that their treatment should be denied in favor of someone more deserving. Those who believe that legalizing assisted-suicide will promote free choice may discover that it does anything but.

Supporting authority not included in the published letter, below:

1.  This is a link to Compassion & Choices' newsletter announcing that Humphry would be the keynote speaker at its annual meeting in Washington State on October 22, 2012:  http://choiceisanillusion.files.wordpress.com/2011/10/derek.pdf

2.  This is an excerpt from Oregon's Register-Guard newspaper:

"A spotlight was cast on the mail-order suicide kit business after a 29-year-old Eugene man committed suicide in December using a helium hood kit.  The Register-Guard traced the $60 kit to [the company, which] has no website and does no advertising; clients find [the] address through the writings of Humphry."

http://projects.registerguard.com/web/newslocalnews/26910049-46/kit-police-suicide-fbi-springfield.html.csp

3.  Here is a link to my opinion letter with Richard Wonderly MD  analyzing Compassion & Choices' definition of "terminally ill adult patient." http://choiceisanillusion.files.wordpress.com/2012/07/schrempp_wonderly_opn_ltr1.pdf

Time to strengthen assisted suicide law

http://helenair.com/news/opinion/readers_alley/time-to-strengthen-assisted-suicide-law/article_b8257dd0-45be-11e2-b96a-0019bb2963f4.html

December 13, 2012, Independent Record

I have several concerns about the practice of assisted suicide, which has been rejected by most states and is currently legal in only two states (Washington and Oregon). 1) The potential for elder abuse is very real. Patients in Oregon with a “terminally ill” diagnosis have been refused treatment and steered toward assisted suicide. Patients can be pressured by a relative, who can even administer the dose. 2) A “terminally ill” diagnosis can be wrong. Some patients recover with treatment and may live a long time. 3) Montana already has a high suicide rate and state policy is directed at lowering that rate. The suicide rate in Oregon has increased since their law was passed.

Please tell your legislators to clarify and strengthen our law against assisted suicide.

Ruth Plesner
Victor

Liberal Massachusetts Defeated Assisted Suicide

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

Support withered for assisted-suicide question

By Chris Camire

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

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

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

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

"We focused our campaign strategy on looking at those weaknesses," said Baerlein.

Recipe for Elder Abuse

http://missoulian.com/news/opinion/mailbag/assisted-suicide-recipe-for-elder-abuse/article_261d7ce0-3e1f-11e2-8f87-001a4bcf887a.html

December 04, 2012 7:45 am

Brad Williams (letter, Nov. 28) is correct, assisted suicide is not legal in Montana (Associated Press, Nov. 16). The Montana Supreme Court decision, Baxter v. State, merely gives doctors a potential defense to prosecution for homicide.

In the 2011 legislative session, Sen. Anders Blewett and I introduced competing bills in response to Baxter, neither of which passed. His bill sought to legalize assisted suicide; mine sought to eliminate the defense.

During the hearing on Blewett's bill, he conceded that assisted suicide was not legal under Baxter. He said: "under the current law ... there's nothing to protect the doctor from prosecution."

Similar statements were made by others. For example, Dr. Stephen Speckart testified: "most physicians feel significant disease with the limited safeguards and possible risk of criminal prosecution after the Baxter decision."

To view a transcript, see:  http://maasdocuments.files.wordpress.com/2011/07/blewett_speckhart_trans_001.pdf

Legal assisted suicide is, regardless, a recipe for elder abuse in which heirs are empowered to pressure and abuse older people to cut short their lives.

Assisted suicide is not legal in Montana. The potential defense to prosecution is, however, a "toe in the door," which could lead to legalization in the future. Tell your legislators that you support reversing the defense to keep assisted suicide out of Montana.

Sen. Greg Hinkle, Thompson Falls

“Dr. Stevens, you saved my life!”

http://missoulian.com/news/opinion/mailbag/doctor-helped-patient-with-cancer-choose-life-over-assisted-suicide/article_63e092dc-37e5-11e2-ae61-001a4bcf887a.html?print=true&cid=print

 

Doctor helped patient with cancer choose life over assisted suicide

 

November 27, 2012 6:15

 

I am a doctor in Oregon, one of two states where assisted suicide is legal. This letter responds to your article about the controversy over this practice in Montana. (AP article re: Medical Examiners Board, Nov. 16). I write to clarify that legalizing assisted suicide would allow non-dying persons to be steered to suicide.

Oregon’s assisted-suicide law applies to patients predicted to have less than six months to live. In 2000, I had a cancer patient named Jeanette Hall. Another doctor had given her a terminal diagnosis of six months to a year to live. This was based on her not being treated for cancer.

At our first meeting, Jeanette told me that she did not want to be treated, and that she wanted to opt for what our law allowed – to kill herself with a lethal dose of barbiturates.

I did not and do not believe in assisted suicide. I informed her that her cancer was treatable and that her prospects were good. But she wanted “the pills.” She had made up her mind, but she continued to see me.

On the third or fourth visit, I asked her about her family and learned that she had a son. I asked her how he would feel if she went through with her plan. Shortly after that, she agreed to be treated, and her cancer was cured.

Five years later she saw me in a restaurant and said, “Dr. Stevens, you saved my life!”

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

I understand that assisted suicide will be an issue in your upcoming legislative session. I urge you to encourage your legislators to clarify your law to keep assisted suicide out of Montana.

Kenneth Stevens,
Sherwood, Oregon

Assisted suicide leaves no room for doctors' errors or erroneous prognostications

 http://ravallirepublic.com/news/opinion/mailbag/article_91d0a4cc-c434-5a41-9459-c808bf523634.html

 

Jeanette Hall's letter ( "Assisted suicide prompts some terminally ill patients to give up on life prematurely"), about how she would have died from assisted suicide if her doctor hadn't talked her out of it, hit a nerve. Her stated motivation was that she had been diagnosed with cancer and given six months to a year to live. That was 12 years ago.

 

Doctors do not know the future. They are often wrong. Indeed, this has happened twice in my family.

 

The first time was with my father. At age 66, he collapsed as he was leaving a doctor's appointment in the hospital at Glasgow. A week or so later his doctor recommended that we "pull the plug." I instead moved my father to another hospital. He fully recovered and lived nine more years. The doctor was wrong.

 

The second time was with me. When I was 62 years old, I was paralyzed due to a disease and put on a respirator. After four months, my doctors offered to take me off the respirator. They said that there was no chance of recovery. They said that if I lived, I would always be respirator dependent and a quadriplegic. Instead, I eventually lost my paralysis and even went back to work. My doctors, excellent doctors with years of experience, were wrong. It is now 14 years later.

 

Proponents of assisted suicide sometimes claim that assisted suicide is no different than pulling the plug. This is untrue. When you pull the plug, the patient doesn't necessarily die. If the patient does die, he or she dies due to his or her illness, not a lethal overdose.

 

I hope that we can keep assisted suicide out of Montana.

 

Jerry and Dora Lou Jacobson,

Glasgow

 

Assisted suicide: Idea is repugnant

http://missoulian.com/news/opinion/mailbag/assisted-suicide-idea-is-repugnant/article_f498f69c-407e-11e2-afae-001a4bcf887a.html

I was glad to see the letter in your publication by Brad Williams  (Nov. 28). Assisted suicide is an important topic for Montana, where proponents are wrongly claiming that the practice is legal and the majority of the population are senior citizens (over 50 years of age).

I retired from the Motion Picture Pension and Health Plans in Studio City, Calif., as the chief financial officer. One reason that I retired to Montana was that I had the perception that it was senior-citizen friendly, i.e., unlike Oregon and Washington, which have adopted laws allowing doctors and family members to assist people in killing themselves. That was repugnant to me.

The proposed legalization is for terminally ill persons. "Terminally ill" is a term that I am all too familiar with. In my previous employment, one would need to be terminally ill to qualify for a pension if they had not reached a specified age. Many, many times doctors deemed someone terminally ill and they wound up outliving their caregivers; not really, but they lived many years. If these persons had instead been applying for a lethal dose and used it, they would have been dead before their time.

Ted Friesen, Bigfork 

National disability rights group concerned Montana could legalize assisted suicide

http://missoulian.com/news/opinion/mailbag/national-disability-rights-group-concerned-montana-could-legalize-assisted-suicide/article_19f98ef0-38b0-11e2-ab52-0019bb2963f4.html

December 02, 2012

Not Dead Yet is a national disability rights group with members in Montana, some of whom are seniors. On behalf of our members, I write to say that we are extremely concerned that assisted suicide, sometimes euphemistically called "aid in dying," could be legalized in Montana.

It is estimated that there are 21,265 cases of elder abuse annually in Montana, reported and unreported (http://www.eadaily.com/15/elder-abuse-statistics).

Statistically, 90 percent of elder abusers are a family member or trusted other. Similarly, people with disabilities are up to four times more likely to be abused than their same-age nondisabled peers.

In Oregon and Washington, legal assisted suicide has opened new paths of abuse against persons who "qualify" to use these laws. A more obvious problem is a complete lack of oversight when the lethal drug is administered. If an abuser were to administer the drug without the person's consent, who would know?

It is simply naive to suggest that assisted suicide can be added to the array of medical treatment options, without taking into account the harsh realities of elder abuse and the related potential for coercion.

For more information about problems with legalization of assisted suicide, please see www.notdeadyet.org and www.montanansagainstassistedsuicide.org.Diane Coleman,
President/CEO,
Not Dead Yet,
Rochester, New York

Also published in the Ravalli Republic at
http://www.ravallirepublic.com/news/opinion/mailbag/article_f695c2f6-65c7-5194-9276-43365fd08f35.html?print=true&cid=print

Efforts to legalize assisted suicide may be one cause for high suicide rates

http://www.ravallirepublic.com/news/opinion/mailbag/article_bd36263c-c0e8-5bef-b57b-a7eafe75a77b.html?print=true&cid=print

Dec. 4, 2012

Your article, “Cowboy culture’ factor in Montana’s high suicide rate” (Nov. 25-27), discusses possible reasons for that high rate. A reason I did not see discussed is the active and ongoing push to legalize physician-assisted suicide in Montana.

I am a doctor in Oregon, where physician-assisted suicide is legal. In Oregon, physician-assisted suicide means that a physician facilitates a patient’s suicide by providing a lethal prescription. In Oregon, our law also allows family members to participate in the suicide, for example, by helping with the lethal dose request process and by picking up the lethal dose at the pharmacy. Physician-assisted suicide is sometimes called “aid in dying.“

Oregon’s overall suicide rate, which excludes suicide under our assisted suicide act, is 35 percent above the national average. This rate has been “increasing significantly” since 2000. Just three years prior, in 1997, Oregon legalized physician-assisted suicide. This statistical correlation is consistent with a suicide contagion in which the normalization of one type of suicide encouraged other suicides.

In 2011, a bill similar to Oregon’s law was proposed and defeated in the Montana Legislature. I understand that another bill will be proposed this coming legislative session. With this active promotion of physician-assisted suicide, there is the possibility of a normalization process similar to what appears to have taken place in Oregon. If so, this is another factor in Montana’s high rate of suicide.

I hope that you will encourage your legislators to keep assisted suicide out of Montana. Don’t make our mistake.

William L. Toffler,
Professor of family medicine,
Oregon Health & Science University,
National director and board member,
Physicians for Compassionate Care Education Foundation,
Portland, Ore.

Montana has not legalized assisted suicide

http://billingsgazette.com/news/opinion/mailbag/montana-has-not-legalized-assisted-suicide/article_758a6b1d-dc3d-5488-9750-a13b37d7d1ef.html

December 02, 2012 12:00 am

 

A recent AP article which appeared Nov. 16 in most major newspapers in our state incorrectly stated that Montana is the third state to allow assisted suicide, along with Washington and Oregon. Attorneys Greg Jackson and Matt Bowman did an extensive analysis of the case and concluded it "did not legalize assisted suicide and it continues to carry both criminal and civil liability for any doctor, institution, or lay person involved." The Montana Lawyer, the official publication of the Montana State Bar concluded the issue is open to argument, confirming that the Legislature needs to clarify the issue this coming session.

Your readership needs to know that there are problems inherent in passing a law that would allow a physician to kill their patient. People need to understand that we are talking about a physician writing a prescription for the express purpose of one taking their own life. The very oath that physicians take in stepping into this profession states that they "shall do no harm." Their purpose is to cure, to heal, to provide comfort and care at the end of life, but not to aid in facilitating the end of that life through active means. Physicians are fallible human beings and often are wrong in their prognosis concerning how long a patient will survive their illness. Often, it is depression that prompts one to think that life is not worth living or perhaps the feeling that because of their illness they are a burden to their family. The whole matter is a recipe for elder abuse.

I appreciate the opportunity to set the record straight and hope that The Gazette will continue to report on this vital topic.

David W Hafer, DDS, MS
Dayton

Assisted suicide may not bring peace to either terminally ill or their families

http://www.ravallirepublic.com/news/opinion/mailbag/article_68d5ea27-25d1-5654-b61e-ca2c67d0c68d.html?print=true&cid=print

 

November 30, 2012 6:15 am  

 

This letter is a follow up to your recent (Nov. 16) article on assisted suicide and the Montana Medical Board.

 

A study was recently released in Switzerland, where assisted suicide is legal (“Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2012) 542-546, available at http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf). The study found that 1 out of 5 family members or friends present at an assisted suicide were traumatized. These persons “experienced full or sub-threshold (Post Traumatic Stress Disorder) related to the loss of a close person through assisted suicide.”

This study is consistent with what I have observed with my law practice clients whose parents participated in the Washington/Oregon death with dignity acts (assisted suicide). With one client, one branch of the family wanted the parent to use the lethal dose, while the other did not. The parent spent much of his final days traumatized and struggling over the decision of whether or not to kill himself. This was instead of making the best of the time that he had left. My client was also traumatized. In that case, the parent did not use assisted suicide and died a natural death.

With another case, it’s unclear that the parent’s assisted-suicide death was voluntary. My client lives with that memory.

Legal assisted suicide is sold as a peaceful and loving death. It may be anything but.

Margaret Dore, Seattle WA

Senator Jim Shockley: Assisted suicide not legal

http://www.ravallirepublic.com/news/opinion/mailbag/article_155276c2-3c08-11e2-a232-001a4bcf887a.html

Brad Williams is correct that assisted-suicide is not legal in Montana. (Legalization could lead to abuse). The Montana Supreme Court's assisted-suicide case, Baxter v. State, limited its holding to giving doctors who assist a suicide a potential defense if those doctors are charged with homicide for the death of their patients. There are several steps that the doctor must demonstrate to perfect the defense.

Baxter did not invalidate our homicide statutes. Baxter did not overrule our case law allowing family members to sue an attending physician for negligence, malpractice, or wrongful death.

As an attorney in private practice, I did my share of wills, probates and estates. I observed that some heirs did not care as much for the elderly as they did for the elderly person's assets.

With the legalization of assisted-suicide, heirs would be encouraged to suggest, cajole or coerce older people to kill themselves, i.e., before such persons are able to change their wills, give their money to charity or simply spend it. Legal assisted suicide is a recipe for elder abuse.

Jim Shockley
Senate District 45

Legal assisted suicide Orwellian and discriminatory

http://www.ravallirepublic.com/news/opinion/mailbag/article_10cd3eb4-39cb-11e2-b954-0019bb2963f4.html?print=true&cid=print

November 28, 2012
Dear Editor:

I am confused by the ongoing dispute about whether we should legalize assisted suicide in Montana. I am a medical doctor whose patients include incarcerated persons. Law enforcement, jails and prisons are mandated to monitor for signs of depression and suicidal ideation, and to identify, intervene and/or initiate treatment. We are told that our failure to do so would be a significant breach of an inmate's civil rights. Yet according to proponents of assisted suicide, patients also have a right to receive a doctor's assistance with the suicide. This makes no sense.

On the one hand, you have a group of people (prisoners) who suffer from situational depression due to their circumstances. Suicide attempts in this population are not rare. On the other hand, you have a group of people (persons diagnosed with a terminal diagnosis) who suffer from situational depression due to their circumstances. Why is one group entitled to protection and the other is not? Is it because with the second group, you call it "aid in dying" because people are dying anyway? They may not be dying anyway. Doctors diagnoses can be wrong. I have seen patients in my own practice live longer than expected. What about an older inmate? Would he be entitled to protection or a lethal dose? This all strikes me as very Orwellian and also discriminatory to people labeled terminal. I thought freedom from discrimination was a constitutional right.

I have seen suicidal people get better and rebuild lives that looked pretty grim. I do not agree that doctors or anyone else should be steering people to suicide in Montana. I hope that our legislature will clarify once and for all that assisted suicide is not legal in Montana.

Carley C. Robertson, Havre

Assisted suicide makes it easier to cover up elder abuse, even murder

http://www.ravallirepublic.com/news/opinion/mailbag/article_3fafcdd7-df10-5c31-baa6-d51d57078f77.html?print=true&cid=print

November 29, 2012

 

Re: Assisted Suicide and Elder Abuse

 

This letter responds to your recent AP article about assisted-suicide (Associated Press, Nov. 16). I write to emphasize elder financial abuse as a reason to keep assisted suicide out of Montana.

The landmark 2009 report by MetLife Mature Market Institute describes elder financial abuse as a crime “growing in intensity.” (See www.metlife.com/assets/cao/mmi/publications/studies/mmi-study-broken-trust-elders-family-finances.pdf, p.16.) The perpetrators are often family members, some of whom feel themselves “entitled” to the elder’s assets (Id, pp. 13-14.) The report states that they 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 (Id, p. 14.) The report states that victims “may even be murdered” by perpetrators (Id., p. 24.)

With legal assisted suicide in Oregon and Washington state, perpetrators are instead able to take a “legal” route by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over administration. The elder could be cajoled or coerced into taking the lethal dose, for example, while under the influence of alcohol. The lethal dose could be administered while the elder slept. If he awoke and struggled, who would know?

Alex Schadenberg,
Euthanasia Prevention Coalition,
London, Ontario, Canada,

Assisted Suicide is not legal

http://www.greatfallstribune.com/apps/pbcs.dll/article?AID=2012311260039&nclick_check=1


In the Nov. 16 Tribune article, Brad Williams is correct; assisted-suicide is not legal in Montana. The Montana Supreme Court decision, Baxter v. State, merely gives doctors a potential defense to prosecution for homicide. In the 2011 legislative session, Sen. Anders Blewett and I introduced competing bills in response to Baxter, neither of which passed. His bill sought to legalize assisted-suicide; mine sought to eliminate the defense.

During the hearing on Blewett's bill, he conceded that assisted-suicide was not legal under Baxter. He said, "Under the current law ... there's nothing to protect the doctor from prosecution." Similar statements were made by others. For example, Dr. Stephen Speckart testified, "Most physicians feel significant 'dis-ease,' with the limited safeguards and possible risk of criminal prosecution after the Baxter decision." To view a transcript, see: http://maasdocuments.files.wordpress.com/2011/07/blewett_speckhart_trans_001.pdf

Legal assisted-suicide is, regardless, a recipe for elder abuse in which heirs are empowered to pressure and abuse older people to cut short their lives. Assisted-suicide is not legal in Montana. The potential defense to prosecution is, however, a "toe in the door," which could lead to legalization in the future. Tell your legislators that you support reversing the defense to keep assisted-suicide out of Montana.

 
Sen. Greg Hinkle,
Thompson Falls

Assisted suicide prompts some terminally ill patients to give up on life prematurely

http://www.ravallirepublic.com/news/opinion/mailbag/article_e05fa28b-dd72-5688-a321-654cc86fc213.html?print=true&cid=print

(Scroll down to listen to radio ad featuring Jeanette Hall and Paul Gorsuch MD - 03 23 13)

November 28, 2012 

Thank you for publishing the letter by Dr. Ken Stevens describing how he talked his patient out of doing assisted suicide in Oregon (Missoulian, online only). I am that patient and he did save my life.

In 1997, I voted for the initiative that legalized assisted suicide in Oregon.

In 2000, I was diagnosed with cancer and told that I had six months to a year to live. I knew that our law had passed, but I didn’t know exactly how to go about doing it. I did not want to suffer, and I did not want to do radiation. I wanted Stevens to help me, but he didn’t really answer me.

Instead, he encouraged me to not give up and ultimately I decided to fight the cancer. I had both chemotherapy and radiation. I am so happy to be alive!

It is now 12 years later. If Stevens had believed in assisted suicide, I would be dead. I thank him and all my doctors for helping me choose “life with dignity.” Assisted suicide should not be legal.

Thank you so much.

Jeanette Hall,
King City, Oregon

Listen to Radio ad with Jeanette Hall and Paul Gorsuch MD

A Recipe for Elder Abuse

http://www.ravallirepublic.com/news/opinion/mailbag/article_3281ea75-6f64-5731-9764-fda7272c9deb.html

Dear Editor:

I agree with the (Nov. 21) letter by Dr. David Hafer, that legal assisted suicide is a recipe for elder abuse.

I am a physician with a high percentage of older patients. I have had the painful misfortune of personally observing countless instances of elder abuse. The motive is usually financial gain.

Legalization of assisted suicide will give perpetrators yet another weapon. This is especially a concern because assisted-suicide proponents have targeted our state. I fear for my patients.

Annie Bukacek, Kalispell

Assisted suicide a bad proposition

http://helenair.com/news/opinion/readers_alley/assisted-suicide-a-bad-proposition/article_0ca98042-3537-11e2-957f-001a4bcf887a.html?print=true&cid=print

Letter to the Editor:

November 23, 2012 12:00 am

 

I have been following assisted suicide issues in various states for several years. Who could have ever imagined that a free society would come to this?

Last year, many of us attended a meeting where we heard from lawyers and doctors from Washington and Oregon speak out about assisted suicide in their states. Their true accounts of elder abuse, suicide parties, fraud, theft, legal wrangling and what can only be called murder were very unsettling.

I sat there stunned and sick inside, thinking of all the misdeeds that had been done under the guise of mercy.

Friends, do we want to bring this type of debacle to our great state? I think not. Assisted suicide is not legal in Montana — though some would like us to think otherwise. Let us work together and take steps to keep it out. As a member of Montanans Against Assisted Suicide, I ask you to join us in our opposition to this barbaric practice. Many vulnerable folks are counting on us to get this one right.

Mrs. Garnett Rope

Vaughn

Assisted Suicide not legal in state, needs clarification

http://mtstandard.com/news/opinion/mailbag/our-readers-speak-assisted-suicide-not-legal-in-state-needs/article_6d1ca724-337f-11e2-9eee-001a4bcf887a.html

November 21, 2012 12:15 am  •  by David W. Hafer

A recent Associated Press article, which appeared last Friday in most major newspapers in our state, incorrectly stated that Montana is the third state to allow assisted suicide, along with Washington and Oregon.

Attorneys Greg Jackson and Matt Bowman did an extensive analysis of the case and concluded it “did not legalize assisted suicide and it continues to carry both criminal and civil liability for any doctor, institution, or lay person involved.”  [Click here to see Jackson/Bowman article]

The Montana Lawyer, the official publication of the Montana State Bar concluded the issue is open to argument, confirming that the Legislature needs to clarify the issue this coming session. [Click here for link to Montana Lawyer article, with this headline:  "The aid-in-dying debate: Can a physician legally help a patient die in Montana? Court ruling still leaves the issue open to argument"]

Assisted Suicide is Not Legal in Montana

This letter, by attorney Craig Charlton, responds to a prior letter claiming that assisted suicide is legal.  Mr. Charlton, attorney for Montanans Against Assisted Suicide, states:

Dear Physician . . . 

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.

The letter states: "Physicians can provide prescriptions to such patients without fear that doing so could give rise to criminal or disciplinary sanction." This statement is contrary to Baxter, which merely gives doctors a defense to prosecution. Baxter states:

"We therefore hold that under § 45-2-211, MCA, a terminally ill patient's consent to physician aid in dying constitutes a statutory defense to a charge of homicide against the aiding physician when no other consent exceptions apply."[1]

You may also be interested in this analysis of Baxter by attorneys Greg Jackson and Matt Bowman:

"[T]he Court's narrow decision didn't even ‘legalize’ assisted suicide. . . . After Baxter, assisted suicide continues to carry both criminal and civil liability risks for any doctor, institution, or lay person involved."[2]

Please note that [Compassion & Choices'] "aid in dying" letter omits any discussion of a doctor’s potential civil liability for wrongful death and/or malpractice.  Baxter did not overrule Montana case law imposing civil liability on doctors who cause or fail to prevent a suicide. See Krieg v. Massey, 239 Mont. 469, 472-3 (1989) and Nelson v. Driscoll, 295 Mont. 363, Para 32-33 (1999).  Other cases include  Edwards v. Tardif, 240 Conn. 610, 692 A.2d 1266 (1997)(affirming a civil judgment against a physician who had prescribed an "excessively large dosage" of barbiturates to a suicidal patient who then killed herself with the barbiturates).

For another example, see William Dotinga, "Grim Complaint Against Kaiser Hospital," at http ://www.courthousenews.com/2012/02/06/43641.htm  This case is relevant to Baxter given that patient consent is the linchpin to Baxter's defense to prosecution. Moreover, even if a doctor avoids prosecution, there is civil liability. . . .

Letter from Craig Charlton to Montana Physicians, dated June 20, 2012.  To see a print copy of the entire letter, click here.   

* * * 

[1]  Baxter v. Montana, 354 Mont. 234, para. 50, 224 P.3d 1211 (2009).

[2]  To see the entire Jackson/Bowman analysis, go here: http://www.montanansagainstassistedsuicide.org/p/baxter-case-analysis.html

MMA Adopts Helpful Position Statement

The Montana Medical Association's Board of Trustees has adopted a new position statement: Licensing Boards "should not adopt rules that would expand the scope of practice of Montana's licensed health care professionals without first having clear statutory authorization to do so."[1]

Our legal challenges to Position Statement No. 20 include this same reasoning, that Position Statement No. 20 is an invalid expansion of a physician's scope of practice without statutory authority.[2]

We are encouraged to see the Montana Medical Association adopting a similar position. 

* * *

[1]  The MMA's new position statement can be viewed in its entirety by clicking here.
[2]  Position Statement No. 20 is subject to two legal challenges by Montanans Against Assisted Suicide (MAAS).  The first is a formal petition to the Board of Medical Examiners, to request an actual ruling, which has been denied to date.  That petition can be viewed by clicking here.  The second legal challenge is a petition to the First Judicial Court of Lewis and Clark County setting forth MAAS' substantive arguments.  To view the amended petition, filed on October 12, 2012, click here; to view the attachments to that petition, click here.

MMA Position Statement on Scope of Practice

The Montana Medical Association Bulletin sets forth the following Position Statement adopted by the MMA Board of Trustees on September 7, 2012.  To view a print copy, click here.

Expansion of Scope of Practice by Professional Licensing Boards

The Montana Medical Association recognizes that professional licensing boards authorized by Montana state statutes to license individuals in certain health care professions ("health care licensing boards") have, at times, attempted to and actually have expanded the scope of health care licensees without having the statutory authority to do so. This practice is of concern to medical physicians and other licensed health care professionals.

Laws Against Assisted Suicide are Constitutional

Laws prohibiting assisted suicide in Montana are constitutional under both the US Constitution and the Montana State Constitution.  This is true for three reasons. 

1.  The US Supreme Court Upheld Constitutionality

In 1997, the Supreme Court of the United States upheld the constitutionality of a statute prohibiting assisted suicide under the United States Constitution.  In Washington v. Glucksberg, 521 U.S. 702, 705-6, 117 S.Ct. 2258, 2261 (1997), the Supreme Court stated:

"The question presented . . . is whether Washington's prohibition against 'caus[ing]' or 'aid[ing] a suicide offends the Fourteenth Amendment to the United States Constitution. We hold that it does not."

2.  Montana's Constitution Does Not Include a "Right to Die"

Montana's Constitution was adopted in 1972.  Archived documents show that during the Constitutional Convention, a proposed right to die was considered and rejected.[1]  

With this history, there is no right to die in the Montana Constitution.[2] 

3.  The Montana Supreme Court's Constitutional Ruling

In Baxter v. State, 354 Mont. 234, 224 P.3d 1211 (2009), the Supreme Court of Montana vacated a district court decision holding that there is a Constitutional right to physician-assisted suicide under the Montana Constitution.[3] The Supreme Court stated:  "The District Court's ruling on the constitutional issues is vacated . . ."[4]

Montana's Constitution Does Not Include a "Right to Die"

By Margaret Dore

In 1972, Montana held its Constitutional Convention.  The Bill of Rights Committee was charged with drafting a declaration of rights to be included in the constitution.  On February 2, 1972, the Committee received "Delegate Proposal 103," which proposed a right to die.[1] 

On February 3, 1972, the Committee held a hearing on the "right to die."[2]  Therein, "Mrs. Joyce Franks presented the theory to the Committee that all persons should be able to choose his own death with dignity."[3]  She also submitted a seven page document titled "Bill of Rights Speech."[4]  In this document, she proposed wording for a constitutional right to die and also discussed her father and the right to die in terms of physician-assisted suicide and/or euthanasia.[5] 

Other persons also submitted testimony.[6]

On February 9, 1972, the Bill of Rights Committee rejected Proposal #103, the "Right to Die."[7]   

On February 12, 1972, Joe Roberts appeared before the Committee in support of the right to die.[8]  His written remarks noted the reason for the Committee's rejection of the right to die, as follows:

"[T]he consensus of the delegates I have talked to indicated that while they were sympathetic to Mrs. Frank's personal tragedy, they were afraid of the implications of stating broadly a Right to Die in the Montana Constitution.[9] 

On March 18, 1972, the Committee's "Declaration of Rights" was adopted by the full convention without the right to die.[10]

Today, the Committee's Declaration of Rights is Article II of the Montana Constitution.[11] 

With this history, there is no right to die in the Montana Constitution: it was proposed; advocated by Mrs. Franks and other persons; and rejected.

MAAS Requests Ruling From Board, It's About Time

On September 26, 2012, Montanans Against Assisted Suicide submitted a formal petition to the Board of Medical Examiners requesting that the Board rule on Position Statement No. 20.  A hard copy of the petition can be viewed by clicking here.  The petition states in part:

"This matter has been pending before the Board for a year. On May 2, 2012, MAAS filed a formal request to vacate Position Statement No. 20, which implies that assisted suicide and/or euthanasia is legal in Montana, which is not the case. On July 6, 2012, MAAS submitted additional argument to the Board.

MAAS’s grounds for relief were twofold: (1) The Board enacted Position Statement No. 20 without required notice and participation by the public; and (2) the Board lacks statutory, constitutional and/or rulemaking authority to enter such a statement. These grounds for relief are explained in more detail in the materials previously filed with the Board on this issue. 

Laws Against Assisted Suicide are Constitutional

By Margaret Dore

This article describes why laws against physician-assisted suicide are constitutional in Montana.  See below.

A.  Physician-Assisted Suicide

The American Medical Association defines "physician-assisted suicide" as follows: "[A] physician facilitates a patient’s death "by providing the necessary means and/or information to enable the patient to perform the life-ending act (e.g., the physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide)."[1]

Physician-assisted suicide is also called assisted suicide and "aid in dying," a term which also means euthanasia.[2] 

B. Assisted Suicide is Not Legal in Montana

In Montana, the law on assisted suicide is governed by statutes and case law.[3]  The most recent case law is Baxter v. State, 354 Mont. 234, 224 P.3d 1211 (2009), which gives doctors who assist a patient's suicide a defense to a homicide charge.  Baxter states:

"We therefore hold that under § 45-2-211, MCA, a terminally ill patient's consent to physician aid in dying constitutes a statutory defense to a charge of homicide against the aiding physician when no other consent exceptions apply."[4]

Under Baxter, this defense fails if the patient's consent cannot be shown.[5]  In that case, prosecution for homicide can go forward.[6]

Baxter did not overrule Montana case law imposing civil liability on persons who cause or fail to prevent another person's suicide.  See Krieg v. Massey, 239 Mont. 469, 472-3 (1989) and Nelson v. Driscoll, 295 Mont. 363, ¶¶ 32-33 (1999).  Other relevant case law includes Edwards v. Tardif, 240 Conn. 610, 692 A.2d 1266 (1997) (affirming a civil judgment against a doctor who had prescribed an ”excessively large dosage” of barbiturates to a suicidal patient who then killed herself with the barbiturates).  

Attorneys Greg Jackson and Matt Bowman state: "After Baxter, assisted suicide continues to carry both criminal and civil liability risks for any doctor, institution, or lay person involved."[7]  In short, Baxter did not legalize assisted suicide."

C.  Clarifying Legislation Would be Constitutional

Some assisted suicide proponents, nonetheless, claim that assisted suicide is legal under Baxter.[8]  With this situation, clarifying legislation is needed.  Some proponents, however, counter that any such legislation would be unconstitutional.  This is untrue.  See below.

The Oregon Health Plan Steers Patients to Suicide

On September 21, 2012, the Attorney General of Canada filed an affidavit by Dr. Ken Stevens in the Quebec assisted suicide case, Leblanc v Canada.  Therein, Dr. Stevens describes how the Oregon Health Plan steers patients to suicide.

Please view the text of his affidavit below.  To view a hard copy of his affidavit, click here. 

Margaret Dore to Speak at Deaconess Hospital, Bozeman, Sept 12th, 7pm

To view event flyer, click here.

"Assisted Suicide:  Whose Choice?"

A Presentation by Margaret Dore, Esq.

Margaret Dore

Margaret Dore is President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide.  She is also an attorney in Washington State where assisted suicide is legal and patient choice is not assured.  The law instead invites patient coercion and elder abuse.  The Washington law  also devalues people with disabilities.  Ms. Dore is a former Law Clerk to the Washington State Supreme Court.  She was an amicus curie in Montana's Baxter case.  For more information, see www.margaretdore.com and www.choiceillusion.org  

Ms. Dore will discuss assisted suicide laws in Washington and Oregon and how those laws are a recipe for abuse.  She will compare the situation in Washington and Oregon to proposals seeking to legalize assisted suicide in Montana.

Senator Hinkle Corrects the New England Journal of Medicine

"Assisted Suicide is Not Legal in Montana"

Dear Editor:

I am a Montana State Senator.  I disagree with your article, "Redefining Physicians' Role in Assisted Dying," claiming that assisted suicide is legal in Montana.  At the very least, Montana law is unclear.

Last year, Senate Bill 167, which would have legalized assisted suicide in Montana, failed.  This leaves assisted suicide governed by a Montana Supreme Court case, Baxter v. Montana.  An analysis by attorneys Greg Jackson and Matt Bowman describes Baxter as follows:

"The Montana Supreme Court s assisted-suicide decision . . . didn't even 'legalize' assisted-suicide. . . . After Baxter, assisted-suicide continues to carry both criminal and civil liability risks for any doctor, institution, or lay person involved."[1]

Since then, competing articles have appeared in the official Montana State Bar publication disputing whether Baxter legalized assisted suicide.[2]  The editor's headline states: "Court ruling still leaves the issue open to argument." [3]

Correct reporting would be that assisted suicide is not legal in Montana and/or hotly disputed.  Thank you for your attention to this matter.

To the Board: "Why do you think Montana has such a high rate of suicide?"

To: DLI BSD Medical Examiners

Subject: Against Assisted suicide

We agree with Montanans Against Assisted Suicide.  Please vacate statement No. 20. Senator Blewitt and Dr Speckert admit it is illegal, so how can the Board make it legal?  This puts everyone at risk especially the elderly and special needs people.  Why do you think Montana has such a high rate of suicide?  Our young people see how human beings are not regarded with real honor and respect and figure if life gets hard, suicide is an option.  This will also add to elder abuse.

Sincerely Jerry and Virginia Geier

To Board: Assisted suicide "kills the very person under the physician's care"

To: DLI BSD Medical Examiners
Subject: Position Statement No 20

To whom it may concern,

Please vacate position statement no. 20 as assisted suicide is neither legal, consistent with established American Medical Association statements, the Hippocratic oath, puts the vulnerable and elderly at risk, and kills the very person under the physician’s care.

Respectfully submitted,
Samuel J. Reck, MD

To Board: "Even Sen. Blewett & Dr. Speckart have admitted that assisted suicide is not legal"

Subject: PLEASE Vacate Position Statement No. 20

I have written you before and I continue to request that you vacate your Position Statement No. 20. Even Sen. Blewett & Dr. Speckart have admitted that assisted suicide is not legal in Montana (see http://maasdocuments.files.wordpress.com/2011/07/blewett_speckhart_trans_001.pdf ) How can the Board make it legal?

Sandra A Wedel Great Falls, MT

Board: "Please do not go down Washington's path"

Subject: Position Statement No. 20

To the Board of Medical Examiners:

I am an attorney in Bellevue, Washington.

My law practice emphasizes elder law and probate matters. I am writing to urge you to VACATE Position Statement No. 20.

Instances of elder abuse have risen significantly in recent years. Assisted suicide provides an easy cover for an abuser who coerces a vulnerable adult into “signing up” rather than “burdening” the expectant heir. Warning signs of financial abuse often go unrecognized by physicians and others.

You are undoubtedly aware that assisted suicide is unfortunately legal in Washington. I support the position of Montanans Against Assisted Suicide. Please do not go down Washington’s path.

Do not hesitate to contact me if you have any questions. Thank you.

Theresa Schrempp
theresas@lawyerseattle.com
Sonkin & Schrempp, PLLC
12715 Bel Red Rd Ste. 150
Bellevue WA 98005
425 289.3444 direct

Ted Friesen: "They would be dead before their time"

As published in the Senior News for August/September 2012:

I was glad to see the advertising in your publication by Montanans Against Assisted Suicide & For Living with Dignity.  Assisted suicide is an important topic for Montana where  proponents are wrongly claiming that the practice is legal and the majority of the population are senior citizens (over 50 years of age).

I retired from the Motion Picture Pension and Health Plans in Studio City, California, as the Chief Financial Officer.  One reason that I retired to Montana was that I had the perception that it was senior citizen friendly, unlike Oregon and Washington, which have adopted laws allowing doctors and family members to assist people in killing themselves.  That was repugnant to me. 

The proposed legalization is for terminally-ill persons.  “Terminally-ill” is a term that I am all too familiar with.  In my previous employment, one would need to be terminally-ill to qualify for a pension if they had not attained a specified age.  Many, many times doctors deemed someone terminally-ill and they wound up outliving their care-givers, not really but they lived many years.  If these persons had instead been applying for a lethal dose and used it, they would be dead before their time.

Ted Friesen, Big Fork

To Board: " The representatives of the people did not chose legalization"

Subject: Statement 20

July 19, 2012

Dear Members of the Montana Board of Medical Examiners,

Please add my name to those requesting that you vacate Position Statement Number 20. During the last legislative session Senator Anders Blewett stated that suicide was not legal in Montana. His Senate Bill 167 died in committee. The representatives of the people did not chose legalization.

Assisted suicide is too often legalized elder abuse. Suicide is already a problem in our state.

Representative Janna Taylor
House District 11

"The Board is both misleading physicians and endangering patients"

To the Montana Board of Medical Examiners:

Not Dead Yet is a national disability rights group with members in Montana. This letter is to urge you to rescind the position statement that the Board of Medical Examiners formulated entitled "Physician Aid in Dying" (Position 20).

First, it is incorrect to state that the Baxter decision will "...shield a physician from liability for acting in accordance with a patient's end-of-life wishes if an adult, mentally competent terminally ill patient consents to the physician's aid-in-dying." The Montana Supreme Court merely stated that if the physician can show that he/she acted in accordance with a person's wishes and consent, then such consent can be raised as a defense to a charge of homicide against the physician. Once raised, a judge or jury may or may not find the defense valid after considering all the facts and circumstances of the case.

For example, a judge or jury could reasonably expect a doctor who assists in a patient’s suicide to take practical steps to ensure that the patient’s request to die is voluntary and not coerced by others who might benefit from the death financially or by being relieved of care giving responsibilities. The potential for coercion is fraught with risks for physicians.

It is estimated that there are 21,265 cases of elder abuse annually in Montana, reported and unreported. http://www.eadaily.com/15/elder-abuse-statistics/ Statistically, 90% of elder abusers are a family member or trusted other. Similarly, people with disabilities are up to four times more likely to be abused than their same-age nondisabled peers.

A relative who is willing to abuse an elder or disabled person might be equally willing to bring up assisted suicide as an option for an ill relative. An abuser might take their relative to visit the doctor to request assisted suicide. An abuser might pick up the lethal prescription at the pharmacy. Even if the abuser went so far as to administer the drugs without the person’s actual consent at the time of death, who would know?

It is simply naïve to suggest that assisted suicide can be added to the array of medical treatment options, on a par with palliative care, without taking into account the harsh realities of elder abuse and the related potential for coercion. The Montana Supreme Court overlooked the public policy implications of elder abuse in its analysis, but in individual cases this issue is likely to become a factor that physicians could only ignore at their peril.

In stating that physicians have a shield against liability for assisted suicide when either a judge or a jury may view a case very differently, the Board is both misleading physicians and endangering patients.

We urge the Board to reconsider and rescind its position on assisted suicide.

Sincerely,

Diane Coleman, JD, MBA
President/CEO
Not Dead Yet