A Short History of Assisted Suicide and Euthanasia in Montana

By Margaret Dore, Esq., MBA 

State Capitol

Assisted suicide means that someone provides the means and/or information for another person to commit suicide.  If a doctor is involved, the practice may be termed physician-assisted suicide.  Euthanasia is the administration of a lethal agent by another person. 

A.  Assisted Suicide

In 1895, the Montana Legislature enacted a criminal statute prohibiting assisted suicide as a "crime against the public safety."[1] In 1907, 1921 and 1947, this statute was re-codified, but its text remained unchanged.[2] The statute stated: "Every person who deliberately aids, or advises or encourages another to commit suicide is guilty of a felony."[3]

Assisters Can Have Their Own Agenda

http://ravallirepublic.com/news/opinion/mailbag/article_d9ec8917-b025-5aad-97dd-0520559fde00.html

Greed, personal motives can influence 'choice' to commit assisted suicide . . .

A Roundup man was recently charged with “aiding or soliciting suicide” of a 16-year-old girl here in Montana. His apparent motive was to prevent her testimony against him in another matter, i.e., by getting her to kill herself. According to an Associate Press article, he coerced her to actually take steps towards that goal, which fortunately did not result in her death. See  http://billingsgazette.com/news/local/crime-and-courts/convicted-rapist-charged-with-aiding-or-soliciting-suicide-of-victim/article_65c2f39c-ae01-5104-a279-da45b352ef42.html

Similarly, in Minnesota, a former nurse was recently convicted of assisting a young man to kill himself. Both the nurse and the Roundup man had used webcams to communicate with their victims. The nurse’s reported motive was the “thrill of the chase.” See  http://www.independent.co.uk/news/world/americas/suicideobsessed-us-nurse-convicted-of-helping-coventry-man-kill-himself-9722534.html.

These stories illustrates a fundamental problem with legalizing assisted suicide. The assisting person can have his or her own agenda to encourage a person to kill themselves. The “choice” will not necessarily be that of the victim/patient.

In my practice, where I have a high percentage of older patients, I have witnessed greed by family members over inheritances, including vicious battles over the death bed. This same motive of greed could lead to a coerced suicide, especially if assisted suicide were legalized in our state.

Let’s keep legal assisted suicide out of Montana.

Annie Bukacek,
Kalispell

In Montana, Elder Abuse a Growing Concern

http://missoulian.com/lifestyles/booming/elder-abuse-a-growing-concern/article_8b895eb2-0210-11e4-bf33-001a4bcf887a.html

July 03, 2014 7:45 am  •  By MICHAEL HAGENLOCK for the Missoulian

Did you know that every day 10,000 people turn 65 in the United States? According to U.S. Department of Health and Human Services, that trend is going to continue for nearly the next 20 years.

At the same time this population is growing, we know that a startling number of elders face abusive conditions. Every year an estimated 5 million older Americans are victims of abuse, neglect or exploitation.

But that’s only part of the picture. Experts believe that for every case of elder abuse or neglect reported, about 24 cases go unreported. The U.S. census predicts that by 2015 Montana will have the nation’s fourth-oldest population and that by 2025, 25 percent of Montana will be 65 or older. By 2030, the number is expected to double.

Beware of Vultures: Senator Jennifer Fielder on Compassion & Choices

"[I]t seems odd that the top lobby spender in Montana this year was Compassion and Choices, a 'nonprofit' group that spent $160,356 advocating for legalization of assisted suicide."

By Senator Jennifer Fielder

As we wrangled through the budget this spring, the beautiful state capitol began to feel like a big, ripe carcass with a dark cloud of vultures circling about.  

Senator Jennifer Fielder

The magnitude of money in government attracts far more folks who want to be on the receiving end than it does those who just want fair and functional government. Until that ratio improves, it may be impossible to rein in unnecessary regulation and spending. 

Special interest groups spent over $6 million dollars on lobbyists to pressure Montana legislators during the 2013 session. Seems like a lot of money, until you compare it to the billions of taxpayer dollars at stake. Does the average taxpayer stand a chance against organized forces like that?

Assisted suicide: Senate bill was defeated

http://www.ravallirepublic.com/news/opinion/mailbag/article_f38cc835-638d-59c1-bd88-880c1cb3c1c8.html 

June 09, 2013 9:45 am

I was appalled to read Charles Johnson’s article implying that assisted suicide is legal in Montana. To the contrary, Senate Bill 220, which had sought to legalize assisted-suicide, was defeated in committee during the 2013 legislative session. The bill was tabled, nine votes to three. See www.montanansagainstassistedsuicide.org/p/sb-220-tabled.html.

Don't Give Doctors More Power to Abuse Patient Choice: Vote "Yes" on HB 505

Prepared by Margaret Dore, Esq.

For a print version, click here

1.  Letter from Kate Kelly to the Senate Judiciary Committee, A Response to David “Doc” Moore, March 24, 2013 (“If these terrible deaths happen when aid in dying (assisted suicide and euthanasia) is not legal, what will happen if these practices are made legal? Doctors will have even more power to take away patient choice”).  Letter available at http://www.choiceillusionmontana.org/2013/03/a-response-to-representative-moore.html

2.  Letter from Mike Moe to the Senate Judiciary Committee, March 23, 2013 (“Please vote for  HB 505 to prevent doctors and nurses from having more power to cause patient deaths. They abuse the power they already have. Please consider my mother’s story . . .”).  Letter available at http://www.choiceillusionmontana.org/2013/03/vote-for-hb-505-to-stop-bad-situation.html

3.  Letter from Carol Mungas to the Great Falls Tribune, March 14, 2013 (“As illustrated by my husband’s case, doctors and nurses already abuse the power they have.  The stakes are too high to consider expanding their power by legalizing assisted-suicide”).  Letter available at http://www.choiceillusionmontana.org/2013/03/i-support-house-bill-505-which-clearly.html

4.  Letter from Gail Bell to the Ravalli Republic, March 5, 2013 (“Because of my mother’s experiences, I no longer believe in “physician-assisted suicide.  Support House Bill 505").  Letter available at http://www.choiceillusionmontana.org/2013/03/because-of-my-mothers-experiences-i-no_8.html

"Once in place, this 'trend' is not controllable"

Dear Senators:

For those of you who don't know me, I am an attorney in Washington state where physician-assisted suicide is legal. I am writing to urge you to not make Washington's mistake by allowing assisted suicide/euthanasia to become part of your state's legal fabric.  Once in place, this "trend" is not controllable.  I urge you to vote "Yes" on HB 505 to clearly state that assisted suicide is not legal in Montana.

Physician-Assisted Suicide Part of Elder Abuse Fraud

On March 26, 2013, Philip Tummarello, a retired police Sergeant Inspector, testified before the Montana Senate Judiciary Committee on on behalf of HB 505.  His testimony included the Thomas Middleton case in which physician-assisted suicide had facilitated the defrauding of an elderly man.  An article from KTVZ.com states: 

"State and court documents show Middleton, who suffered from Lou Gehrig's disease, moved into Sawyer's home in July 2008, months after naming her trustee of his estate, The Bulletin reported Saturday.  Middleton deeded his home to the trust and directed her to make it a rental until the real estate market improved.

Instead, Sawyer signed documents that month to list the property for sale, two days after Middleton died by physician-assisted suicide.  The property sold in October of that year for more than $200,000, the documents show, and it was deposited into an account for one of Sawyer's businesses, Starboard LLC, and $90,000 of that was transferred to two other Sawyer companies, Genesis Futures and Tami Sawyer PC."  (Emphasis added).

To read the entire article, go here: http://www.ktvz.com/news/Sawyer-Arraigned-on-State-Fraud-Charges/-/413192/619440/-/view/print/-/1w9ly3z/-/index.html

 

Oregon's New Report Consistent with Elder Abuse

By Margaret Dore, Esq.

Oregon's assisted suicide statistics are out for 2012.[1]

This annual report is similar to prior years.  The preamble implies that the deaths were voluntary (self-administered), but the information reported does not address that subject.[2]

Oregon's assisted suicide law allows the lethal dose to be administered without oversight.[3]  This creates the opportunity 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, for example, when the patient is asleep.  Who would know?

The new Oregon report provides the following demographics:  

"Of the 77 DWDA deaths during 2012, most (67.5%) were aged 65 years or older; the median age was 69 years.  As in previous years, most were white (97.4%), [and] well-educated (42.9% had at least a baccalaureate degree) . . . ."[4]  Most (51.4%) had private health insurance.[5]

Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately victims of financial abuse and exploitation.[6]

As set forth above, Oregon's law is written so as to allow the lethal dose to be administered to patients without their consent and without anyone knowing how they died.  The law thus provides the opportunity for the perfect crime.  Per the new report, the persons dying (or killed) under that law are  disproportionately seniors with money, a group disproportionately victimized by financial abuse and exploitation.

Oregon's new report is consistent with elder abuse.

Footnotes:

[1]  The new report can be viewed here: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year15.pdf and http://choiceisanillusion.files.wordpress.com/2013/01/year-15-2012.pdf
[2]  Id.
[3]  Oregon's law can be viewed here:  http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx
[4]  Report cited at note 1.
[5]  Id.
[6]  See "Broken Trust:  Elders, Family, and Finances," a Study on Elder Financial Abuse Prevention, by the MetLife Mature Market Institute, the National Committee for the Prevention of Elder Abuse, and the Center for Gerontology at Virginia Polytechnic Institute, March 2009.

"Because of my mother's experiences, I no longer believe in "physician-assisted suicide." Support House Bill 505."

Family member's 'accidental' death provides example for opposition to assisted suicide

http://www.ravallirepublic.com/news/opinion/mailbag/article_2051b845-5a8d-5cdc-be0e-0b7bfbb5e2bf.html?comment_form=true 

This letter is being written for a right to live.  We taxpayers paid a phenomenal amount of money when others decided it was time for my mother to die.  She would not die!  Three times she defied attempts on her life, costing her bed sores, hospice and her daughter being arrested while helping her (the latter arrest record was dismissed).

Mom succumbed in the hospital on Sept. 6, 2010.  The coroner's report case No. 100906 lists congestive heart failure with oxygen deprivation and fentanyl therapy.  The manner of death: accident.

Fentanyl is reported "to be 80 to 200 times as potent as morphine."  A fentanyl patch of 100 mcg/hour has a range within 24 hours of 1.9-3.8ng/mL. Mom's death result was 2.7 ng/mL on or about 48 hours.

Complaint No. 2012-069-MED was filed with the Montana Department of Labor and Industry Board of Medical Examiners. The screening panel voted to dismiss the complaint with prejudice, which means the board may not consider the complaint in the future.

Because of my mother's experiences, I no longer believe in "physician-assisted suicide."  Support House Bill 505.

Gail Bell,
Bozeman

Tell your legislators to VOTE NO on SB 220!

By Margaret Dore, Esq.

SB 220 seeks to legalize Oregon-style assisted suicide in Montana.  

To read a legal analysis of SB 220, click here.  To read the attachments to that analysis, click here.

The introduction to the analysis states:

This memo discusses why the claim that SB 220 will assure patient control is untrue. SB 220 is instead a recipe for elder abuse. The bill puts the elderly in the crosshairs of their heirs and abusive family members.

SB 220 also eliminates safeguards such as waiting periods that supposedly render the Oregon and Washington laws safe.  Doctor reporting is also eliminated.

The former Hemlock Society, Compassion & Choices, claims that this is because Oregon’s reporting system has "demonstrated the safety of the practice."  To the contrary, Oregon’s reports support that the claimed safety is speculative. The reported statistics are also consistent with elder abuse. No wonder Compassion & Choices wants the reporting system gone.

To contact your legislators, go here:  http://leg.mt.gov/css/About-the-Legislature/Lawmaking-Process/contact-legislators.asp

Quick Facts About Assisted Suicide

By Margaret Dore, Esq.*

For a new print version, suitable for a handout, click here.

1.  Assisted Suicide

Assisted suicide means that someone provides the means and/or information for another person to commit suicide.  When a physician is involved, the practice is physician-assisted suicide.[1]

2. The Oregon and Washington Laws

In Oregon, physician-assisted suicide was legalized in 1997 via a ballot measure.[2]  In Washington State, a similar law was passed via another ballot measure in 2008 and went into effect in 2009.[3]  No such law has made it through the scrutiny of a legislature despite more than 100 attempts.[4]

3.  Patients are Not Necessarily Dying

The Oregon and Washington laws are restricted to patients predicted to have less than six months to live.[5]  Such persons are not necessarily dying.  Doctors can be wrong.[6]  Moreover, treatment can lead to recovery.  Consider Jeanette Hall, who was diagnosed with cancer and given six months to a year to live.[7]  She was adamant that she would "do" Oregon’s law, but her doctor, Ken Stevens, convinced her to be treated instead.[8] She is still alive 12 years later.[9]

4.  A Recipe for Elder Abuse

The Washington and Oregon laws are a recipe for elder abuse. The most obvious reason is due to a lack of oversight when the lethal dose is administered.[10] For example, there are no witnesses required at the death; the death is allowed occur in private.[11] With this situation, the opportunity is created for an heir, or some other person 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?

5. Empowering the Healthcare System

In Oregon, patients desiring treatment under the Oregon Health Plan have been offered assisted suicide instead. 

The most well known cases involve Barbara Wagner and Randy Stroup.[12] Each wanted treatment.[13] The Plan denied their requests and steered them to suicide by offering to pay for their suicides.[14] Neither Wagner nor Stroup saw this scenario as a celebration of their "choice." Wagner said: "I'm not ready to die."[15] Stroup said: "This is my life they’re playing with."[16]

Wagner and Stroup were steered to suicide. Moreover, it was the Oregon Health Plan, a government entity, doing the steering.[17]

6. Suicide Contagion

Oregon's suicide rate, which excludes suicides under its physician-assisted suicide law, has been "increasing significantly" since 2000.[18] 

Just three years prior, Oregon legalized physician-assisted suicide. This increased suicide rate is consistent with a suicide contagion. In other words, legalizing one type of suicide encouraged other suicides.  Montana already has one of the highest suicide rates in the nation.[19]

7.  A "Wedge" Issue

In Washington State, where assisted suicide was legalized four years ago, there is already a discussion to expand its law to direct euthanasia for non-terminal people.[20]  Indeed, last March, there was a Seattle Times newspaper column describing reader suggestions for euthanasia for people unable to afford care, which would be involuntary euthanasia.[21]

* Margaret Dore is an attorney in Washington State where assisted suicide is legal.  She is also President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide.  For more information, see www.margaretdore.com and www.choiceillusion.org 

[1]  Compare: American Medical Association, Code of Medical Ethics, Opinion 2.211, available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2211.page
[2]  The Oregon and Washington laws are similar.  For a short article about Washington’s law, see Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, available at https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm
[3]  Id.
[4]  http://epcdocuments.files.wordpress.com/2011/10/attempts_to_legalize_001.pdf
[5]  See ORS 127.800 s.1.01(12) and RCW 70.245.010(13).
[6]  See e.g., Nina Shapiro, "Terminal Uncertainty: Washington’s new "Death With Dignity" law allows doctors to help people commit suicide—once they’ve determined that the patient has only six months to live. But what if they’re wrong?," 01/14/09, available at http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty 
[7]  See Jeanette Hall, Letter to the editor, "She pushed for legal right to die, and - thankfully - was rebuffed, Boston Globe, October 4, 2011 ("I am so happy to be alive!), available at http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/she_pushed_for_legal_right_to_die_and___thankfully___was_rebuffed/ Kenneth Stevens MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, Sept. 2010, (scroll down to last letter at www.margaretdore.com/info/Stevens.pdf ).
[8]  Id.
[9]  Per her telephone call today.
[10]  The Oregon and Washington Acts can be viewed in their entirety here and here.
[11]  Id.
[12]  See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008, at http://abcnews.go.com/Health/story?id=5517492&page=1; "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008, at http://www.katu.com/news/specialreports/26119539.html ; and Ken Stevens, MD, Letter to Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, September 2011, to view, scroll down to bottom of second page here: http://www.margaretdore.com/info/September_Letters.pdf
[13] Id.
[14] Id.
[15] KATU TV at note 12
[16] ABC News at note 12
[17]  See also Affidavit of Ken Stevens MD (Leblanc v. Canada), with attachments, available at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf 
[18]  See "Suicides in Oregon: Trends and Risk Factors," Oregon Department of Human Services, Public Health Division, September 2010, page 6, ("Deaths relating to the death with Dignity Act (physician-assisted suicides) are not classified as suicides by Oregon law and therefore excluded from this report"), available at http://epcdocuments.files.wordpress.com/2011/10/or_suicide_report_001.pdf
See also Oregon Health Authority, News Release, "Rising suicide rate in Oregon reaches higher than national average," September 9, 2010, ("suicide rates have been increasing significantly since 2000") available at http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf
[19]  Cindy Uken, "State of Dispair: High-Country Crisis, Montana’s suicide rate leads the nation," Billings Gazetter, November 25, 2012, http://billingsgazette.com/news/state-and-regional/montana/montana-s-suicide-rate-leads-the-nation/article_b7b6f110-3e5c-5425-b7f6-792cc666008d.html?print=true&cid=print
[20]  See Brian Faller, "Perhaps it's time to expand Washington's Death with Dignity Act, The Olympian, November 16, 2011, available at http://www.theolympian.com/2011/11/16/1878667/perhaps-its-time-to-expand-washingtons.html
[21]  See Jerry Large, "Planning for old age at a premium," The Seattle Times, March 8, 2012 at http://seattletimes.nwsource.com/text/2017693023.html ("After Monday's column,  . . . a few [readers] suggested that if you couldn't save enough money to see you through your old age, you shouldn't expect society to bail you out. At least a couple mentioned euthanasia as a solution.")  (Emphasis added).

Physician-assisted suicide: Permission is recipe for abuse

January 30, 2013 8:30 am

In the 2011 legislative session, Sen. Anders Blewett and I introduced competing bills in response to the Montana Supreme Court’s assisted-suicide case, Baxter v. State. The case did not legalize assisted-suicide. Its language was, however, a “toe in the door,” which could lead to legalization in the future.

Neither bill passed. His bill had sought to legalize assisted-suicide; mine had sought to reverse Baxter. This legislative session, there will likely be a similar contest.

The vast majority of states to consider assisted suicide have rejected it. In the past two years, three states have strengthened their laws against assisted suicide: Georgia, Louisiana and Idaho. Only two states allow it, Oregon and Washington. Their laws were enacted by initiative campaigns.

No such law has made it through the scrutiny of a legislature despite more than 100 attempts.

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. I urge you to tell your legislators that you support legislation to close on the door on assisted suicide in Montana.

To learn more, see this website: www.choiceillusionmontana.org

Greg Hinkle, Thompson Falls

Physician-assisted suicide runs risk of invisible coercion

http://mtstandard.com/news/opinion/mailbag/physician-assisted-suicide-runs-risk-of-invisible-coercion/article_121a9ba4-681a-11e2-b046-0019bb2963f4.html?print=true&cid=print

Ben Mattlin writes in The New York Times on Oct. 31, 2012, that he counts himself as a pro-choice liberal who ought to support physician-assisted suicide, but as a lifelong disabled person, he cannot.

Physician-assisted suicide is a person swallowing a lethal drug prescribed by a doctor. With plenty of room for abuse, Mattlin says, it’s a bad idea.

In Montana, the issue of physician-assisted suicide has been kicked around in the Legislature and in the courts, including the Montana Supreme Court, resulting in a mixed message that needs clarity. This Legislature will try again.

Here’s Mattlin: “My problem, ultimately, is this: I’ve lived so close to death for so long that I know how thin and porous the border between coercion and free choice is, how easy it is for someone to inadvertently influence you to feel devalued and hopeless — to pressure you ever so slightly but decidedly into being ‘reasonable’ to unburdening others, to ‘letting go.’”

He goes on to say that, while the push for physician-assisted suicide comes from many who have seen a loved one suffer, supporters of it can’t truly conceive of the many “subtle forces — invariably well-meaning, kindhearted, even gentle, yet as persuasive as a tsunami — that emerge when your physical autonomy is hopelessly compromised.”

Mattlin was born with spinal muscular atrophy. He has never walked, stood, or had much use of his hands. Half of babies with this condition die within two years. Today, Mattlin, almost 50, is a husband, father, journalist and author.

When a hospital blunder compromised his heath further, doctors questioned whether his life was worth saving. Mattlin writes, “They didn’t know about my family, my career, my aspirations.” His wife rescued him.

From this he learned how easy it is to be perceived as someone whose quality of life is untenable and how this becomes one of many invisible forces of coercion. Others include, “that certain look of exhaustion in a loved one’s eyes, or the way nurses or friends sigh in your presence while you are zoned out in a hospital bed.”

Mattlin writes that this can cast a dangerous cloud of depression upon even the most cheery of optimists. He says, “advocates of Death with Dignity laws who say that patients themselves should decide whether to live or die are fantasizing. We are inexorably affected by our immediate environment. The deck is stacked.”

Cort Freeman
2950 Bayard St.
Butte

Assisted suicide would exacerbate problem of elder abuse in Montana

http://missoulian.com/news/opinion/mailbag/assisted-suicide-would-exacerbate-problem-of-elder-abuse-in-mt/article_bffd5bbc-68d3-11e2-ae9f-0019bb2963f4.html?print=true&cid=print

For over 20 years, I have been an internal medicine physician with a high percentage of older patients. I have had the painful misfortune of personally observing countless instances of elder abuse.

Elder abuse is horrific and on the rise. Perpetrators of the abuse include hired caregivers, neighbors and family members. In my experience, the motive is usually financial gain. This was true in the case of one of my patients, where a much younger man obtained financial control (became payee for Social Security and retirement benefits) by taking advantage of an elderly woman’s loneliness and dementia. He feigned romantic interest in her, flattering her to the point that she took his side against her family members. She became isolated and totally dependent on him. After many months, Adult Protective Services was able to provide a guardian. This same motive of greed could lead to coerced assisted suicide if there was anticipated financial gain, and death could occur quickly if assisted suicide was legal – before protection could be put in place.

In Oregon and Washington, where assisted suicide is legal, portions of those states’ statutes lend themselves to elder abuse, such as the fact that no witness is required at the time of death. An elderly patient of mine recently died peacefully and of natural causes in his home, surrounded by family. His daughter was devastated when a family member visiting from Oregon asked if they had given him pills to end his life, as they would have done in her state.

Elder abuse is already a huge problem in Montana. I hope Montana’s legislators will have the courage to stop legalization of assisted suicide here and thereby protect the elderly and disabled.

For more information, including a summary of this important issue, see www.montanansagainstassistedsuicide.org.

Annie Bukacek,
Kalispell

Updated Quick Facts About Assisted Suicide

By Margaret Dore, Esq.*

For a new print version, suitable for a handout, click here.

1.  Assisted Suicide

Assisted suicide means that someone provides the means and/or information for another person to commit suicide.  When a physician is involved, the practice is physician-assisted suicide.[1]

2. The Oregon and Washington Laws

In Oregon, physician-assisted suicide was legalized in 1997 via a ballot measure.[2]  In Washington State, a similar law was passed via another ballot measure in 2008 and went into effect in 2009.[3]  No such law has made it through the scrutiny of a legislature despite more than 100 attempts.[4]

3.  Patients are Not Necessarily Dying

The Oregon and Washington laws are restricted to patients predicted to have less than six months to live.[5]  Such persons are not necessarily dying.  Doctors can be wrong.[6]  Moreover, treatment can lead to recovery.  Consider Jeanette Hall, who was diagnosed with cancer and given six months to a year to live.[7]  She was adamant that she would "do" Oregon’s law, but her doctor, Ken Stevens, convinced her to be treated instead.[8] She is still alive 12 years later.[9]

4.  A Recipe for Elder Abuse

The Washington and Oregon laws are a recipe for elder abuse. The most obvious reason is due to a lack of oversight when the lethal dose is administered.[10] For example, there are no witnesses required at the death; the death is allowed occur in private.[11] With this situation, the opportunity is created for an heir, or some other person 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?

5. Empowering the Healthcare System

In Oregon, patients desiring treatment under the Oregon Health Plan have been offered assisted suicide instead. 

The most well known cases involve Barbara Wagner and Randy Stroup.[12] Each wanted treatment.[13] The Plan denied their requests and steered them to suicide by offering to pay for their suicides.[14] Neither Wagner nor Stroup saw this scenario as a celebration of their "choice." Wagner said: "I'm not ready to die."[15] Stroup said: "This is my life they’re playing with."[16]

Wagner and Stroup were steered to suicide. Moreover, it was the Oregon Health Plan, a government entity, doing the steering.[17]

6. Suicide Contagion

Oregon's suicide rate, which excludes suicides under its physician-assisted suicide law, has been "increasing significantly" since 2000.[18] 

Just three years prior, Oregon legalized physician-assisted suicide. This increased suicide rate is consistent with a suicide contagion. In other words, legalizing one type of suicide encouraged other suicides.  Montana already has one of the highest suicide rates in the nation.[19]

7.  A "Wedge" Issue

In Washington State, where assisted suicide was legalized four years ago, there is already a discussion to expand its law to direct euthanasia for non-terminal people.[20]  Indeed, last March, there was a column describing reader suggestions for euthanasia for people unable to afford care, which would be on an involuntary basis for people who want to live.[21]

* Margaret Dore is an attorney in Washington State where assisted suicide is legal.  She is also President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide.  For more information, see www.margaretdore.com and www.choiceillusion.org 

[1]  Compare: American Medical Association, Code of Medical Ethics, Opinion 2.211, available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2211.page
[2]  The Oregon and Washington laws are similar.  For a short article about Washington’s law, see Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, available at https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm
[3]  Id.
[4]  http://epcdocuments.files.wordpress.com/2011/10/attempts_to_legalize_001.pdf
[5]  See ORS 127.800 s.1.01(12) and RCW 70.245.010(13).
[6]  See e.g., Nina Shapiro, "Terminal Uncertainty: Washington’s new "Death With Dignity" law allows doctors to help people commit suicide—once they’ve determined that the patient has only six months to live. But what if they’re wrong?," 01/14/09, available at http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty 
[7]  See Jeanette Hall, Letter to the editor, "She pushed for legal right to die, and - thankfully - was rebuffed, Boston Globe, October 4, 2011 ("I am so happy to be alive!), available at http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/she_pushed_for_legal_right_to_die_and___thankfully___was_rebuffed/ Kenneth Stevens MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, Sept. 2010, (scroll down to last letter at www.margaretdore.com/info/Stevens.pdf ).
[8]  Id.
[9]  Per her telephone call today.
[10]  The Oregon and Washington Acts can be viewed in their entirety here and here.
[11]  Id.
[12]  See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008, at http://abcnews.go.com/Health/story?id=5517492&page=1; "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008, at http://www.katu.com/news/specialreports/26119539.html ; and Ken Stevens, MD, Letter to Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, September 2011, to view, scroll down to bottom of second page here: http://www.margaretdore.com/info/September_Letters.pdf
[13] Id.
[14] Id.
[15] KATU TV at note 12
[16] ABC News at note 12
[17]  See also Affidavit of Ken Stevens MD (Leblanc v. Canada), with attachments, available at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf 
[18]  See "Suicides in Oregon: Trends and Risk Factors," Oregon Department of Human Services, Public Health Division, September 2010, page 6, ("Deaths relating to the death with Dignity Act (physician-assisted suicides) are not classified as suicides by Oregon law and therefore excluded from this report"), available at http://epcdocuments.files.wordpress.com/2011/10/or_suicide_report_001.pdf
See also Oregon Health Authority, News Release, "Rising suicide rate in Oregon reaches higher than national average," September 9, 2010, ("suicide rates have been increasing significantly since 2000") available at http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf[19]  Cindy Uken, "State of Dispair: High-Country Crisis, Montana’s suicide rate leads the nation," Billings Gazetter, November 25, 2012, http://billingsgazette.com/news/state-and-regional/montana/montana-s-suicide-rate-leads-the-nation/article_b7b6f110-3e5c-5425-b7f6-792cc666008d.html?print=true&cid=print
[20]  See Brian Faller, "Perhaps it's time to expand Washington's Death with Dignity Act, The Olympian, November 16, 2011, available at http://www.theolympian.com/2011/11/16/1878667/perhaps-its-time-to-expand-washingtons.html
[21]  See Jerry Large, "Planning for old age at a premium," The Seattle Times, March 8, 2012 at http://seattletimes.nwsource.com/text/2017693023.html ("After Monday's column, some readers were unsympathetic, 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.")

Assisted Suicide is a Bipartisan Issue

Dear Editor:

I am a former three-term State Representative in New Hampshire who has been following the assisted suicide issue  throughout the United States.  The sentiment expressed by the recent AP article on this issue in Montana is correct, that it can lead to “cross aisle allegiances.” [01/06/13]

In New Hampshire, a bill to legalize assisted suicide was defeated in 2011 in the New Hampshire House, 234 to 99.  A similar bill was defeated in the House in 2010.  The vote was 242 to 113.

These were bi-partisan votes.  In 2010, the House was controlled by the Democrats. In 2011, the House was controlled by the Republicans.  In both years, assisted suicide was defeated by a 2 to 1 margin.

Assisted suicide laws empower heirs and others to pressure and abuse older people to cut short their lives.  This is especially an issue when the older person has money.  There is NO assisted suicide law that you can write to correct this huge problem.

Do not be deceived.

Nancy Elliott

Merrimack, New Hampshire

Quick Facts About Assisted Suicide

By Margaret Dore, Esq.*

For a print version, click here.

1.  Assisted Suicide

Assisted suicide means that someone provides the means and/or information for another person to commit suicide.  When a physician is involved, the practice is physician-assisted suicide.[1]

2. The Oregon and Washington Laws

In Oregon, physician-assisted suicide was legalized in 1997 via a ballot measure.[2]  In Washington State, a similar law was passed via another ballot measure in 2008 and went into effect in 2009.[3]  No such law has made it through the scrutiny of a legislature despite more than 100 attempts.[4]

3.  Patients are Not Necessarily Dying

The Oregon and Washington laws are restricted to patients predicted to have less than six months to live.[5]  Such persons are not necessarily dying.  Doctors can be wrong.[6]  Moreover, treatment can lead to recovery.  Consider Jeanette Hall, who was diagnosed with cancer and given six months to a year to live.[7]  She was adamant that she would "do" Oregon’s law, but her doctor, Ken Stevens, convinced her to be treated instead.[8] She is still alive 12 years later.[9]

4.  A Recipe for Elder Abuse

The Washington and Oregon laws are a recipe for elder abuse. The most obvious reason is due to a lack of oversight when the lethal dose is administered.[10] For example, there are no witnesses required at the death; the death is allowed occur in private.[11] With this situation, the opportunity is created for an heir, or some other person 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?

5. Empowering the Healthcare System

In Oregon, patients desiring treatment under the Oregon Health Plan have been offered assisted suicide instead. 

The most well known cases involve Barbara Wagner and Randy Stroup.[12] Each wanted treatment.[13] The Plan denied their requests and steered them to suicide by offering to pay for their suicides.[14] Neither Wagner nor Stroup saw this scenario as a celebration of their "choice." Wagner said: "I'm not ready to die."[15] Stroup said: "This is my life they’re playing with."[16]

Wagner and Stroup were steered to suicide. Moreover, it was the Oregon Health Plan, a government entity, doing the steering.[17]

6. Suicide Contagion

Oregon's suicide rate, which excludes suicides under its physician-assisted suicide law, has been "increasing significantly" since 2000.[18] 

Just three years prior, Oregon legalized physician-assisted suicide. This increased suicide rate is consistent with a suicide contagion. In other words, legalizing one type of suicide encouraged other suicides.  Montana already has one of the highest suicide rates in the nation.[19]

7.  A "Wedge" Issue

In Washington State, where assisted suicide was legalized four years ago, there is already a discussion to expand its law to direct euthanasia for non-terminal people.[20]  Indeed, last March, there was a column describing reader suggestions for euthanasia for people unable to afford care, which would be on an involuntary basis for people who want to live.[21]

* Margaret Dore is an attorney in Washington State where assisted suicide is legal.  She is also President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide.  For more information, see www.margaretdore.com and www.choiceillusion.org 

[1]  Compare: American Medical Association, Code of Medical Ethics, Opinion 2.211, available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2211.page
[2]  The Oregon and Washington laws are similar.  For a short article about Washington’s law, see Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009, available at https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm
[3]  Id.
[4]  http://epcdocuments.files.wordpress.com/2011/10/attempts_to_legalize_001.pdf
[5]  See ORS 127.800 s.1.01(12) and RCW 70.245.010(13).
[6]  See e.g., Nina Shapiro, "Terminal Uncertainty: Washington’s new "Death With Dignity" law allows doctors to help people commit suicide—once they’ve determined that the patient has only six months to live. But what if they’re wrong?," 01/14/09, available at http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty 
[7]  See Jeanette Hall, Letter to the editor, "She pushed for legal right to die, and - thankfully - was rebuffed, Boston Globe, October 4, 2011 ("I am so happy to be alive!), available at http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/she_pushed_for_legal_right_to_die_and___thankfully___was_rebuffed/ Kenneth Stevens MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, Sept. 2010, (scroll down to last letter at www.margaretdore.com/info/Stevens.pdf ).
[8]  Id.
[9]  Per her telephone call today.
[10]  The Oregon and Washington Acts can be viewed in their entirety here and here.
[11]  Id.
[12]  See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008, at http://abcnews.go.com/Health/story?id=5517492&page=1; "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008, at http://www.katu.com/news/specialreports/26119539.html ; and Ken Stevens, MD, Letter to Editor, "Oregon mistake costs lives," The Advocate, the official publication of the Idaho State Bar, September 2011, to view, scroll down to bottom of second page here: http://www.margaretdore.com/info/September_Letters.pdf
[13] Id.
[14] Id.
[15] KATU TV at note 12
[16] ABC News at note 12
[17]  See also Affidavit of Ken Stevens MD (Leblanc v. Canada), with attachments, available at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf 
[18]  See "Suicides in Oregon: Trends and Risk Factors," Oregon Department of Human Services, Public Health Division, September 2010, page 6, ("Deaths relating to the death with Dignity Act (physician-assisted suicides) are not classified as suicides by Oregon law and therefore excluded from this report"), available at http://epcdocuments.files.wordpress.com/2011/10/or_suicide_report_001.pdf
See also Oregon Health Authority, News Release, "Rising suicide rate in Oregon reaches higher than national average," September 9, 2010, ("suicide rates have been increasing significantly since 2000") available at http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf[19]  Cindy Uken, "State of Dispair: High-Country Crisis, Montana’s suicide rate leads the nation," Billings Gazetter, November 25, 2012, http://billingsgazette.com/news/state-and-regional/montana/montana-s-suicide-rate-leads-the-nation/article_b7b6f110-3e5c-5425-b7f6-792cc666008d.html?print=true&cid=print
[20]  See Brian Faller, "Perhaps it's time to expand Washington's Death with Dignity Act, The Olympian, November 16, 2011, available at http://www.theolympian.com/2011/11/16/1878667/perhaps-its-time-to-expand-washingtons.html
[21]  See Jerry Large, "Planning for old age at a premium," The Seattle Times, March 8, 2012 at http://seattletimes.nwsource.com/text/2017693023.html ("After Monday's column, some readers were unsympathetic, 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.")

"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.

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.