Hall Declaration: " If Dr. Stevens had believed in assisted suicide, I would be dead"

I, JEANETTE HALL, declare as follows:

1.  I live in Oregon where assisted suicide is legal. Our law was enacted in 1997 via a ballot measure that I voted for.

2.  In 2000, I was diagnosed with cancer and told that I had 6 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 tried to ask my doctor, Kenneth Stevens, but he didn’t really answer me. In hindsight, he was stalling me.

3.  I did not want to suffer. I wanted to do our law and I wanted Dr. Stevens to help 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!

4.  It has now been 17 years since my diagnosis. If Dr. Stevens had believed in assisted suicide, I would be dead. Assisted suicide should not be legal.

_/s/__________
Jeanette Hall

Oregon doctor's experience leads him to warn Montanans not to accept assisted suicide

http://ravallirepublic.com/news/opinion/mailbag/article_df457041-2d8f-5c56-92c8-05d08616234d.html

Dear Editor:

I am the doctor cited in the opinion piece, “Assisted suicide is not legal, not the answer.” (Aug. 21). I am also professor emeritus and former chair of the Department of Radiation Oncology at Oregon Health & Science University. I have treated thousands of patients with cancer.

The opinion piece correctly describes how Oregon’s Medicaid program uses coverage incentives to steer people to assisted suicide, which is legal in Oregon: Medicaid will not necessarily cover a patient’s treatment to potentially cure a disease or to extend the patient’s life. The program will cover his or her suicide. Desired treatments for cure or to extend life are thereby displaced with the “treatment” of suicide.

I first became involved with the assisted suicide issue shortly before my first wife died of cancer in 1982. We had just made what would be her last visit with her doctor. As we were leaving, he had suggested that she overdose herself on medication. I still remember the look of horror on her face. She said, “Ken, he wants me to kill myself.”

To learn more about how assisted suicide works in Oregon, please see my affidavit, with supporting documentation attached, can be viewed here:  https://maasdocuments.files.wordpress.com/2014/08/dr-stevens-affidavit_001.pdf .

Protect your health care. Don’t let legal assisted suicide come to Montana.

Kenneth Stevens,
Sherwood, Oregon

Protect your health care; keep assisted suicide out of Montana

http://missoulian.com/news/opinion/mailbag/protect-your-health-care-keep-assisted-suicide-out-of-montana/article_80004bcc-ae06-11e3-99f7-001a4bcf887a.html

I am a doctor in Oregon, where physician assisted suicide is legal. I have been following the ongoing attempt to legalize assisted suicide in Montana.

I was first exposed to this issue in 1982 shortly before my first wife died of cancer. We had just visited her doctor. As we were leaving, he had suggested that she overdose herself on medication. I still remember the look of horror on her face. She said “Ken, he wants me to kill myself.“

In Oregon, the combination of assisted-suicide legalization and prioritized medical care based on prognosis has created a danger for my patients on the Oregon Health Plan (Medicaid). Helpful treatments are often not covered. The plan will cover the patient’s suicide. For more detail, please read my affidavit filed on behalf of the Canadian government at http://maasdocuments.files.wordpress.com/2012/09/signed-stevens-aff-9-18-12.pdf 

Our assisted suicide law was passed in 1997. In 2000, one of my patients was adamant she would use our law. I stalled her and ultimately convinced her to be treated instead. Nearly 14 years later she is thrilled to be alive.

Protect your health care, yourselves and your families. I urge you to tell your elected officials to keep assisted suicide out of Montana.

Kenneth Stevens,
Sherwood, Ore.

Oregon resident would not be alive today if she had used physician-assisted suicide

http://www.ravallirepublic.com/news/opinion/mailbag/article_5e415659-29c8-5891-9ea1-bb63834c6435.html

This letter responds to the (April 7) guest column by Dr. Eric Kress promoting assisted suicide. If Kress had been my doctor in 2000, I would be dead.

I live in Oregon, where physician-assisted suicide is legal. 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 tried to ask my doctor, but he didn’t really answer me.

I did not want to suffer. I wanted to do our law and I wanted my doctor to help me. Instead, he encouraged me to not give up and ultimately I decided to fight. I had both chemotherapy and radiation. It is now 12 years later. I am so happy to be alive!

Last month, doctors in Montana contacted me to let them use my story to promote House Bill 505, which is a bill to prevent assisted suicide in Montana. This is a link to their recent press release: www.montanansagainstassistedsuicide.org/2013/03/112-montana-physicians-who-support-hb.html.

Vote “yes” on HB505.

Don’t make Oregon’s mistake.

Jeanette Hall,
King City, Ore.

Legal Assisted Suicide Puts the Government in Your Life

With the legalization of physician-assisted suicide, the Oregon State Government received a new right, which it exercises:   The right to steer citizens to suicide with treatment and/or financial incentives.  Oregon doctor, Ken Stevens, describes this right in detail below.*

In Montana, where physician-assisted suicide is not legal, the government does not have that right.  The law in Montana is, however, in a confused state, which has opened the door to possible legalization.

To prevent that from happening, tell your legislators to vote "Yes" on HB 505! 
_____ 

*  Dr. Stevens states:

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.

Oregon Lawyer: "Without transparency, our law is not safe."

Dear Montana Representative:

 I understand that HB 505 will strengthen Montana law against assisting suicide, including physician-assisted suicide.  For that reason I write in support of that bill.

I am a lawyer in Oregon who specializes in injury claims, including wrongful death cases. I write to inform you that our law lacks transparency and that even law enforcement is denied access to information collected by the state. Moreover, this is official state policy.

In 2010, I was retained by a client whose father had died under our assisted-suicide act. Unlike other deaths I have investigated, it was difficult to get basic information.

Oregon doctor could not save patient from assisted suicide

http://mtstandard.com/news/opinion/mailbag/oregon-doctor-could-not-save-patient-from-assisted-suicide/article_a4b605ba-6767-11e2-bf94-0019bb2963f4.html

 

I am a doctor in Oregon, where assisted suicide is legal. A few years ago, I was caring for a 76-year-old man who presented to my office a sore on his arm, eventually diagnosed as melanoma. I referred him to specialists for evaluation and therapy.

I had known this patient and his wife for more than a decade. He was an avid hiker, a popular hobby here in Oregon. As his disease progressed, he was less able to do this activity, becoming depressed, which was documented in his chart.

During this time, my patient expressed a wish for assisted suicide to one of the specialists. Rather than take the time to address his depression, or ask me as his primary care physician to talk with him, she called me and asked me to be the “second opinion” for his suicide. She told me that barbiturate overdoses “work very well” for patients like this, and that she had done this many times before.

I told her that assisted suicide was not appropriate for this patient and that I did not concur. I was very concerned about my patient’s mental state, and told her that addressing his underlying issues would be better than simply giving him a lethal prescription. Unfortunately, my concerns were ignored, and two weeks later my depressed patient was dead from an overdose prescribed by this doctor.

Under Oregon’s law, I was not able to protect my depressed patient. If assisted suicide becomes legal in Montana, you may not be able to protect your friends or family members.

I urge you to contact your legislators to tell them to keep assisted suicide out of Montana. Don’t make Oregon’s mistake.

Dr. Charles J. Bentz
Portland, Ore.

Assisted Suicide: Stress, Trauma and Fear

By Margaret Dore, Esq.

In 2012, a study was released in Switzerland, addressing trauma suffered by persons who witnessed an assisted suicide.[1]  The study found that 1 out of 5 family members or friends present at an assisted suicide were traumatized.[2]  These persons "experienced full or sub-threshold PTSD [Post Traumatic Stress Disorder] related to the loss of a close person through assisted suicide."[3]

Consider also the letter below by nurse Marlene Deakins, and her brother, Ron Olfert, now deceased from Sanders County.  Their letter describes the "unnecessary stress" and "fear" of their brother, Wes Olfert, after he asked a question about assisted suicide in Washington State.  Their letter states:

"Our brother, Wes Olfert, . . . died in Washington State where assisted suicide is legal. When he was first admitted to the hospital, he made the mistake of asking for information about assisted suicide.  We say a mistake, because this set off a chain of events that interfered with his care and caused him unnecessary stress in what turned out to be the last months of his life.

By asking the question, he was given a 'palliative care' consult by a doctor who heavily and continually pressured him to give up on treatment before he was ready to do so. It got so bad that Wes actually became fearful of this doctor and asked us and a friend to not leave him alone with her."[4]

Kathryn Judson, in Oregon, similarly, became afraid for her husband. This was after his doctor gave him an unsolicited pitch for suicide. She states:

"We got a different doctor, and David lived another five years or so. But after that nightmare in the first doctor's office, and encounters with a 'death with dignity' inclined nurse, I was afraid to leave my husband alone again with doctors and nurses, for fear they'd morph from care providers to enemies, with no one around to stop them."[5]

Footnotes: 

[1]  "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 
[2]  Id.
[3]  Id.
[4]  Ron Olfert and Marlene Deakins RN, Letter to the Board of Medical Examiners, "He made the mistake of asking for information about assisted suicide," June 29, 2012, available at http://www.montanansagainstassistedsuicide.org/2012/06/dear-board-of-medical-examiners-we-are.html  (Accuracy confirmed by Margaret Dore, the writer of this post, who spoke with both Ron Olfert and Marlene Deakins).
[5]  Kathryn Judson, "I was afraid to leave my husband alone," Hawaii Free Press, February 15, 2011, available at http://www.montanansagainstassistedsuicide.org/2013/01/i-was-afraid-to-leave-my-husband-alone.html

Reject Assisted Suicide

http://www.ravallirepublic.com/news/opinion/mailbag/article_27714944-70cb-11e2-a2a3-001a4bcf887a.html?print=true&cid=print

As a physician in Oregon where doctor-assisted suicide is legal, I write to urge your readers to contact their legislators to reject assisted-suicide in Montana.

One of my first requests for assisted-suicide came from a man with multiple sclerosis. He was wheelchair dependent with multiple sclerosis yet lived a very active life. While I was seeing him, I asked him about his disease. He acknowledged it was a major challenge and told me that if he got too much worse, he might want to “just end it.” “It sounds like you are telling me this because you might ultimately want assistance with your own suicide if things got worse,” I said. He nodded affirmatively, and seemed relieved that I seemed to really understand.

I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his assisted-suicide. He simply said, “Thank you.”

Unfortunately, in Oregon, people are often instead told that they are right to want to die – that their lives have no value. I urge you to not let this tragedy be repeated in Montana.

William L. Toffler MD
Portland, Ore.

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).

Oregon doctor could not save patient from assisted suicide

http://mtstandard.com/news/opinion/mailbag/oregon-doctor-could-not-save-patient-from-assisted-suicide/article_a4b605ba-6767-11e2-bf94-0019bb2963f4.html

I am a doctor in Oregon, where assisted suicide is legal. A few years ago, I was caring for a 76-year-old man who presented to my office a sore on his arm, eventually diagnosed as melanoma. I referred him to specialists for evaluation and therapy.

I had known this patient and his wife for more than a decade. He was an avid hiker, a popular hobby here in Oregon. As his disease progressed, he was less able to do this activity, becoming depressed, which was documented in his chart.

During this time, my patient expressed a wish for assisted suicide to one of the specialists. Rather than take the time to address his depression, or ask me as his primary care physician to talk with him, she called me and asked me to be the “second opinion” for his suicide. She told me that barbiturate overdoses “work very well” for patients like this, and that she had done this many times before.

I told her that assisted suicide was not appropriate for this patient and that I did not concur. I was very concerned about my patient’s mental state, and told her that addressing his underlying issues would be better than simply giving him a lethal prescription. Unfortunately, my concerns were ignored, and two weeks later my depressed patient was dead from an overdose prescribed by this doctor.

Under Oregon’s law, I was not able to protect my depressed patient. If assisted suicide becomes legal in Montana, you may not be able to protect your friends or family members.

I urge you to contact your legislators to tell them to keep assisted suicide out of Montana. Don’t make Oregon’s mistake.

Dr. Charles J. Bentz
Portland, Ore.

Oregon Assisted Suicide Law is Not Safe According to Lawyer

http://mtstandard.com/news/opinion/mailbag/oregon-assisted-suicide-law-is-not-safe-according-to-lawyer/article_329524a6-629a-11e2-bea8-0019bb2963f4.html?print=true&cid=print

I am a lawyer in Oregon who specializes in injury claims including wrongful death cases. I understand that Montana will be considering assisted suicide legislation this session. I write to inform your readers that Oregon’s assisted suicide law lacks transparency. Even law enforcement is denied access to information collected by the State. Moreover, this is official state policy.

In 2010, I was retained by a client whose father had died under our assisted-suicide act. Unlike other deaths I have investigated, it was difficult to get basic information.

After I wrote the state epidemiologist, I received a letter from the Attorney General’s Office that the agency charged with collecting assisted-suicide data, the Oregon Health Authority, “may only make public annual statistical information.” The letter also referred me to the Oregon Medical Board and law enforcement.

The Board wrote me that there could be no investigation without an allegation of misconduct against a physician. At my request, a police officer was assigned to the case. Per his confidential report, the Oregon Health Authority would neither confirm nor deny that my client’s father had died under our act. Per the report, the officer did, however, talk to the doctor signing the death certificate who said that he did not know that the death had involved assisted-suicide. The death certificate listed the immediate cause of death as “cancer” and the manner of death as “natural.”

Per the report, the officer also spoke with potential perpetrators who assured him that the death had been voluntary. He closed the case.

This is a link to Oregon’s data release policy as of Jan. 1, that it “will not confirm on a case-by-case basis whether an individual has used, or a provider has been involved, with Death with Dignity.” http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/policy.aspx

Without transparency our law is not safe.

Isaac Jackson
Box 41240
Eugene, Ore.

“Dr. Stevens, you saved my life!”

http://ravallirepublic.com/news/opinion/mailbag/article_34acbde8-3686-11e2-b260-0019bb2963f4.html?cid=print

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, Medical Examiners Board, Nov. 16, 2012). 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, MD
Sherwood, Ore.

Oregon Doctor's Letter to Medical Society

I practice internal medicine in Oregon where assisted suicide is legal.  I write to urge you to maintain your policy against physician-assisted suicide and have attached a copy of this letter to this e-mail.  Contrary to marketing rhetoric by suicide advocates, the safeguards do not protect patients.  Please consider my patient’s story below.

I was caring for a 76 year-old man who presented to my office with a sore on his arm, eventually diagnosed as metastatic malignant melanoma.  I referred him to both medical and radiation oncology for evaluation and therapy. I had known this patient and his wife for over a decade. He was an avid hiker, a popular hobby here in Oregon, and as his disease progressed, he was less able to do this, becoming depressed, which was documented in his chart. My patient expressed a wish for doctor-assisted suicide to the medical oncologist, but rather than take the time to address depression or ask me, as his primary care physician, to talk with him, the specialist called me and asked me to be the "second opinion" for his suicide.  I told her that assisted suicide was not appropriate for this patient, but unfortunately, my concerns were ignored, and two weeks later my depressed patient was dead from an overdose prescribed by this doctor. His death certificate listed the cause of death as melanoma.

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.")

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.

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.