Tuesday, December 4, 2012

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

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

Dec. 4, 2012

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

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

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

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

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

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

Montana has not legalized assisted suicide

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

December 02, 2012 12:00 am
 
A recent AP article which appeared Nov. 16 in most major newspapers in our state incorrectly stated that Montana is the third state to allow assisted suicide, along with Washington and Oregon. Attorneys Greg Jackson and Matt Bowman did an extensive analysis of the case and concluded it "did not legalize assisted suicide and it continues to carry both criminal and civil liability for any doctor, institution, or lay person involved." The Montana Lawyer, the official publication of the Montana State Bar concluded the issue is open to argument, confirming that the Legislature needs to clarify the issue this coming session.

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

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

David W Hafer, DDS, MS
Dayton

Sunday, December 2, 2012

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

 
November 30, 2012 6:15 am  
 
This letter is a follow up to your recent (Nov. 16) article on assisted suicide and the Montana Medical Board.
 
A study was recently released in Switzerland, where assisted suicide is legal (“Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2012) 542-546, available at http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf). The study found that 1 out of 5 family members or friends present at an assisted suicide were traumatized. These persons “experienced full or sub-threshold (Post Traumatic Stress Disorder) related to the loss of a close person through assisted suicide.”

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

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

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

Margaret Dore, Seattle WA

Saturday, December 1, 2012

Senator Jim Shockley: Assisted suicide not legal

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

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

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

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

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


Jim Shockley
Senate District 45

Thursday, November 29, 2012

Legal assisted suicide Orwellian and discriminatory

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

November 28, 2012
Dear Editor:

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

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

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


Carley C. Robertson, Havre

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

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

November 29, 2012
 
Re: Assisted Suicide and Elder Abuse
 
This letter responds to your recent AP article about assisted-suicide (Associated Press, Nov. 16). I write to emphasize elder financial abuse as a reason to keep assisted suicide out of Montana.

The landmark 2009 report by MetLife Mature Market Institute describes elder financial abuse as a crime “growing in intensity.” (See www.metlife.com/assets/cao/mmi/publications/studies/mmi-study-broken-trust-elders-family-finances.pdf, p.16.) The perpetrators are often family members, some of whom feel themselves “entitled” to the elder’s assets (Id, pp. 13-14.) The report states that they start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or coercing elders to sign over the deeds to their homes, change their wills or liquidate their assets (Id, p. 14.) The report states that victims “may even be murdered” by perpetrators (Id., p. 24.)

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

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

Assisted Suicide is not legal

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


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

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

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

 

Sen. Greg Hinkle,
Thompson Falls

Wednesday, November 28, 2012

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

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

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

November 28, 2012 

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

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

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

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

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

Thank you so much.

Jeanette Hall,
King City, Oregon

Listen to Radio ad with Jeanette Hall and Paul Gorsuch MD

Monday, November 26, 2012

A Recipe for Elder Abuse

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

Dear Editor:

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

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

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


Annie Bukacek, Kalispell

Sunday, November 25, 2012

Assisted suicide a bad proposition

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

Letter to the Editor:

November 23, 2012 12:00 am
 
I have been following assisted suicide issues in various states for several years. Who could have ever imagined that a free society would come to this?

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

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

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

Mrs. Garnett Rope

Vaughn

Assisted Suicide not legal in state, needs clarification

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

November 21, 2012 12:15 am  • 


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

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

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

Sunday, November 18, 2012

Assisted Suicide is Not Legal in Montana

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

Dear Physician . . . 

You may have received a letter from Compassion & Choices, formerly known as the Hemlock Society, dated June 5, 2012. The letter claims that assisted suicide, referred to as "aid in dying," is legal under the Baxter decision issued by the Montana Supreme Court on December 31, 2009. This is untrue. I urge you to read the materials below or contact your own counsel for advice regarding the court's decision in Baxter.

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


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

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

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

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

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

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

* * * 
[1]  Baxter v. Montana, 354 Mont. 234, para. 50, 224 P.3d 1211 (2009).
[2]  To see the entire Jackson/Bowman analysis, go here: http://www.montanansagainstassistedsuicide.org/p/baxter-case-analysis.html