Why Do So Many Disability Groups Oppose Physician Assisted Suicide?

by:  James D. McGaughey, Executive Director,

Connecticut Office of Protection and Advocacy for Persons with Disabilities. 

(Adapted from an article that originally appeared in the

International Social Role Valorization Journal in 2010.)

http://www.ct.gov/opapd/cwp/view.asp?Q=519546&A=3683 

In 2009, a proposal that would have legalized Physician Assisted Suicide was introduced in the Connecticut General Assembly.  The language of that proposal paralleled legislation being pursued in other states by Compassion and Choices, a successor organization to the Hemlock Society.  When the proposal was withdrawn without a public hearing, Compassion and Choices moved to the Courts, seeking a judicial ruling that provisions of the Connecticut Statutes prohibiting assisting a person to commit suicide should not be applied to physicians who write lethal prescriptions for their patients.  Their lawsuit was dismissed.  Now, in 2013, it appears that another attempt to legalize Physician Assisted Suicide is being made in Connecticut.  While the details of the current proposals are unavailable as of this writing, they will likely be similar to proposals that are being pursued in other states – proposals that have drawn stiff opposition from disability advocates in those states.
 

Proponents of legalizing Physician Assisted Suicide argue that it’s all about compassion and personal autonomy.  Citing examples of individuals who have ended, or who apparently want to end their lives by taking lethal doses of prescribed drugs, they propose adoption of the euphemistic term “assistance with dying”, and suggest Physician Assisted Suicide be seen as a compassionate alternative to suffering intractable pain or endless, intrusive, de-dignifying medical interventions.  If all we hear is their side of the story it seems reasonable enough.  After all, shouldn’t we have the option of avoiding an ignoble end?  Shouldn’t our doctors be able to prescribe drugs that will do the job quietly and professionally?  Isn’t this a matter of personal choice? What’s wrong with just having the option?  

Leading disability rights groups see plenty of problems with it. A number of well respected organizations, including the National Council on Disability, the American Association of People with Disabilities (AAPD), the National Council on Independent Living (NCIL), the National Spinal Cord Injury Association, the World Institute on Disability, Justice For All, TASH (formerly called The Association of the Severely Handicapped), the Disability Rights Education and Defense Fund (DREDF), and grass roots groups such as ADAPT and Not Dead Yet have all adopted positions opposing legalization of assisted suicide.  In fact, members of many of these groups have been teaming up with local independent living centers and state-level advocacy coalitions to challenge the state-by state campaign to promote Physician Assisted Suicide.

" I support House Bill 505, which clearly states that assisted suicide is not legal"

http://www.greatfallstribune.com/article/20130313/OPINION/303130037/On-our-minds-Fires-suicide-bill-breweries

My husband, Dr. James E. Mungas, was a respected physician and surgeon here in Great Falls. He developed amyotrophic lateral sclerosis, and I took care of him. His mind was clear and thought processes unimpaired. He was against assisted suicide and euthanasia.

I needed to travel out of town for a day and a half. We agreed he would stay at a local care facility in my absence. Once there, nurses began administering morphine. After the first dose, my husband knew that he had been overdosed and typed out a message to call respiratory therapy. None came that day. Over the next few days, he struggled to breathe and desperately struggled to remain conscious to communicate, but the nurses kept pushing the morphine button and advised our children to do the same. My children and I did not understand the extent morphine would repress the respiratory system until later.  This was neither palliative care nor managing pain; this was hastening death. He was effectively euthanized against his will. He did not get his choice. It is traumatic, still, to realize his last communications were attempts to get help.

As illustrated by my husband's case, doctors and nurses already misuse or abuse the power they have. The stakes are too high to consider expanding their power by legalizing assisted-suicide. The recent guest column by Dr. Stephen Speckart and other doctors claims that assisted suicide is already legal. For that reason, I support House Bill 505, which clearly states that assisted suicide is not legal.

— Carol Mungas,
Great Falls

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.

Pass HB 505 - Rick Blevins, MD

http://www.greatfallstribune.com/apps/pbcs.dll/article?AID=2013303120037

The Montana Legislature is considering the question of physician-assisted suicide. The Senate has rejected an Oregon-style bill that would have legalized such a practice. The House has passed House Bill 505, which will end the confusion about assisted suicide in Montana. I am in favor of this bill and wish to clarify misconceptions expressed in a Viewpoint article published March 4.


HB 505 seeks to clarify the relevant law, which has been misinterpreted as a result of the Montana Supreme Court Baxter decision of 2009. This decision did not legalize physician assisted suicide, contrary to claims made by authors of the Viewpoint article. The court only stated that a patient’s consent, if given, may be used as a legal defense. Lawyers are scratching their heads about the meaning and the ramifications of this decision which is why the Legislature should act to provide needed clarity.


HB 505 only addresses the aiding or solicitation of suicide, including physician-assisted suicide. It specifically “does not include end of life palliative care in which a dying person receives medication to alleviate pain that may incidentally hasten the dying person’s death or any act to withhold or withdraw life-sustaining treatment” authorized by the Montana Rights of the Terminally Ill Act. The quotes are directly from the text of HB 505.

Please contact your senators and tell them to end the confusion. Please tell them to vote “yes” on HB 505.— Rick Blevins, M.D.,

Don’t make Washington’s assisted-suicide mistake

http://mtstandard.com/news/opinion/mailbag/don-t-make-washington-s-assisted-suicide-mistake/article_10022e80-8b75-11e2-b398-001a4bcf887a.html?print=true&cid=print


My husband and I operate two adult family homes (elder care facilities) in Washington State where assisted suicide is legal. I am writing to urge you to not make Washington’s mistake.

Our assisted suicide law was enacted by a ballot measure in November 2008. During the election, the law was promoted as a right of individual people to make their own choices. That has not been our experience. We have also noticed a shift in the attitudes of doctors and nurses towards our typically elderly clients to eliminate their choices.

Four days after the election, an adult child of one of our clients asked about getting the pills (to kill his father). It wasn’t the client saying that he wanted to die. At that time, our assisted suicide law had not yet gone into effect. The father died before the law went into effect.

Since then, we have noticed that some members of the medical profession are quick to bring out the morphine to begin comfort care without considering treatment. Sometimes they do this on their own without telling the client and/or the family member in charge of the clients care.

Since our law was passed, I have also observed that some medical professionals are quick to write off older people as having no quality of life whereas in years past, most of the professionals we dealt with found joy in caring for them. Our clients reciprocated that joy and respect.

Someday, we too will be old. I, personally, want to be cared for and have my choices respected. I, for one, am quite uncomfortable with these developments. Don’t make our mistake.

Elizabeth Benedetto

Possible expansion of physician-assisted suicide laws in other states should concern Montana

http://missoulian.com/news/opinion/mailbag/possible-expansion-of-physician-assisted-suicide-laws-in-other-states/article_e29d5322-8b2c-11e2-aba7-001a4bcf887a.html

I am doctor in Washington state where physician-assisted suicide is legal for “terminal patients” predicted to have less than six months to live. I disagree with the letter by Kristen Wood (letter, Feb. 28) that expansion is not a concern in this context.

In Washington state, our assisted suicide law has only been in effect for four years. We have, however, already had proposals to expand that law to direct euthanasia of non-terminal people. See e.g., Brian Faller, “Perhaps it’s time to expand Washington’s Death with Dignity Act,” Nov. 16, 2011. Last year, there was also this article in the Seattle Times, suggesting euthanasia for people who cannot afford their own care, which would be involuntary euthanasia: Jerry Large, “Planning for old age at a premium,” 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.“)

I am very concerned with where this is all going. I hope that Montana does not follow our lead to legalize assisted suicide.

Richard Wonderly,
Seattle, Washington

"He made the mistake of asking for information about assisted suicide"

http://missoulian.com/news/opinion/mailbag/legalizing-assisted-suicide-allows-physicians-to-pressure-patients/article_5726f258-84fb-11e2-9707-001a4bcf887a.html

Last year, my 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. I 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 me and a friend to not leave him alone with her. Justified or not, Wes was afraid that the doctor would do something to him or have him sign something if she would find him alone.

In fact, even though he was on heavy doses of narcotic pain medications and not in a clear state of mind to sign documents without someone to advocate for him, this palliative care MD actually did try to get him to sign a DNR or “Do Not Resuscitate” form without his Durable POA or any family member present. Fortunately, his close friend/POA arrived at that moment to stop this from happening. Some of the other doctors and staff members seemed to also write Wes off once they learned that he had asked about assisted suicide.

I am writing to urge your readers to prevent assisted suicide in Montana. I do this on behalf of myself and my other brother, Ron Olfert, of Sanders County, who also died last year. He was strongly opposed to assisted suicide.

Please contact your legislators and ask them to vote “yes” on House Bill 505.

Marlene Deakins, RN
Tuscon, Arizona

The "Oregon Experience" Includes Murder-Suicide

Increased Suicide

Oregon’s overall suicide rate, which excludes suicide under Oregon’s physician-assisted suicide act, is 35% above the national average.  Moreover, this rate has been “increasing significantly since 2000.”  See  http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf  Just three years prior, in 1997, Oregon legalized physician-assisted suicide.  Other suicides have thus increased with legalization of physician-assisted suicide.  This is consistent with a copy cat or suicide contagion phenomenon (normalizing one type of suicide, i.e., physician assisted suicide, encouraged other suicides).

Violent Death

In Oregon, many suicide deaths are violent.  For 2007, “[f]irearms were the dominant mechanism of suicide among men.”  This is according to an Oregon Department of Human Services report issued in September 2010.  See excerpts here:  http://maasdocuments.files.wordpress.com/2013/02/oregon-suicide-info_0011.pdf 

Murder-Suicide

In Oregon, murder-suicides "follow the national pattern."  http://blog.oregonlive.com/health_impact/print.html?entry=/2009/11/recent_murder-suicides_follow.html


The Wife Would Still be a Victim

According to  Donna Cohen, the typical murder-suicide case involves a depressed controlling husband who shoots his ill wife:  “The wife does not want to die and is often shot in her sleep.  If she was awake at the time, there are usually signs that she tried to defend herself.”   See WebMD,  "Murder-Suicides in Elderly Rise: Husbands commit most murder suicides–without wives’ consent," January 30, 2005,  http://www.medicinenet.com/script/main/art.asp?articlekey=50782

If physician assisted suicide were legal in Montana, the wife, not wanting to die, would still be a victim. 

"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

HB 505 Text

For a print copy, click here 

A BILL FOR AN ACT ENTITLED: "AN ACT CLARIFYING THE OFFENSE OF AIDING OR SOLICITING SUICIDE; CLARIFYING THAT PHYSICIAN-ASSISTED SUICIDE IS A FORM OF AIDING OR SOLICITING SUICIDE; CLARIFYING THAT THE CONSENT OF A VICTIM IS NOT A DEFENSE TO AIDING OR SOLICITING SUICIDE; PROVIDING DEFINITIONS; AMENDING SECTION 45-5-105, MCA; AND PROVIDING AN IMMEDIATE EFFECTIVE DATE AND AN APPLICABILITY DATE."

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:

Section 1. Section 45-5-105, MCA, is amended to read:

"45-5-105. Aiding or soliciting suicide. (1) A person who purposely aids or solicits another person to commit suicide, but such suicide does not occur, including physician-assisted suicide, commits the offense of aiding or soliciting suicide.

WE WON!!!! HB 505 PASSES THE HOUSE!

THANK YOU TO EVERYONE WHO HELPED GET US THIS FAR!

WAY TO GO!!!!

WE WON!!!! HB 505 PASSES SECOND READING!

HB 505 just passed second reading in the Montana House of Representatives!

The Vote was 54 to 45!

Way to go!!!!!