"The Board is both misleading physicians and endangering patients"

To the Montana Board of Medical Examiners:

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

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

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

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

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

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

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

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

Sincerely,

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

Position Statement No. 20: "Let's nip this in the bud, and send it to its death forever."

I have written before, but just want to gently remind you that as a Montana state citizen I am very much opposed to physician assisted suicide. We've heard from folks in Oregon and Washington and it is a moral and legal outrage. We don't want this sort of open-ended legal wrangling here.

I am respectfully asking you to vacate the new position statement #20. Let's nip this in the bud, and send it to its death forever.

I remain respectfully yours,

Mrs. Garnett Rope

To Board, asking to speak "to expand on my previously expressed concerns"

July 12, 2012

Subject: Request to be put on agenda for July 20 meeting


Mr. Marquand:

I respectfully request permission to speak to Position Statement No.20 at the meeting of the Board of Medical Examiners on Friday, July 20th, 2012, to expand on my previously expressed concerns about this proposal. There may be a number of others attending the meeting with me, but none are asking to speak.

Thank you.

Carol Mungas

Update on Board: Thank You Letter Received

As described in an earlier post, on July 20, 2012, the Montana Board of Medical Examiners denied Montanans Against Assisted Suicide and other members of the public a requested hearing on Position Statement No. 20.   The Board voted to instead thank interested persons in writing.  A copy of the letter sent to Montanans Against Assisted Suicide can be viewed here. Montanans Against Assisted Suicide anticipates a further legal challenge. 

Board Denies Hearing on Legal Issues; Legal Challenge Anticipated

On May 7, 2012, the Montana Board of Medical Examiners voted to postpone consideration of whether Position Statement No. 20 should be vacated.[1]  Position Statement No. 20 concerns "aid in dying," a euphemism for assisted suicide and euthanasia.[2]  The reasons given for the delay included "to allow additional time for public input."[3]


On July 6, 2012, Montanans Against Assisted Suicide filed additional "public input" including a letter and a legal memorandum titled:  "Summary of Legal Arguments Requiring Position Statement No. 20 to be Vacated as a Matter of Law."[4]  The letter requested twenty minutes oral argument.[5]


On July 20, 2012, the Board held the postponed hearing.  The Board acknowledged that it had received the above documents and also acknowledged the presence of Cory Swanson, attorney for Montanans Against Assisted Suicide.  The Board did not allow Mr. Swanson to speak.


The Board did, however, allow a presentation by a DLI staff attorney on position papers generally.  The Board asked him a few questions and voted to have their staff thank people in writing for their input. The exact text will be posted once we get it.  


Montanans Against Assisted Suicide anticipates a further legal challenge.

* * *

[1]  See Board of Medical Examiner Minutes for May 7, 2012, Item #5. 
[2]  See “Model Aid-in-Dying Act,” published in the Iowa Law Review at   http://www.uiowa.edu/~sfklaw/euthan.html  Note the letters “euthan” in the link.
[3]  See note 1 at Item #4 (Comments by Craig Charlton and Anne O'Leary; the quote is from Ms. O'Leary).
[4]  To see letter, click here.  To see legal memorandum, click here. 
[5]  See letter in note 5.

"Does the Board really want to put itself in the embarrassing position of overstepping its authority by condoning this procedure? "

Dear Members of the Board, 


I am writing again, as a Family Medicine physician in Bozeman since '89, to address the renewed attention given to Position Statement 20. I am having trouble understanding why our Montana Board of Medical Examiners would step out on a limb and seemingly promote, or at least encourage physicians to go along with a procedure, Physician Assisted Suicide for the following reasons: 


1. Compassion and Choices [fna the Hemlock Society], which has brought the original lawsuit, and lobbied for this procedure is an out of state special interest group, looking to expand Physician Assisted Suicide all over the country. How is it that our own Board of Medical Examiners is stepping out on a limb to enable this organization to meet its goals? 


2. The Montana Supreme Court's decision in the Baxter case gives no reassurance that this procedure will not be frowned upon in the court of law when it is tested. Does the Board really want to put itself in the embarrassing position of overstepping its authority by condoning this procedure?