SB 220 Talking Points (Tell your legislators to vote no!)

For more detailed information with supporting documentation, click  here. 

1.  What does SB 220 do? 

SB 220 seeks to legalize physician-assisted suicide in Montana.

2.  What is physician-assisted suicide?

The American Medical Association (AMA) defines physician-assisted suicide as occurring "when a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act."[1]  An example would be a doctor’s prescription for a lethal drug to facilitate a patient’s suicide.[2]

3.  What is the American Medical Association's position on physician-assisted suicide?

The American Medical Association rejects assisted suicide, stating:

"Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks."[3]

4.  Is it true that assisted suicide is only legal in two states?

Yes.  There are just two states where physician-assisted suicide is legal: Oregon and Washington.[4]

5.  Are there also states that have strengthened their laws against assisted suicide?

Yes.  In the last two years, three states have strengthened their laws against assisted suicide.[5]. Those states are: Idaho; Georgia; and Louisiana.[6]

6.  How does SB 220 work?

SB 220 has an application process to obtain the lethal dose, which includes a written lethal dose request form.[7]

Once the lethal dose is issued by the pharmacy, there is no oversight.[8] The death is not required to be witnessed by disinterested persons.[9] Indeed, no one is required to be present.[10]

Tell your legislators to VOTE NO on SB 220!

By Margaret Dore, Esq.

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

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

The introduction to the analysis states:

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

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

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

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

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).

Physician-assisted suicide: Permission is recipe for abuse

January 30, 2013 8:30 am

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

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

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

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

Legal assisted suicide is, regardless, a recipe for elder abuse in which heirs are empowered to pressure and abuse older people to cut short their lives. I urge you to tell your legislators that you support legislation to close on the door on assisted suicide in Montana.

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

Greg Hinkle, Thompson Falls

Physician-assisted suicide runs risk of invisible coercion

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

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

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

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

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

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

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

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

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

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

Cort Freeman
2950 Bayard St.
Butte