Showing posts with label Elder Abuse. Show all posts
Showing posts with label Elder Abuse. Show all posts

Friday, September 21, 2018

"Death with Dignity" Collapses Under Scrutiny

John Kelly
Click here to read published version.

I write to respond to the oped by John Berkowitz and three Western Massachusetts legislators in support of assisted suicide bill H.1994 (Eagle, Sept. 11).

Unsolvable problems with assisted suicide include the fact that terminal diagnoses are often wrong. Studies show that between 13 percent and 20 percent of people so diagnosed are not dying, and may live years or even decades longer. As examples, the late Sen. Ted Kennedy lived a full year longer than his terminal diagnosis of two to four months, while Florence resident John Norton credits the unavailability of assisted suicide for decades of good life after a mistaken prognosis.

Monday, October 26, 2015

Dore Letter to Joint Committee on Public Health

I am a lawyer in Washington State where assisted suicide is legal.  I am also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. 

H.1991 is a promoted as assuring patient control, which it doesn't do.  Key problems include the following:

  • Someone else is allowed to speak for the patient during the lethal dose request process. 
  • The term, "self-administer," allows someone else to administer the lethal dose to the patient 
  • There is no oversight at the death: Even if the patient struggled against administration, who would know?
  • The death certificate is required to be falsified to reflect a natural death, which prevents perpetrators from being prosecuted even in a straight up murder for the money.
In short, the bill allows the perfect crime.

Here is a link to my memo explaining the bill's problems in more detail.  Even if you are for the concept of assisted suicide, H.1991 is the wrong bill.  http://www.massagainstassistedsuicide.org/2015/10/dore-memo-opposing-h1991.html 

Thank you for your attention to this matter.

Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion, a nonprofit corporation
www.margaretdore.com
www.choiceillusion.org
1001 4th Avenue, Suite 4400
Seattle WA  98154

Dore Memo Opposing H.1991

H.1991 is similar to Ballot Question 2, which was defeated by a vote of the people in 2012.  This memo and its attachments discusses why H.1991 is a recipe for elder abuse.  Passage will also cause family trauma, and encourage people with years to live to throw away their lives.  There are other problems.  Even if you are for the concept of assisted suicide, H.1991 is the wrong bill.

Margaret Dore

Thursday, November 1, 2012

NY Times: Suicide by Choice? Not so Fast


NEXT week, voters in Massachusetts will decide whether to adopt an assisted-suicide law. As a good pro-choice liberal, I ought to support the effort. But as a lifelong disabled person, I cannot.

There are solid arguments in favor. No one will be coerced into taking a poison pill, supporters insist. The “right to die” will apply only to those with six months to live or less. Doctors will take into account the possibility of depression. There is no slippery slope.

Fair enough, but I remain skeptical. There’s been scant evidence of abuse so far in Oregon [and] Washington . . . , the [two] states where physician-assisted death is already legal, but abuse — whether spousal, child or elder — is notoriously underreported, and evidence is difficult to come by. What’s more, Massachusetts registered nearly 20,000 cases of elder abuse in 2010 alone.

Monday, October 29, 2012

Assisted Suicide Users are Older People with Money

By Margaret Dore, Esq., Updated October 29, 2012

Users of assisted suicide in Oregon and Washington are overwhelmingly white and generally well-educated.[1]  Many have private insurance.[2]  Most are age 65 and older.[3]  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.[4] 

In the United States, elder financial abuse costs elders an estimated $2.9 billion per year.[5] Perpetrators include strangers, family members and friends.[6]. The goals of financial abuse perpetrators are achieved "through deceit, threats, and emotional manipulation of the elder."[7]

The Oregon and Washington assisted suicide acts, and the similar Massachusetts proposal, do not protect users from this abuse. Indeed, the terms of these acts encourage abuse. These acts allow heirs and other persons who will benefit from an elder's death to actively participate in his or her lethal dose request.[8] There is also no oversight when the lethal dose is administered, not even a witness is required.[9] This creates the opportunity for an heir, or someone else who will benefit from the person's death, to administer the lethal dose to that person without his consent.[10]  Even if he struggled, who would know?

This is not to say that all persons who use the Oregon and Washington acts are subject to abuse or that their actions are not voluntary.  Rather, the Oregon and Washington acts do not protect such persons from abuse.  Neither will the Massachusetts proposal.

For more information about problems with the Massachusetts' proposal, click here and here. For a "fact check" on the proposal, click here.

[1] See the most current official report from Washington State, "Washington State Department of Health 2011 Death with Dignity Act Report, Executive Summary ("Of the 94 participants in 2011 who died, . . . 94% were white, non-Hispanic . . .75 percent had at least some college education"), available at http://www.doh.wa.gov/portals/1/Documents/5300/DWDA2011.pdf  See also the most current official report from Oregon, also for 2011 ("most [users] were white (95.6%) [and] well-educated (48.5% had at least a baccalaureate degree) . . .", available at http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf
[2] See Washington's report in note 1, page 5, table 2 (46% had private insurance only, or a combination of private and Medicaid/Medicare).  See Oregon's report in note 1("patients who had private insurance (50.8%) was lower in 2011 than in previous years (68.0%). . ."
[3] See Washington's report in note 1, page 5, Table 2 (74% were aged 65 or older).  See Oregon's report in note 1, page 2 ("Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70 years").
[4]  Educated persons are generally financially better off than non-educated persons; persons with private insurance have funding to pay for it; seniors generally are well off.  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, Executive Summary, page 4 ("Elders’ vulnerabilities and larger net worth make them a prime target for financial abuse").
[5]  The Met Life Study of Elder Financial Abuse, " Crimes of Occasion, Desperation, and Predation Against America's Elders," June 2011, page 2, key findings ("The annual financial loss by victims of elder financial abuse is estimated to be at least $2.9 billion dollars, a 12% increase from the $2.6 billion estimated in 2008"). 
[6] Id.
[7] Id., page 3.
[8] See e.g. Margaret K. Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009; and Margaret K. Dore, Memo to Joint Judiciary Committee (regarding Bill H.3884, now Ballot Question No. 2), Section III
[9] Id.  See also entire proposed Massachusetts Act at http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf
[10]  The drugs used, Secobarbital and Pentobarbital, are water and alcohol soluable, such that they can be injected without consent, for example, to a sleeping individual.  See "Secobarbital Sodium Capsules, Drugs.Com, at  http://www.drugs.com/pro/seconal-sodium.html  If the person wakes up and trys to fight, who would know? 

Saturday, October 27, 2012

Ballot Question 2: A Recipe for Elder Abuse

A repeat post brought back by popular demand; for a more in depth analysis, please  click here.

By Margaret Dore
December 2, 2011

A ballot initiative to legalize physician-assisted suicide is pending in Massachusetts.[1]

Physician-assisted suicide is legal in just two states: Oregon and Washington.  In both states, acts to legalize the practice were enacted via sound-bite ballot initiative campaigns.[2]  In a third state, Montana, there is a court case that gives doctors a potential defense to prosecution for homicide.  No such law has made it through the scrutiny of a legislature.  Just this year, bills to legalize assisted suicide were defeated in Montana, New Hampshire and Hawaii.[3] Just this year, Idaho enacted a statute to strengthen its law against assisted suicide.[4]

The proposed Massachusetts act is a recipe for elder abuse.  Key provisions include that an heir, who will benefit financially from a patient's death, is allowed to participate as a witness to help sign the patient up for the lethal dose.  See Section 21 of the act, allowing one of two witnesses on the lethal dose request form to be an heir, available here.  This situation invites undue influence and coercion.

Once the lethal dose is issued by the pharmacy, there is no oversight.  See entire proposed act, available here.  For example, there are no required witnesses when the lethal dose is administered.  See act here.  Without disinterested witnesses, an opportunity is created 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.  Even if he struggled who would know?

In Massachusetts, proponents are framing the issue as religious.  In Washington state, proponents used a similar tactic and even religious slurs to distract voters from the pitfalls of legalization.  What the proposed law said and did was all but forgotten.
        
Do not be deceived.
* * *

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.  Her publications include Margaret K. Dore, "Physician-Assisted Suicide: A Recipe for Elder Abuse and the Illusion of Personal Choice," The Vermont Bar Journal, Winter 2011.
* * *
[1]  To view the proposed Massachusetts initiative, click here:  http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf 
[2]  Oregon's physician-assisted suicide act was enacted via Ballot Measure 16.  Washington's act was enacted via Initiative 1000.
[3]  In Montana, SB 167 was tabled in Committee and subsequently died on April 28, 2011.  In New Hampshire, HB 513 was defeated on March 16, 2011.  In Hawaii, SB 803 was defeated on February 7, 2011 .
[4]  On July 1 2011, Idaho's new statute strengthening Idaho law against assisted suicide went into effect:   http://www.choiceillusionidaho.org/2011/07/idaho-strengthens-law.html

Thursday, October 18, 2012

Robert Joyce on Elder Abuse, Other Reasons to Vote No on Question 2

"The referendum shockingly increases the risk of abuse to elders ..."


Dear Editor:

It’s not clear why The Bulletin titled Joe Galeota’s recent column as it did [“Terrible,” October 11, 2012].

If it’s because the column offered no information about the content of the physician-prescribed suicide referendum, I agree. That is terrible. . . . 

Let’s get serious, and consider just a few of the many reasons why voters should defeat this flawed bill.

The referendum shockingly increases the risk of abuse to elders, many of whom do not have loving families and/or have lost their circle of friends and/or have no one to advocate for them. We should consider that Massachusetts had 19,500 reported cases of elder abuse in 2011. There are insufficient elder abuse investigators to keep up with the 54 new cases reported each day. One study has suggested that there are 23.5 unreported cases for every one reported case.

The referendum does not even provide the level of protection required when a person signs a will in Massachusetts (i.e., two disinterested witnesses), and there is absolutely no oversight at the time the lethal drugs would be administered. 

The Massachusetts Medical Society, representing more than 24,000 physicians and medical students, opposes the bill. So does the American Medical Society.

Insurance companies, hospitals and governmental medical providers have a clear and compelling financial interest in denying us of adequate end-of-life care.

How much do you trust insurers, hospitals and governments? Unless you answer “with my life,” you should oppose physician-prescribed suicide and vote NO on Question Two.

It would indeed be “terrible” if we allow this referendum to pass!

Robert W. Joyce

Saturday, October 13, 2012

Vote No on Question 2

"Ignoring any moral issues, the initiative is vulnerable to abuse and should not be passed into law."

By Anthony Speranza


http://www.salemnews.com/opinion/x1684126269/Column-Vote-no-on-Question-2

This year in Massachusetts, voters will decide on Question 2: an initiative petition to legalize physician-assisted suicide in the commonwealth. Ignoring any moral issues, the initiative is vulnerable to abuse and should not be passed into law.

Dignity 2012, a group in support of the issue referred to as "Death with Dignity," claims the proposed law "contains strict safeguards to ensure that the patient is making a voluntary and informed decision." The safeguards written into the law, however, are insufficient. First, nearly all responsibility rests in the hands of a patient's physician. Section 6 of the initiative states that no patient shall be prescribed the life-ending medication if either of two physicians deem that the patient suffers from a "psychiatric or psychological disorder or depression." While the theory behind this precaution is practical, it falls short of effective. Only 15 days separate the date of request from the date of prescription of the lethal dose. There is no clear definition of what tests must be run in this time to check a patient's mental capacity. According to Jennifer Popik, a medical ethics attorney, "There is no requirement that the patient be given a psychiatric evaluation... This means that a physician ... can prescribe suicide to that patient without even a specialist's evaluation." The "safeguard" concerning mental health is rendered useless because a psychiatric evaluation is not compulsory. A similar law in Oregon serves as a warning: According to a report by the Oregon Public Health Department, of the 71 patients who chose physician-assisted suicide last year, only one was referred for psychiatric evaluation.

Friday, August 31, 2012

New England Journal of Medicine Article Misleading

Dear Editor

I am a lawyer in Washington State, one of two states where assisted-suicide is legal.  The other state is Oregon, which has a similar law.  Lisa Lehmann's article, "Redefining Physicians' Role in Assisted Dying," is misleading regarding how these laws work.

First, the Oregon and Washington laws are not limited to people in their "final months" of life.[1,2]  Consider for example, Jeanette Hall, who in 2000 was persuaded by her doctor to be treated rather than use Oregon's law.  She is alive today, twelve years later.[3]

Second, these laws are not "safe" for patients.[4][5]  For example, neither law requires a witness at the death.  Without disinterested witnesses, the opportunity is created for the patient's heir, or someone else 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?  

Third, the fact that persons using Oregon's law are "more financially secure" than the general population is consistent with elder financial abuse, not patient safety.  Do not be deceived. 


* * *

[1]  Margaret K. Dore, "Aid in Dying: Not Legal in Idaho; Not About Choice," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 18-20, September 2010, available at http://www.margaretdore.com/pdf/Not_Legal_in_Idaho.pdf.
[2]  Kenneth Stevens, MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 16-17, September 2010, available at http://www.margaretdore.com/info/September_Letters.pdf 
[3]  Ms. Hall corresponded with me on July 13, 2012.
[4]  See article at note 1.  See also Margaret Dore, "Death with Dignity": A Recipe for Elder Abuse and Homicide (Albeit Not by Name)," at 11 Marquette Elder's Advisor 387 (Spring 2010), original and updated version available at http://www.choiceillusion.org/p/the-oregon-washington-assisted-suicide.html 
[5]  Blum, B. and Eth, S.  "Forensic Issues: Geriatric Psychiatry." In Kaplan and Sadock's Comprehensive Textbook of Psychiatry, Seventh Edition, B. Sadock and V. Sadock editors.  Baltimore, MD: Lippincott, Williams and Wilkins, pp. 3150-3158, 2000. 

Tuesday, August 14, 2012

Users of Assisted Suicide are Seniors with Money


By Margaret Dore, Esq.
Updated August 18, 2012
Users of assisted suicide "are overwhelmingly white, well educated and financially comfortable."[1]  They are also age 65 and older.[2]  In other words, users are older people with money, which would be the middle class and above, a group disproportionately at risk of financial abuse.[3]

The Oregon and Washington assisted suicide acts, and the similar Massachusetts proposal, do not protect users from this abuse. Indeed, the terms of these acts encourage financial abuse.  These acts allow heirs and other persons who will benefit from an elder's death to actively participate in the lethal dose request.[4]  There is also no oversight when the lethal dose is administered, not even a witness is required.[5]  This creates the opportunity for an heir, or someone else who will benefit from the person's death, to administer the lethal dose to that person without his consent.  Even if he struggled, who would know?


Under the Washington act and the Massachusetts' proposal, the death certificate is required to reflect a natural death.[6]  In Oregon, a natural death is listed by custom.[7]  A concerned nephew, learning that his aunt has suddenly died and that she had a new will favoring a ne'er do will son, will thereby be mislead as to what actually happened.

This does not mean that all deaths under the Oregon and Washington acts are  abusive or without consent.  What it means is that these laws, and the similar Massachusetts proposal, invite abuse and have a distinct lack of transparency.  In Oregon, not even law enforcement is allowed to access state-collected information about these deaths.[8]  Even if the person struggled, who would know?

For more information about specific problems with the Massachusetts' proposal, click here and here.  For a "fact check" on the proposal, click here.

* * *

[1]  Katie Hafner, "In Ill Doctor, a Surprise Reflection of Who Picks Assisted Suicide," New York Times, August 11, 2012.
[2]  See e.g., the most current official report from Oregon, "Oregon Death with Dignity Act--2011" ("Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70 years"), available athttp://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf
[3]  The MetLife Study of Elder Financial Abuse, "Crimes of Occasion, Desperation, and Predation Against America's Elders," June 2011 (a follow up to MetLife's 2009 "Broken Trust: Elders, Family, and Finances"), available athttp://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf
.
[4]  See Memo to Joint Judiciary Committee (regarding Bill H.3884, now ballot measure No. 2), Section III.A.2. ("Someone else is allowed to speak for the patient") and 
and Section II.C. ("One of the [two] witnesses [on the lethal dose request form] is allowed to be an heir who will benefit financially from the patient's death"), available at http://www.massagainstassistedsuicide.org/p/memo-to-joint-judiciary-committee.html
[5]  See above memo at Section III.A.1("No witnesses at the death").  See also entire proposed Massachusetts Act at http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf 
[6]  See proposed Massachusetts Act at Section 4 (2) ("The attending physician may sign the patient's death certificate which shall list the underlying terminal disease as the cause of death").  Washington's act, RCW 70.245.040(2) has this same language. 
[7]  See e.g., Charles Bentz, "Oregon Doctor's Letter to Massachusetts Medical Society," posted November 28, 2011 ("His death certificate listed the cause of death as melanoma.  The public record is not accurate. My depressed patient did not die from his cancer, but at the hands of a once-trusted colleague."), available at http://www.massagainstassistedsuicide.org/2011/11/oregon-doctors-letter-to-massachusetts.html#more 
[8]  See E-mail from Alicia A. Parker, Mortality Research Analyst, Center for Health Statistics, Oregon Health Authority, January 4, 2012 ("We have been contacted by law enforcement and legal representatives in the past, but
have not provided identfying information of any type"), available at http://epcdocuments.files.wordpress.com/2012/08/alicia-a-parker.pdf

Saturday, May 26, 2012

Benedetto Letter to Boston Globe

Dear Editor:

My wife and I operate an elder care facility in Washington State where assisted-suicide is legal.  I am writing to urge your readers to vote against assisted-suicide.

Washington's law was passed by a ballot measure in November 2008.  Four days after the election, an adult child of one of our clients asked about getting "them pills" (to kill the father). It wasn't the father saying that he wanted to die.

Since the act passed, we have also 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 client's care.

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.  I hope that you can prevent assisted suicide.

Juan Carlos Benedetto

Friday, May 18, 2012

Boston Globe: Philip Moran & Karen Schneiderman

May 13, 2012  http://articles.boston.com/2012-05-13/magazine/31664040_1_human-life-physicians-suicide

ON DEATH AND DYING

“Dying Wishes” in the April 29 Globe Magazine refers to “Death with Dignity” instead of what it really is: “physician-assisted suicide.” As stated by then chief justice William Rehnquist in the 1997 case of Washington v. Glucksberg, “An examination of our Nation’s history, legal traditions, and practices demonstrates that Anglo American common law has punished or otherwise disapproved of assisted suicide for over 700 years.” He goes on to state that there are at least five government interests to support that history.  They are prohibiting killing and preserving human life; preventing the serious public health problem of suicide, especially among the young, the elderly, and those suffering from untreated pain or depression; protecting the medical profession’s integrity; protecting the poor, elderly, disabled, and persons in other vulnerable groups from pressure to end their lives; and avoiding a possible slide toward voluntary and even involuntary euthanasia. I submit these are more than sufficient reasons to vote “No” on this ballot question.
Philip D. Moran / Salem 

With fear and rage I respond to the article “Dying Wishes.” A ballot question? The idea of people voting on the worth of a human being is sickening, but my greatest fear has to do with the notion that if a person chooses to request assistance dying, that person is clearly depressed. During such depression it is impossible to make a clear decision. We all have such periods, sick or not, but almost always, with time or therapy or medication or support, that feeling goes away. As a person with a lifelong disability, I have had serious health crises and wished to terminate my life, but I have been fortunate to have medical care and family and friends to help me through my struggles. Those who are not so fortunate rely on the medical establishment. For those of us with disabilities and for elderly folks, our value in this society is already less significant, and we need to rely on physicians to help keep us alive, rather than kill us in the name of compassion.
Karen Schneiderman / Jamaica Plain

Wednesday, May 2, 2012

Washington State's Annual Report: No Information About Consent

By Margaret Dore


Washington assisted suicide act is similar to the proposed assisted suicide initiative in Massachusetts.[1]  


Washington's act was enacted via a ballot initiative in 2008 and went into effect in 2009.[2]  During the election, proponents claimed that its passage would ensure individuals control over their deaths.  A glossy brochure declared, "Only the patient — and no one else — may administer the [lethal dose]."[3]  The Act, however, does not say this anywhere.


Today, the Washington State Department of Health issued its annual report about Washington's act.[4]  That report, similarly, does not demonstrate that individuals are in control. The report provides no information as to whether the people who died under the act consented and/or acted voluntarily at the time of death.  The report instead talks about "ingestion" of the lethal dose.  A drug can be "ingested" while a person is asleep, sedated and/or not aware of his or her surroundings.


For more information about Washington's act, See Margaret Dore, "'Death with Dignity': What Do We Advise Our Clients?," Bar Bulletin, May 2009.[5]  


* * *
[1]  See RCW 70.245.010 et seq.
[2]  Washington's act was passed by in November 2008 as Initiative 1000 and was now been codified as RCW chapter 70.245.
[3]   I-1000 color pamphlet, "Paid for by Yes! on 1000."
[4]  See News Release here and report here.
[5]  Further information can be viewed here.

Sunday, April 22, 2012

Bob Joyce: "Details of Mass. assisted-suicide bill raise concerns"

http://articles.boston.com/2012-04-20/letters/31366522_1_assisted-suicide-bill-ballot-question-life-ending-drugs

THIS STORY APPEARED IN the Boston Globe, April 20, 2012

I was glad to see that lawmakers in Vermont defeated an assisted suicide bill similar to the pending ballot question initiative here in Massachusetts. The article bringing the good news, however, risks conveying an inaccurate impression about how the Massachusetts proposal would work (“Mass. group hails defeat of Vermont suicide bill,” Boston.com, April 14).

The article suggests that the proposed ballot question would allow patients to “self-administer” life-ending drugs. The use of this term could lead the casual reader to think that self-administration is required. It is not. I am a lawyer who has read the proposal. It merely states that a patient “may” self-administer the lethal dose. There is no requirement that administration must be by self-administration.
Also of concern is the fact that the proposal does not require that administration be by disinterested people. Disinterested witnesses are also not required. These factors increase the risk of elder abuse by heirs and other people who stand to benefit from the death.

As a lawyer who has seen my older clients abused, I am hopeful that this Massachusetts proposal will follow the Vermont proposal to the grave.

Robert W. Joyce

Newton

Wednesday, April 11, 2012

A "Doctor & Heir Protection Bill"

By Margaret Dore

On April 2, 2012, the Attorney General issued draft ballot question title and draft yes/no statements for the assisted suicide initiative.  Below please find my objection based on the initiative's being a doctor and heir protection bill.  For a print copy, please click here.  

I.  INTRODUCTION
The proposed act in Petition 11-12 protects persons who cause or assist the death and/or suicide of another person.  This memo discusses why the draft title and one-sentence statements for the act are misleading and should be amended.


II.  THE ACT


A.  The Act Protects People who Cause or Assist a Patient’s Death and/or Suicide


Under current law, people who cause or assist another person’s death or suicide face serious legal consequences.  They can be convicted of a crime, including murder.[1]  They can be found civilly liable for assisting a suicide, committing malpractice and/or causing a wrongful death.[2]  They can also be deprived of an inheritance or life insurance proceeds payable due to the death.[3] 


With the proposed act, however, persons who cause or assist another person’s death and/or suicide are protected from these consequences.  The act also opens the door to new paths of elder abuse.


How the act works, some of its protections and how it will promote elder abuse are described below.

Thursday, March 1, 2012

Fact Check for the Initiative, H.3884

  

Margaret Dore
March 1, 2012
1.  Legalization will Empower the Government

Proponents claim that legalizing assisted suicide will keep the government out of people's lives.  The opposite is true.

Fact check:  In Oregon, where assisted suicide is legal, legalization has allowed the Oregon Health Plan, a government entity, to steer people to suicide.  The most well known cases involve Barbara Wagner and Randy Stroup.  Each wanted treatment.  The Plan denied treatment and steered them to suicide by offering to pay for the suicides. Neither Wagner nor Stroup saw this as a celebration of their control. Wagner said: "I’m not ready to die." Stroup said: "This is my life they’re playing with."  See  See Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008; and "Letter noting assisted suicide raises questions," KATU TV, July 30, 2008.


2.  The Initiative Allows Someone Else to Administer the Lethal Dose

Proponents claim that only the patient may administer the lethal dose.  This is not true.

Fact check:  The initiative, H.3884, states that patients "may" self-administer the lethal dose. There is no language stating that administration “must” be by self-administration.  "Self-administer" is also a specially defined term that allows someone else to administer the lethal dose to the patient.  See here.

3.  An Heir is Allowed to Witness the Lethal Dose Request

Proponents claim that the lethal dose request form must be "independently witnessed" by two people.  This is not true. 

Fact check:  The initiative, Sections 3 and 21, provides that one of two witnesses on the lethal dose request form cannot be a patient’s heir or other person who will benefit financially from the patient's death; the other witness can be an heir or other person who will benefit financially from the death.


4.  Substantial Compliance

Proponents claim that the initiative has "strict safeguards" to protect patients.  The initiative, however, only requires "substantial compliance" with its provisions.  Section 18(1)(a) states:  "A person who substantially complies in good faith with provisions of this chapter shall be deemed to be in compliance with this chapter." 

5.  Assisted Suicide is a Recipe for Elder Abuse

Proponents claim that the initiative is safe, which is not true.

Fact check: The initiative does not require witnesses at the death.  Without disinterested witnesses, the opportunity is created for an heir, or someone else who will benefit financially from the death, to administer the lethal dose to the patient without the patient's consent.  Even if he struggled, who would know?  

6.  Patients are not Necessarily Dying

Proponents imply that the initiative only applies to people in their "final days."  This is untrue.

Fact check:  See 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?," Seattle Weekly, January 14, 2009; and Jeanette Hall, "She pushed for legal right to die, and - thankfully - was rebuffed," Boston Globe, October 4, 2011.

7.  Assisted Suicide is a Wedge Issue

Proponents deny that assisted suicide is a "wedge issue" to legalize direct euthanasia of non-terminal people.

Fact check:  In Washington state, where assisted suicide has been legal since 2009, there has been a proposal to expand Washington's law to direct euthanasia for non-terminal people.  See Brian Faller, "
Perhaps it's time to expand Washington's Death with Dignity Act," The Olympian, November 16, 2011.

8.  Legal Assisted Suicide Threatens People with Disabilities 

Proponents claim that people with disabilities are not at risk from legalization of assisted suicide, which is untrue.

Fact check:  Disability rights groups such as Not Dead Yet oppose assisted suicide as a threat to their lives.  In Oregon and Washington, official government forms for assisted suicide acts in those states promote disability as a reason to commit suicide.[1]  People with disabilities are thereby devalued.  In 2009, there was a proposed assisted suicide bill in New Hampshire that squarely applied to people with disabilities.[2]  If the initiative were to be passed now, people with disabilities see themselves as potentially next in line under a future expansion of that law.  As noted above, there has already been a proposal in Washington state to expand its law to direct euthanasia for non-terminal people. 

* * * 

[1]  See e.g. "Oregon Death with Dignity Act Attending Physician Follow-up Form," question 15, providing seven suggested answers as to why there was a lethal dose request.  Some of the answers are written in terms of disability being an acceptable reason to kill yourself.  These answers include:  "[A] concern about . . . the loss of control of bodily functions."
[2]  Stephen Drake and Not Dead Yet, "New Hampshire Poised to Redefine "Terminally Ill" - to PWDs and others for Assisted Suicide Eligibility," January 30, 2009 (regarding New Hampshire's 2009 assisted suicide bill, HB 304, which applied to people with disabilities, people with HIV/AIDS and other non-dying people).

Sunday, December 11, 2011

Press Release: Mass Against Assisted Suicide

FOR IMMEDIATE RELEASE 


Choice is an Illusion, a nonprofit corporation opposed to assisted suicide, has launched a new website agianst the Massachusetts "death with dignity" initiative.  The website's name is "Mass Against Assisted Suicide." 

Margaret Dore, President of Choice is an Illusion and an elder law attorney, states: "The initiative's introduction declares that the process will be 'entirely voluntary' for the patient.  The act, as written, does not deliver on this promise.  The act is instead a recipe for elder abuse."

The proposed act has an application process to obtain a lethal dose for the purpose of causing the patient's death.  The act allows the patient's heir, who will benefit financially from the death, to actively help the patient sign up for the lethal dose.  Dore states:  "The act allows an heir to participate as one of two witnesses on the lethal dose request form.  The act also allows someone else to speak for the patient." 

"This does not meet the stink test," said Dore. "Signing away your life under the proposed act has less protection than signing a will."

Dore explained that when signing a will, similar conduct can create a presumption of fraud and undue influence.

Dore also pointed out that there is no oversight once the lethal dose of has been filled under the proposed act.

"The death is not required to be witnessed by disinterested persons," Dore said.  "Indeed, no one is required to be present." 

"Without disinterested witnesses, the opportunity is created for an heir, or someone else who will benefit from the death, to administer the lethal dose to the patient without his consent.  Who would know?"

This year in New Hampshire, a similar "death with dignity" act was defeated in the House of Representatives by a vote of 234 to 99

Former New Hampshire State Representative Nancy Elliott said: "Assisted suicide laws empower heirs and others to pressure and abuse older people to cut short their lives.  This is especially an issue when the older person has money.  There is no assisted suicide bill that you can write to correct this huge problem."
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To view the new website, go here:  http://www.massagainstassistedsuicide.org  To learn more about "Choice" is an Illusion, visit:  www.choiceillusion.org  To learn about the New Hampshire bill that failed, go here:  http://www.choiceillusionnewhampshire.org/2011/05/new-hampshire-defeats-assisted-suicide.html




* * *

Margaret Dore is President of Choice is an Illusion and an elder law attorney. Contact her at 206-389-1754 or margaretdore@margaretdore.com.  See also http://www.margaretdore.org/   

Sunday, December 4, 2011

Assisted Suicide: A Recipe for Elder Abuse; Do Not be Deceived

For a more in depth legal analysis, please click here

By Margaret Dore
December 4, 2011

A ballot initiative to legalize physician-assisted suicide is pending in Massachusetts.[1]

Physician-assisted suicide is legal in just two states: Oregon and Washington.  In both states, acts to legalize the practice were enacted via sound-bite ballot initiative campaigns.[2]  In a third state, Montana, there is a court case that gives doctors a potential defense to prosecution for homicide.  No such law has made it through the scrutiny of a legislature.  Just this year, bills to legalize assisted suicide were defeated in Montana, New Hampshire and Hawaii.[3] Just this year, Idaho enacted a statute to strengthen its law against assisted suicide.[4]

The proposed Massachusetts act is a recipe for elder abuse.  Key provisions include that an heir, who will benefit financially from a patient's death, is allowed to participate as a witness to help sign the patient up for the lethal dose.  See Section 21 of the act, allowing one of two witnesses on the lethal dose request form to be an heir, available here.  This situation invites undue influence and coercion.

Once the lethal dose is issued by the pharmacy, there is no oversight over administration of the dose to the patient.  See entire proposed act, available here.  For example, no witnesses are required.  See act here.  Without disinterested witnesses, an opportunity is created for an heir, or another 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?

In Massachusetts, proponents are framing the issue as religious.  In Washington state, proponents used a similar tactic and even religious slurs to distract voters from the pitfalls of legalization.  What the proposed law said and did was all but forgotten.
        
Do not be deceived.

* * *
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.  Her publications include Margaret K. Dore, "Physician-Assisted Suicide: A Recipe for Elder Abuse and the Illusion of Personal Choice," The Vermont Bar Journal, Winter 2011.
* * *
[1]  To view the proposed Massachusetts initiative, click here:  http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf 
[2]  Oregon's physician-assisted suicide act was enacted via Ballot Measure 16.  Washington's act was enacted via Initiative 1000.
[3]  In Montana, SB 167 was tabled in Committee and subsequently died on April 28, 2011.  In New Hampshire, HB 513 was defeated on March 16, 2011.  In Hawaii, SB 803 was defeated on February 7, 2011 .
[4]  On July 1 2011, Idaho's new statute strengthening Idaho law against assisted suicide went into effect:   http://www.choiceillusionidaho.org/2011/07/idaho-strengthens-law.html


Monday, October 17, 2011

Assisted Suicide: A Recipe for Elder Abuse

By Margaret Dore

A ballot initiative to legalize physician-assisted suicide via a "death with dignity" act is now in the signature-gathering stage in Massachusetts.[1]

Physician-assisted suicide is legal in just two states: Oregon and Washington.[2]  In both states, acts to legalize the practice were enacted via sound-bite ballot initiative campaigns.[3]  No such law has made it through the scrutiny of a legislature.  Just this year, bills to legalize assisted suicide were defeated in Montana, New Hampshire and Hawaii.[4] Just this year, Idaho enacted a statute to strengthen its law against assisted suicide.[5]

The proposed Massachusetts act is a recipe for elder abuse.  Key provisions include that an heir, who will benefit financially from a patient's death, is allowed to participate as a witness to help sign the patient up for the lethal dose.  See Section 21 of the act, allowing one of two witnesses on the lethal dose request form to be an heir, available here.  This situation invites undue influence and coercion.

Once the lethal dose is issued by the pharmacy, there is no oversight.  See entire proposed act, available here.  The act does not require witnesses when the lethal dose is administered.  See act here.  Without disinterested witnesses, an opportunity is created for an heir, or another person who will benefit from the patient's death, to administer the lethal dose to him without his consent.  Even if he struggled who would know?

In Massachusetts, proponents are framing the issue as religious.  In Washington state, proponents used a similar tactic and even religious slurs to distract voters from the pitfalls of legalization.  What the proposed law said and did was all but forgotten.
        
        Do not be deceived.

* * *
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.  Her publications include Margaret K. Dore, "Physician-Assisted Suicide: A Recipe for Elder Abuse and the Illusion of Personal Choice," The Vermont Bar Journal, Winter 2011.
* * *
[1]  To view the proposed Massachusetts initiative, click here:  http://www.mass.gov/Cago/docs/Government/2011-Petitions/11-12.pdf
[2]  In Montana, there is a court decision that gives doctors who cause or aid a suicide, a potential defense to criminal prosecution for homicide.  The decision does not legalize assisted suicide by giving doctors or anyone else immunity from criminal prosecution and civil liability.  To learn more, go here:  http://www.montanansagainstassistedsuicide.org/p/baxter-case-analysis.html  The assisted suicide promotion group, Compassion & Choices, has a new campaign claiming that assisted suicide is "already legal" in Hawaii.  This is an odd claim given that bills to legalize assisted suicide in Hawaii have repeatedly failed, most recently this year.  See here for the most recent billhttp://capitol.hawaii.gov/Archives/measure_indiv_Archives.aspx?billtype=SB&billnumber=803&year=2011
[3]  Oregon's physician-assisted suicide act was enacted via Ballot Measure 16.  Washington's act was enacted via Initiative 1000.
[4]  In Montana, SB 167 was tabled in Committee and subsequently died on April 28, 2011.  In New Hampshire, HB 513 was defeated on March 16, 2011.  In Hawaii, SB 803 was defeated on February 7, 2011 .
[5]  On July 1 2011, Idaho's new statute strengthening Idaho law against assisted suicide went into effect:   http://www.choiceillusionidaho.org/2011/07/idaho-strengthens-law.html