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.
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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.
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[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