Monday, June 24, 2019

Reject End of Life Option Act, H.1926 and S.1208

Click here to view pdf version.


I am an attorney in Washington State where assisted suicide is legal.[1] The proposed bills seek to legalize “aid in dying,” a traditional euphemism for active euthanasia and physician-assisted suicide.[2]

Most states reject these practices.[3] Other states have strengthened their laws against them.[4] If enacted, the bills will apply to people with years or decades to live. Individuals with money, meaning the middle class and above, will be especially at risk. I urge you to reject the proposed bills.


A. Physician-Assisted Suicide, Assisted Suicide and                         Euthanasia

The American Medical Association defines physician-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.”[5] For example: 
[T]he physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide.[6]
Assisted suicide is a general term in which an assisting person is not necessarily a physician. Euthanasia is the administration of a lethal agent by another person.[7]

B.  Withholding or Withdrawing Treatment

Withholding or withdrawing treatment (“pulling the plug”) is not euthanasia if the purpose is to remove burdensome treatment, as opposed to an intent to kill the patient. More importantly, the          individual will not necessarily die. Consider this quote from Washington State regarding a man removed from a ventilator: 
[I]nstead of dying as expected, [he] slowly began to get better.[8]

Persons assisting a suicide or euthanasia can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton in Oregon. Two days after his death by legal assisted suicide, she sold his home and deposited the proceeds into bank accounts for her own benefit.[9] Consider also Graham Morant, convicted of counseling his wife to kill herself in Australia, to get the life insurance.[10] The Court found:
[Y]ou counselled and aided your wife to kill herself because you wanted ... the 1.4 million.[11]
Medical professionals too can have an agenda. New York physician, Michael Swango, got a thrill from killing his patients.[12] Consider also Harold Shipman, a doctor in the UK, who not only killed his patients, but stole from them and in one case made himself a beneficiary of the patient’s will.[13]


The bills apply to persons who are “terminally ill,” which is defined as an illness or condition expected to cause death within six months.[14] Such persons may in fact have years or decades to live. This is true due to actual mistakes (the test results got switched) and because predicting life expectancy is not an exact science.[15]

Indeed, doctors can sometimes be very wrong. Consider John Norton, who testified before this body in 2012. Diagnosed with ALS at age 18, he was told that he would get progressively worse (be paralyzed) and die in three to five years.[16] Instead, the disease progression stopped on its own. His affidavit states:
If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.[17]

The bills have an application process to obtain the lethal dose, which includes a lethal dose request form. Once the lethal dose is issued by the pharmacy, there is no oversight. No doctor, not even a witness, is required to be present at the death.[18]


Proponents claim that bill passage will assure individual choice, which is not true. See below.

     A. Patient Protections Will Not Be Enforceable

The bills set forth multiple patient protections, for example, that the attending physician “shall” refer the patient to another physician prior to prescribing the lethal dose.[19] The bills also say that actions are to be carried out in “accordance” with the bills.[20]
The bills do not define “accordance.”[21] Dictionary definitions include “in the spirit of,” meaning  in thought or intention.[22] In other words, a mere thought or intention to comply is good enough. The protections will not be enforceable.

B. The Bills Will Allow Other People to Communicate on                  the Patient’s Behalf
The bills describe patients as being “capable.”[23] This is a specially defined term, in which other people will be allowed to communicate on the patient’s behalf during the lethal dose request process, as long as the communicating people are “familiar with the patient’s manner of communicating.” The bills state:
"Capable” means having the capacity to make informed, complex health care decisions; understand the consequences of those decisions; and to communicate them to health care providers, including communication through individuals familiar with the patient’s manner of communicating if those persons are available. (Emphasis added).[24]
Being familiar with a patient’s manner of communicating is an extremely low standard for something so important. Consider, for example, a doctor’s assistant who is familiar with the patient’s manner of communicating in Spanish, but she, herself, does not understand Spanish. That, however, would be good enough for her to communicate on his behalf during the lethal dose request process. The patient would not be in control of his fate.

     C. “Even If the Patient Struggled, Who Would Know?”

The bills have no required oversight over administration of the lethal dose.[25] In addition, the drugs used are water and alcohol soluble, such that they can be injected into a sleeping or restrained person without consent.[26] Alex Schadenberg, Executive Director for the Euthanasia Prevention Coalition, puts it this way:
With assisted suicide laws in Washington and Oregon [and with the proposed bills], perpetrators can . . . take a “legal” route, by getting an elder to sign a lethal dose request.  Once the prescription is filled, there is no supervision over administration. Even if a patient struggled, “who would know?” (Emphasis added).[27]

The bills state that patients may choose to “self-administer” the lethal dose.[28] This is a specially defined term, which paradoxically allows other people to administer the lethal dose to the patient. The bills state:
"Self-administer” means a qualified patient’s act of ingesting medication [the lethal dose] ....(Emphasis added)[29]
The bills do not define “ingest.”[30] Dictionary definitions include:
[T]o take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing.” (Emphasis added).[31]
With these definitions, someone else putting the lethal dose in a patient’s mouth qualifies as self-administration if the patient swallows the lethal dose, i.e., ingests it. Someone else placing a medication patch on the patient’s arm will similarly qualify as self-administration because the patient will then be “absorbing” the dose, i.e., “ingesting” it. Gas administration initiated by another person will also qualify because the patient will be “inhaling” the dose, i.e., ingesting it. With self-administer defined as mere ingesting, someone else is allowed to administer the lethal dose to the patient, which is euthanasia as traditionally defined.


The bills require deaths via the lethal dose to be listed on the patient’s death certificate as caused by a terminal disease, not euthanasia or homicide. The bills state:
The attending physician may sign the patient’s death certificate which shall list the underling terminal disease as the cause of death.  (Emphasis added).[32]
Actions taken by health care providers and patient advocates supporting a qualified patient exercising his or her rights pursuant to this chapter, including being present when the patient self-administers medication, shall not for any purpose, constitute elder abuse, neglect, assisted suicide, mercy killing [euthanasia] or homicide under any civil or criminal law or for purposes of professional disciplinary action. (Emphasis added).[33]

Massachusetts’ death certificates have seven categories for reporting the manner of death, five of which are substantive:  natural cause; accident; homicide; suicide and therapeutic complication.[34]

As noted in the previous section, euthanasia deaths will be reported as caused by a terminal disease, not euthanasia or homicide. The death is also not an accident due its being intentionally performed; it is not suicide due to it’s being performed by another person; it is not a therapeutic complication. This leaves “Natural.”

With this situation, the manner of death for a traditional euthanasia must be reported on the death certificate as Natural. The significance is that doing so will create a legal inability to prosecute for murder. The official legal manner of death will be natural, not homicide, as a matter of law. The bills will create a perfect crime.


Per a 2005 article in the UK’s The Guardian newspaper, there was a public inquiry regarding Dr. Shipman’s conduct, which determined that he had “killed at least 250 of his patients over 23 years.”[35] The inquiry also found:
that by issuing death certificates stating natural causes, the serial killer [Shipman] was able to evade investigation by coroners.[36] 
Per a subsequent article in 2015, proposed reforms included having a medical examiner review death certificates, so as to improve patient safety.[37] Instead, the instant bills move in the opposite direction to require a legal coverup in which doctors and other perpetrators will be empowered to kill with impunity.


Slayer statutes block persons from receiving an inheritance when they murder a person from whom they stand to inherit.”[38] The rational is simple.[39] No one should financially benefit from his or her own crime.”[40]

In Massachusetts, the slayer statute applies when there is a murder conviction for homicide. Actions taken pursuant to the bills, however, are not homicide.[41] Again, the bills state:
Actions taken by health care providers and patient advocates supporting a qualified patient exercising his or her rights pursuant to this chapter, including being present when the patient self-administers medication, shall not for any purpose, constitute elder abuse, neglect, assisted suicide, mercy killing [euthanasia] or homicide under any civil or criminal law or for purposes of professional disciplinary action.  (Emphasis added).[42]
With this situation, the slayer statute will not apply to deaths pursuant to the bills because legally there will be no homicide, and therefore no murder. It won’t matter that the lethal dose was administered to the decedent against his or her will or that he or she was tricked into taking it.  Perpetrators will be allowed to inherit.


  A. The Swiss Study: Physician-Assisted Suicide Can Be                   Traumatic for Family Members

A European research study addressed trauma suffered by persons who witnessed legal physician-assisted suicide in Switzerland.[43] The study found that one out of five family members or friends present at an assisted suicide was traumatized. These people,
experienced full or sub-threshold PTSD [Post Traumatic Stress Disorder] related to the loss of a close person through assisted suicide.[44]
B. My Clients Suffered Trauma in Oregon and Washington             State

I have had two cases where my clients and their family members suffered severe emotional trauma due to legal assisted suicide. One case was in Oregon, the other case was in Washington State.

In the first case, one side of the family wanted the father/patient to take the lethal dose, while the other side did not. The father spent the last months of his life caught in the middle and torn over whether or not he should kill himself. My client, his adult daughter, was severely traumatized. The father did not take the lethal dose and died a natural death.

In the other case, it’s not clear that administration of the lethal dose was voluntary. My client, although he was not present, was severely affected by the incident and also by the sudden loss of  his father.


If enacted, the bills will apply to people with years or decades to live. Some assisting persons, including doctors and family members, will have an agenda, with the more obvious reasons being inheritance and life insurance, but also, as in the case of Dr. Swango, the thrill of seeing someone die.

The bills’ lack of required oversight at the death, coupled with the mandatory falsification of the death certificate will provide cover for murder and create a perfect crime. Families and individuals will be traumatized.

I urge you to vote “No” on H. 1926 and S. 1208.

Margaret Dore, Esq., MBA
Law Offices of Margaret K Dore, P.S.
Choice is an Illusion, a nonprofit corporation


[1] A copy of my bio is in the appendix, at page A-1.
[2] Craig A. Brandt, Model Aid-in-Dying Act, Iowa Law Review,
1989 Oct; 75(1): 125-215, (“Subject: Active Euthanasia ....”); and
Maria T. CeloCruz, “Aid-in-Dying: Should We Decriminalize
Physician-Assisted Suicide and Physician-Committed Euthanasia?,”
summary pages, in the appendix, at A-2 & A-2A.
[3] Patient’s Rights Council, “Assisted Suicide Laws in the United States,”
[4]  In the last nine years, at least eight states have strengthened their laws against assisted suicide and/or euthanasia. These states include: Alabama, Arizona, Georgia, Idaho, Louisiana, New Mexico, Ohio and Utah. See backup documentation in in the appendix, at pages A-3 to A-7. See also (regarding a New Mexico Supreme Court decision overruling legal assisted suicide); (regarding Ohio’s statute) and (regarding Utah bill).
[5]  The AMA Code of Medical Ethics, Opinion 5.7, in the appendix, page A-8.
[6]  Id.
[7]  Opinion 5.8, “Euthanasia,” attached in the appendix, at page A-9.
[8]  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, 01/13/09, attached in the appendix, at pp. A-10 to A-12; quote at A-12.
[9]  "Sawyer Arraigned on State Fraud Charges," KTVZ.COM, 08/16/16, attached in the in the appendix, at page A-13.
[10] R v Morant [2018] QSC 251, Order, 11/02/18, excerpts in the appendix, at pp. A-14 and A-15. Full opinion available here:
[11]  Morant opinion, ¶ 78, attached in the appendix, at A-15.
[12]  Charlie Leduff, “Prosecutors Say Doctor Killed to Feel a Thrill,” The New York Times, 09/07/00, attached in the appendix, at pages A-16 to A-18, (“Basically, Dr. Swango liked to kill people. By his own admission in his diary, he killed because it thrilled him.”)  See also: CBSNEWS.COM STAFF, “Life in Jail for Poison Doctor,” 07/12/00,
[13]  David Batty, “Q & A: Harold Shipman,” The Guardian, 08/25/05, at  (Attached in the appendix, at A-19 to A-21).  See also Fiona Guy, “Healthcare Serial Killers: Doctors and Nurses Who Kill,” Crime Traveler, (2015, Sept 09), available at 
[14]  The bills state:
“Terminally ill" means having a terminal illness or condition which can reasonably be expected to cause death within 6 months, whether or not treatment is provided.
H. 1926 and S. 1208, lines 78 to 79. A copy of H. 1926 is in the appendix, at pages A-22 to A-38.
[15]  See: Jessica Firger, “12 Million Americans Misdiagnosed Each Year,” CBS NEWS, April 17, 2014, attached in the appendix, at A-39; and Nina Shapiro, “Terminal Uncertainty ...,” supra, excerpts attached hereto in the appendix, at A-10 to A-12.
[16]  Affidavit of John Norton, attached in the appendix, at A-40 to A-42.
[17]  Id., ¶ 5.
[18]  See the bills in their entirety, which are currently identical. Bill H. 1926 is attached in in the appendix, at pages A-22 to A-38.
[19]  The bills, § 6, lines 151 to 179, attached in in the appendix, at A-30 & A-31.
[20]  The bills state:
(1) The attending physician shall: ...
(k) ensure that all appropriate steps are carried out in accordance with this chapter before writing a prescription for medication for a qualified patient ....  (Emphasis added).
The bills, line 152, and lines 178 to 179, attached in the appendix, at A-30 and A-31.
[21]  See the bills in their entirety.
[22]  Definitions attached in the appendix, at pages A-45 to A-46.
[23]  The bills, § 1, lines 14-17. (Attached in the appendix, at A-23).
[24]  Id.
[25]  See the bills in their entirety.
[26]  In Oregon and Washington State, reported drugs include Secobarbital, Pentobarbital, Phenobarbital and Morphine Sulfate, which are water and/or alcohol soluble. See excerpts from Oregon’s and Washington’s annual reports, in in the appendix, at pp. A-43 and A-44.  See also, and
[27]  Alex Schadenberg, Letter to the Editor, “Elder abuse a growing problem,” The Advocate, Official Publication of the Idaho State Bar, October 2010.
[28]  The bills, Section 1, line 10, attached in the appendix, at A-22
[29]  Id., lines 76 to 77.
[30]  See the bills in their entirety.
[31]  Attached in the appendix, at A-47.
[32]  The bills, §6(2), lines 189 to 190, attached in the appendix, at A-32.
[33]  The bills, lines 252 to 256.
[34]  See Massachusetts “Death Certificate Medical Certifier Worksheet,” attached in the appendix, at A-48.
[35]  David Batty, attached in the appendix, at A-19.
[36]  Id., attached hereto at A-21.
[37]  Press Association, “Death Certificate Reform Delays ‘Incomprehensible,” The Guardian, January 21, 2015, attached in the appendix, at A-49 to A-50.
[38]  Cushing and Dolan, PC, Attorneys at Law, “What are Slayer Statutes,” January 28, 2015, in the appendix, at A-51 to A-52.
[39]  Ilene S. Cooper and Jaclene D’Agostino, Forfeiture and New York’s “Slayer Rule,” NYSBA Journal, March/April 2015, attached in the appendix, at A-55.
[40]  Id.
[41]  Cushing and Dolan, in the appendix, at A-52. See also “Taking from deceased victim’s estate prohibited,” attached in the appendix, at A-53. The bar to inheritance applies “only to murder in the first degree, murder in the second degree or manslaughter.”
[42]  The bills, lines 252 to 256.
[43]  “Death by request in Switzerland: Post-traumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2012) 542-546, available at  (Cover page attached in the appendix, at A-56).
[44]  Id.