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.

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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://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 bill: http://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

Boston Globe: "She pushed for legal right to die, and - thankfully - was rebuffed

http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/she_pushed_for_legal_right_to_die_and___thankfully___was_rebuffed/

I DISAGREE with Scot Lehigh’s Sept. 23 column, which characterizes assisted suicide as only involving people who are going to die in “a few months or weeks’’ (“Death with dignity in Mass.,’’ Op-ed). I am a retired person living in Oregon, where assisted suicide is legal. Our law was enacted through a ballot initiative that I voted for. In 2000, I was diagnosed with cancer and told that I had six months to a year to live.

 

I knew that our law had passed, but I didn’t know exactly how to go about making use of it. I tried to ask my doctor, but he didn’t really answer me. I didn’t want to suffer. I wanted to do what our law allowed, and I wanted my doctor to help me. Instead, he encouraged me not to give up, and ultimately I decided to fight the disease. I had both chemotherapy and radiation.

 

I am so happy to be alive! It is now 11 years later.

 

If my doctor had believed in assisted suicide, I would be dead. I thank him and all my doctors for helping me to choose “life with dignity.’’

 

Assisted suicide should not be legal. I hope Massachusetts does not make this terrible mistake.

 

Jeanette Hall

King City, Ore.

Oregon doctor finds fault with assisted suicide law

http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/oregon_doctor_finds_fault_with_states_law/ 

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I am a doctor practicing medicine in Oregon and Washington, where physician-assisted suicide is legal. I disagree with Scot Lehigh that these suicides are not like other suicides in which “a healthy person [takes] his life for reasons of despair, depression, or hopelessness’’ (“Death with dignity in Mass.,’’ Op-ed, Sept. 23).

First, doctors can be wrong. So, what looks like a few months to live can be years. For a good article on this subject, see Nina Shapiro’s January 2009 "Terminal Uncertainty" in the Seattle Weekly.

Second, despair, depression, and hopelessness are a part of assisted suicide. A few years ago, a patient of mine who was undergoing cancer treatment with a specialist became depressed, and expressed a wish for assisted suicide.

In most jurisdictions, suicidal ideation is interpreted as a cry for help. In Oregon, the only help my patient got was a lethal prescription intended to kill him.  Don’t make our mistake. Keep assisted suicide out of Massachusetts.

Dr. Charles J. Bentz

Portland, Ore.

 

The writer is an associate professor of medicine in the division of general medicine and geriatrics at Oregon Health & Science University.

Don't Follow Oregon's Lead

By Charles Bentz, MD, for print version, click here.

I am an internal medicine doctor, practicing in Oregon where assisted suicide is legal. I write in support of Margaret Dore’s article, "Aid in Dying: Not Legal in Idaho; Not About Choice." I would also like to share a story about one of my patients.

I was caring for a 76 year-old man who came in with a sore on his arm. The sore was ultimately diagnosed as a malignant melanoma, and I referred him to two cancer specialists for evaluation and therapy. I had known this patient and his wifefor over a decade. He was an avid hiker, a popular hobby here in Oregon. As he went through his therapy, he became less able to do this activity, becoming depressed, which was documented in his chart.

During this time, my patient expressed a wish for doctor-assisted suicide to one of the cancer specialists. Rather than taking the time and effort to address the question of depression, or ask me to talk with him as his primary care physician and as someone who knew him, the specialist called me and asked me to be the “secondopinion” for his suicide. She told me that barbiturate overdoses “work very well” for patients like this, and that she had done this many times before.

I told her that assisted-suicide was not appropriate for this patient and that I did NOT concur. I was very concerned about my patient’s mental state, and I told her that addressing his underlying issueswould be better than simply giving him a lethal prescription. Unfortunately, my concerns were ignored, and approximately two weeks later my patient was dead from an overdose prescribed by this doctor. His death certificate, filled out by this doctor, listed the cause of death as melanoma.The public record is not accurate. Mypatient did not die from his cancer, but at the hands of a once-trusted colleague. This experience has affected me, my practice, and my understanding of what it means to be a physician.


What happened to this patient, who was weak and vulnerable, raises several important questions that I have had to answer, and that the citizens of Idaho should also consider:

*  If assisted suicide is made legal in Idaho, will you  be able to trust your doctors, insurers and HMOs to give you and your family members the best care?  I referred my patient to specialty care, to a doctor I trusted, and the outcome turned out to be fatal.

*  How will financial issues affect your choices? In Oregon, patients under the Oregon Health Plan have been denied coverage for treatment and offered coverage for suicide instead. See e.g. KATUTV story and video athttp://www.katu.com/home/video/26119539.html (about Barbara Wagner). Do you want this to be your choice?

*  If your doctor and/or HMO favors assisted suicide, will they let you know about all possible options or will they simply encourage you to kill yourself?  The latter option will often involve often less actual work for the doctor and save the HMO money.

In most states, suicidal ideation is interpreted as a cry for help. In Oregon, the only help my patient received was a lethal prescription, intended to kill him.

Is this where you want to go? Please learn the real lesson from Oregon.

Despite all of the so-called safeguards in our assisted suicide law, numerous instances of coercion, inappropriate selection, botched attempts, and active euthanasia have been documented in the publicrecord.

Protect yourselves and your families.  Don’t let legalized assisted suicide come to Idaho.

Charles J. Bentz MD

Oregon Health & Sciences University

Portland, OR