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By Margaret DoreDecember 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.
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MMS Press Release: MMS Physicians Reaffirm Opposition to Physician-Assisted Suicide
December 3, 2011
http://www.massmed.org/AM/Template.cfm?Section=Online_Newsroom&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=65342
Contact: Richard P. Gulla
Phone: (781) 434-7101 Email: rgulla@mms.org
Waltham, Mass. -- December 3, 2010 – The Massachusetts Medical Society, the statewide association of physicians with more than 23,000 members, today voted to reaffirm its opposition to physician-assisted suicide, with its House of Delegates voting by a wide margin to maintain a policy the Society has had in effect since 1996.
Opposition to physician-assisted suicide was part of a larger policy statement that includes recognition of patient dignity at the end of life and the physician’s role in caring for terminally-ill patients. The policy was approved by more than 75 percent of the Society’s delegates.
Lynda Young, M.D., president of the Society, said that “Physicians of our Society have clearly declared that physician-assisted suicide is inconsistent with the physician’s role as healer and health care provider. At the same time we recognize the importance of patient dignity and the critical role that physicians have in end-of-life care.”
Dr. Young said the policy goes beyond a single statement of opposition to physician-assisted suicide to include “support for patient dignity and the alleviation of pain and suffering at the end of life.” Additionally, it includes the Society’s commitment to “provide physicians treating terminally-ill patients with the ethical, medical, social, and legal education, training, and resources to enable them to contribute to the comfort and dignity of the patient and the patient’s family.”
The policy was one of several reaffirmed and adopted at the Society’s 2011 Interim Meeting, which brings hundreds of physicians from across the state to examine and consider specific resolutions on public health policy, health care delivery, and organizational administration by the Society’s House of Delegates, its policy-making body. Resolutions adopted by the delegates become policies of the organization. . . .
The Massachusetts Medical Society, with more than 23,000 physicians and student members, is dedicated to educating and advocating for the patients and physicians of Massachusetts. The Society publishes the New England Journal of Medicine, a leading global medical journal and web site, and Journal Watch alerts and newsletters covering 13 specialties. The Society is also a leader in continuing medical education for health care professionals throughout Massachusetts, conducting a variety of medical education programs for physicians and health care professionals. Founded in 1781, MMS is the oldest continuously operating medical society in the country. For more information, visit www.massmed.org, www.nejm.org, or www.jwatch.org.
November 27, 2011
To Massachusetts Medical Society
Dear House of Delegates Officers and Other Interested Parties:
I understand that the Massachusetts Medical Association will be voting on changing its policy against physician-assisted suicide. I have been a cancer doctor in Oregon for more than 40 years. The combination of assisted-suicide legalization and prioritized medical care based on prognosis has created a danger for my patients on the Oregon Health Plan (Medicaid).
The Plan limits medical care and treatment for patients with a likelihood of a 5% or less 5-year survival. My patients in that category, who say, have a good chance of living another three years and who want to live, cannot receive surgery, chemotherapy or radiation therapy to obtain that goal. The Plan guidelines state that the Plan will not cover “chemotherapy or surgical interventions with the primary intent to prolong life or alter disease progression.” The Plan WILL cover the cost of the patient’s suicide.
Under our law, a patient is not supposed to be eligible for voluntary suicide until they are deemed to have six months or less to live. In the well publicized cases of Barbara Wagner and Randy Stroup, neither of them had such diagnoses, nor had they asked for suicide. The Plan, nonetheless, offered them suicide.
In Oregon, the mere presence of legal assisted-suicide steers patients to suicide even when there is not an issue of coverage. One of my patients was adamant she would use the law. I convinced her to be treated. Eleven years later she is thrilled to be alive. Please, don’t let assisted suicide come to Massachusetts.
[Support for this letter regarding Barbara Wagner and Randy Stroup can be found in these articles: http://www.katu.com/news/26119539.html & http://abcnews.go.com/Health/story?id=5517492&page=1 My patient’s letter in the Boston Globe describing her being alive 11 years later can be read here: http://articles.boston.com/2011-10-04/bostonglobe/30243525_1_suicide-doctor-ballot-initiative ]
Kenneth R.Stevens, Jr., MD
Sherwood, OR Professor Emeritus and former Chair, Radiation Oncology Department, Oregon Health & Science University, Portland, Oregon
RE: Massachusetts Medical Society House of Delegates
Report: 105, 1-11(A), Physician-Assisted Suicide Policy.
To members of the Massachusetts Medical Society,
I practice internal medicine in Oregon where assisted suicide is legal. I write to urge you to maintain your policy against physician-assisted suicide and have attached a copy of this letter to this email. Contrary to marketing rhetoric by suicide advocates, the safeguards do not protect patients. Please consider my patient’s story below.
I was caring for a 76 year-old man who presented to my office with a sore on his arm, eventually diagnosed as metastatic malignant melanoma. I referred him to both medical and radiation oncology for evaluation and therapy. I had known this patient and his wife for over a decade. He was an avid hiker, a popular hobby here in Oregon, and as his disease progressed, he was less able to do this, becoming depressed, which was documented in his chart.My patient expressed a wish for doctor-assisted suicide to the medical oncologist, but rather than take the time to address depression or ask me, as his primary care physician, to talk with him, the specialist called me and asked me to be the "second opinion" for his suicide. I told her that assisted suicide was not appropriate for this patient, but unfortunately, my concerns were ignored, and two weeks later my depressed patient was dead from an overdose prescribed by this doctor. His death certificate listed the cause of death as melanoma.
