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.

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).

Teen Suicide: "Assisted Suicide Law Sends Contradictory Message"

From Vermont where the legislature is considering a bill similar to the Massachusetts assisted suicide initiative.

http://vtdigger.org/2012/02/01/page-assisted-suicide-law-sends-contradictory-message/

Editor’s note: This op-ed is by Guy Page, a parent and resident of Cambridge.

In the Jan. 19 mail I received a letter from Lamoille Union High School, where my daughter is enrolled. It begins with the following sentence: “Over the last few years Vermont has seen an increase in suicide among young people.” It went on to describe a school initiative to hopefully address this awful development. I hope they are successful. All of my children have friends, or friends of friends, who have taken their own lives.

My eldest son, Tim, was a constant suicide risk through his teens. Through the wise, compassionate help of state social workers, Tim escaped his teen years alive. I can tell you that he was personally shaken by the implications, to him, of the proposed assisted suicide law several years ago. When he heard about it, my brilliant, troubled son began to shake in anger and almost despair. “Those hypocrites,” he said. “They’ve been telling me all this time that suicide is never OK.” It didn’t matter when I said the law is meant to address another set of problems – his teenaged hypocrisy-o-meter had already pegged assisted suicide as another example of “do as I say, not as I do, it’s all right for adults, not OK for kids.”

Recently I researched teen suicide in Oregon, where assisted suicide became legal in 1998. According to the Oregon health department website, there were more teen suicides after the law passed than before — 1999: 29 suicides. 2000: 44 suicides. 2001: 31. 2002: 37. 2003: 46. 2004: 52. The last two years were the highest two-year period in their survey. Furthermore, 94 percent of teen suicide attempts leading to hospitalization were caused by ingesting drugs – the only form of assisted suicide permitted by Oregon state law. Kids learn from their elders. 

Does this “prove” a link between the Oregon physician-assisted suicide law and teen suicide? No. But the burden of proof is on those who say, “Don’t worry, it will all be OK, none of our teens will think that.” As a parent of an at-risk child, I think this law may unintentionally tell other troubled teens “when it gets too hard it’s okay to end it all.” As the letter from my daughter’s high school says, the real world is a very hard place for some teens right now, and I think this law will just make it harder.

There are plenty of other reasons to oppose this bill. Before my wife passed in February 2011, she was appalled and upset at end-of-life questions asked of her in the ICU that to her seemed motivated by hospital cost-control. It drove a (thankfully temporary) wedge of distrust between her and her caregivers. So Vermont Insurance Commissioner Steve Kimball’s newspaper comments connecting this end-of-life issue with the high cost of health care were chilling. By contrast, Orange County Sen. Mark MacDonald’s daughter was one of Diane’s nurses and provided skilled, affirming care that should be the goal of the state’s health policy. But for me the teen suicide connection is reason enough for the Senate to drop this bill before it does irreversible harm.

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Article printed from VTDigger: http://vtdigger.org/
URL to article: http://vtdigger.org/2012/02/01/page-assisted-suicide-law-sends-contradictory-message/
URLs in this post:

[1] : http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5635a2.htm

Massachusetts Voters, reject Petition 11-12

http://www.washingtontimes.com/news/2012/jan/11/massachusetts-voters-reject-petition-1112/

If adopted this November, a ballot initiative in Massachusetts will legalize physician-assisted suicide for patients whose conditions are predicted to produce death within six months. Initiative Petition 11-12 claims to ensure that the patient's decision to commit suicide is voluntary. That claim, however, is misleading.

The initiative petition requires that two persons witness the patient's written request for a lethal prescription. One witness, however, can have a financial interest in the patient's death. That person can be the only witness present when the lethal drug is taken. Thus, an interested heir could pressure the patient, and no one would know because no objective witness is required when the drug is taken. Also, the petition would require the death certificate fraudulently to list the patient's underlying condition, rather than the lethal drug, as the cause of death.

Initiative Petition 11-12 uses terms like life-ending "medication" and death in a "humane and dignified manner." But there is nothing medicinal about poison and nothing dignified about the prospects for the abuse the initiative petition would allow. It is a bad law that the voters of Massachusetts should reject decisively.
 STEPHEN L. MIKOCHIK
Professor emeritus
Temple Law School