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

Legalization Will Not Prevent Violent Deaths

By Margaret Dore

Assisted suicide proponents claim that legal assisted suicide will prevent violent deaths such as those by murder-suicide and suicide involving a handgun.[1] In Oregon where assisted-suicide has been legal since 1997, murder-suicide has not been eliminated.[2]  Indeed, murder-suicides follow "the national pattern."[3]  As discussed below, suicides involving a handgun have also not been eliminated.  Oregon's suicide rate has instead increased with legalization of assisted suicide.

Oregon’s overall suicide rate, which excludes suicides under Oregon’s assisted suicide act, is 35% above the national average.[4] This rate has been "increasing significantly since 2000."[5]  Just three years prior, in 1997, Oregon legalized physician-assisted suicide.[6] Other suicides thus increased, not decreased, with legalization of assisted suicide.  Moreover, many of these deaths are violent.  For 2007, which is the most recent year reported, "[f]irearms were the dominant mechanism of suicide among men."[7] The claim that legalization will prevent violent deaths is without factual support.

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[1]  See e.g. Lindsey Anderson, Associated Press, "Mass. Voters Consider Physician-Assisted Suicide," October 20, 2012, at http://www.wbur.org/2012/10/20/physician-assisted-suicide ("Dr. Marcia Angell ... believes [her father] would've lived longer and not turned to a pistol had assisted suicide been available").
[2]  See Don Colburn, "Recent murder-suicides follow the national pattern," The Oregonian, November 17, 2009 ("In the span of one week this month in the Portland area, three murder-suicides resulted in the deaths of six adults and two children") (Available at http://www.oregonlive.com/health/index.ssf/2009/11/recent_murder-suicides_follow.html); Baldr Odinson, "Fourth Murder-Suicide for the Eugene Area," New Trajectory:  A blog for Ceasefire Oregon, March 2, 2011, ("Harry Hanus, age 74, shot and killed his wife, Barbara, before taking his own life")

Robert Joyce on Elder Abuse, Other Reasons to Vote No on Question 2

"The referendum shockingly increases the risk of abuse to elders ..."

http://choiceisanillusion.files.wordpress.com/2012/10/joyce-bulletin-letter-10-18-12-pas.pdf

Dear Editor:

It’s not clear why The Bulletin titled Joe Galeota’s recent column as it did [“Terrible,” October 11, 2012].

If it’s because the column offered no information about the content of the physician-prescribed suicide referendum, I agree. That is terrible. . . . 

Let’s get serious, and consider just a few of the many reasons why voters should defeat this flawed bill.

The referendum shockingly increases the risk of abuse to elders, many of whom do not have loving families and/or have lost their circle of friends and/or have no one to advocate for them. We should consider that Massachusetts had 19,500 reported cases of elder abuse in 2011. There are insufficient elder abuse investigators to keep up with the 54 new cases reported each day. One study has suggested that there are 23.5 unreported cases for every one reported case.

The referendum does not even provide the level of protection required when a person signs a will in Massachusetts (i.e., two disinterested witnesses), and there is absolutely no oversight at the time the lethal drugs would be administered. 

The Massachusetts Medical Society, representing more than 24,000 physicians and medical students, opposes the bill. So does the American Medical Society.

Insurance companies, hospitals and governmental medical providers have a clear and compelling financial interest in denying us of adequate end-of-life care.

How much do you trust insurers, hospitals and governments? Unless you answer “with my life,” you should oppose physician-prescribed suicide and vote NO on Question Two.

It would indeed be “terrible” if we allow this referendum to pass!

Robert W. Joyce

People Living with HIV/AIDS: Is This What You Want?

By Margaret Dore, Esq.
Updated August 16, 2016

Some HIV/AIDS groups have endorsed Ballot Question 2, which seeks to legalize assisted suicide in Massachusetts.  This post suggests that these groups and/or persons living with HIV/AIDS should give the issue a second look. 

1.  "Terminal" Does Not Mean "Dying" 

The proposed act applies to persons with a "terminal disease," defined in terms of less than six months to live.[1]  In Oregon, where there is a similar act, the six months to live is determined without requiring treatment.[2] 

In other words, a person living with HIV/AIDS, who is doing well, but who is dependent on treatment to live, could be "terminal" for the purpose of assisted suicide eligibility. 

2.  The Significance of a Terminal Label

Once someone is labeled "terminal," an easy justification can be made that his or her treatment should be denied in favor of someone more deserving.  In Oregon, "terminal" patients are not only denied treatment, they are offered assisted suicide instead.  In a recent affidavit, Oregon doctor Ken Stevens states:

9.  Under the Oregon Health Plan, there is . . .  a financial incentive towards suicide because the Plan will not necessarily pay for a patient’s treatment.  For example, patients with cancer are denied treatment if they have a "less than 24 months median survival with treatment" and fit other criteria. . . . 

12. All such persons . . .  will . . . be denied treatment. Their suicides under Oregon’s assisted suicide act will be covered.[3]

Dr. Stevens concludes:

14. The Oregon Health Plan is a government health plan administered by the State of Oregon. If assisted suicide is legalized in [your jurisdiction], your government health plan could follow a similar pattern. If so, the plan will pay for a patient to die, but not to live.[4]

3.  Barbara Wagner and Randy Stroup

In Oregon, the most well known persons denied treatment and offered suicide are Barbara Wagner and Randy Stroup.[5]  Neither saw this event as a celebration of their "choice."  Wagner said: "I'm not ready to die."[6]  Stroup said: "This is my life they’re playing with."[7] 

4.  Proposals for Expansion

I live in Washington State, where assisted suicide is legal under an act passed in 2008.[8]  Four years later, there have already been proposals to expand our act to non-terminal people.[9]  Moreover, this year, there was a Seattle Times column suggesting euthanasia as a solution for people unable to afford care, which would be nonvoluntary or involuntary euthanasia for those persons who want to live.[10]

Prior to our law's being passed, I never heard anyone talk like this.

Is this what you want?

Legal assisted suicide puts anyone with a significant health condition at risk of being steered to suicide.  For other reasons to vote against assisted suicide, please click here for talking points.  I hope that AIDS groups and people living with AIDS reconsider any support of Ballot Question No. 2.  Thank you.

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Margaret Dore is a lawyer in Washington State where assisted suicide is legal. She is also President of Choice is an Illusion, a non-profit corporation opposed to assisted suicide and euthanasia.  Ms. Dore has been licensed to practice law since 1986. She is a former Law Clerk to the Washington State Supreme Court. She has several published court cases and many published scholarly articles. Her viewpoint is that people should be in control of their own fates, but that assisted suicide laws do not deliver. This year, she had an editorial published in the NY Times: "Assisted Suicide: A Recipe for Elder Abuse." For more information see www.margaretdore.com and www.choiceillusion.org

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[1]  The proposed Massachusetts act, Section 1(13) states:  "'Terminal disease" means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.  To view the entire act, go here:  http://www.massagainstassistedsuicide.org/p/initiatives-text.html

[2]  For an example, see the affidavit of Oregon doctor Ken Stevens describing his patient Jeanette Hall.  She had been given six months to a year to live by another doctor, i.e. without treatment, and had decided that she would use Oregon's law.  Dr. Stevens convinced her to be treated instead.  His affidavit can be viewed here:  http://choiceisanillusion.files.wordpress.com/2012/10/signed-ken-stevens-affidavit_001.pdf  Oregon's definition of "terminal disease" can be viewed here: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ors.aspx

[3]  Dr. Stevens affidavit can be viewed here: http://choiceisanillusion.files.wordpress.com/2012/10/signed-ken-stevens-affidavit_001.pdf 

[4]  Id.

[5]  Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," ABC News, August 6, 2008, available at http://abcnews.go.com/Health/Story?id=5517492&page=1 and "Letter noting assisted suicide raises questions,"  KATU TV, July 30, 2008, available at http://www.katu.com/news/26119539.html

[6]  KATU TV article at Note 5.

[7]  ABC News article at Note 5.
[8]  Washington State's assisted suicide law can be viewed here:  http://apps.leg.wa.gov/RCW/default.aspx?cite=70.245

[9]  See e.g.,  Brian Faller, "Perhaps it's time to expand Washington's Death with Dignity Act, The Olympian, November 16, 2011, available at http://www.theolympian.com/2011/11/16/1878667/perhaps-its-time-to-expand-washingtons.html

[10]  Jerry Large, "Planning for old age at a premium," The Seattle Times, March 8, 2012 at http://seattletimes.nwsource.com/text/2017693023.html  ("After Monday's column, some readers were unsympathetic [to people who couldn't afford their own care], a few suggested that if you couldn't save enough money to see you through your old age, you shouldn't expect society to bail you out. At least a couple mentioned euthanasia as a solution.")