Monday, October 27, 2014

The Brittany Maynard Case Illustrates Problems With Legal Assisted Suicide.

By Margaret Dore, Esq., MBA

Brittany Maynard is a beautiful young woman with a brain tumor. For the last two weeks, her story has been promoted by the former Hemlock Society, now known as Compassion & Choices, in an aggressive multi-media campaign.

1. There is a Risk of Suicide Contagion.

It is well known that media reporting of suicide can encourage other suicides, for example, a "copycat suicide" or a "suicide contagion." A famous example is Marilyn Monroe.  Her widely reported suicide was followed by a increase in other suicides.

This encouragement phenomenon can also occur when the inspiring death is not a suicide.  An example is the televised hanging of Saddam Hussein, which led to suicide deaths of children worldwide.  An NBC News article begins:
The boys' deaths - scattered in the United States, in Yemen, in Turkey and elsewhere in seemingly isolated horror - had one thing in common:  They hanged themselves after watching televised images of Saddam Husseins' execution.
http://www.nbcnews.com/id/16624940/ns/world_news-mideast_n_africa/t/copycat-hangings-follow-saddam-execution/#.VDr5AfldWSo

Groups such as the National Institute of Health and the World Health Organization have developed guidelines for reporting suicide. Important points include that the risk of additional suicides increases "when the story explicitly describes the suicide method, uses dramatic/graphic headlines or images, and repeated/extensive coverage." http://www.nimh.nih.gov/health/topics/suicide-prevention/recommendations-for-reporting-on-suicide.shtml See also: http://www.who.int/mental_health/prevention/suicide/resource_media.pdf

The media campaign by the suicide advocacy group, Compassion & Choices, to promote the death of Ms. Maynard, by "aid in dying," a euphemism for legal assisted suicide in Oregon, violates all of these guidelines.  We are told of the planned method, when and where it will take place and who will be there.  There is repeated extensive coverage in multiple media.

With this situation, the risk of suicide contagion associated with Compassion & Choices' media campaign is real.  The persons at risk include children.

2. Family Members who Witness an Assisted Suicide Can be Traumatized.

According to media reports, Ms. Maynard's plan is to have her family present when she goes, and that with this situation, she hopes to spare them emotional pain.[1]  If so, she may want to reconsider her plan.  A Swiss study of family members and friends who witnessed legal assisted-suicides in Switzerland found that 20% had “severe mental health problems at 14 to 24 months post-loss.”

Here's a link to an article about the study: http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf  Here's the conclusion:
[T]he findings suggest that witnessing death by assisted-suicide impacts the mental health of family members and friends.  About 20% of our respondents had full or partial PTSD and 16% had symptoms of depression after about 19 months after the death. Witnessing the unnatural death of a significant person thus seems to have a strong impact on the bereaved, which may lead to severe mental health problems at 14 to 24 months post-loss.  Id.
3.  Legal Assisted Suicide Encourages People with Years to Live, to Throw Away Their Lives.

In Oregon, assisted suicide is legal for persons with a “terminal disease,” which is defined in terms of a prediction of less than six months to live.[2]

According to media reports, Ms. Maynard has a brain tumor, which is end stage and death is “certain.”  On the other hand, doctors can be wrong.  Consider this article from Washington State, describing the case of Maryanne Clayton:
She . . . had Stage IV lung cancer, the most advanced form there is. Her tumor had metastasized up her spine. . . . The doctor gave [her] two to four months to live. . . . 
That was almost four years ago.[3]
Legal assisted suicide encourages people with years to live, to throw away their lives.
4. Assisting Persons, including Institutions and Organizations, can have their own Agendas.

The recent Melchert-Dinkel case shows a reality that people tend to forget, that with legal or illegal assisted suicide, the assisting person can have an agenda.  For Melchert-Dinkel, his agenda was to get other people to hang themselves in front of his webcam.  He told police that he did it for the "thrill of the chase" See http://www.independent.co.uk/news/world/americas/suicideobsessed-us-nurse-convicted-of-helping-coventry-man-kill-himself-9722534.html

Meanwhile, in Oregon, that state's Medicaid program has a well-documented agenda to steer patients to suicide via coverage incentives.  See https://maasdocuments.files.wordpress.com/2014/08/bradley-c-c-missoulian-as-published.pdf  Similarly, the former Hemlock Society, Compassion & Choices, has an agenda for a public policy change, to reduce patient access to cures.  Id.

Compassion & Choices also has an agenda to ensure that its assisted suicides succeed.  They are nearly always present during Oregon assisted suicides.  They also encourage family members to be present, which as noted above, is reportedly contemplated by Ms. Maynard.  With this situation, the event is similar to a wedding, in which everyone is there and watching. There can be social pressure to go forward.

* * *
Margaret Dore is an attorney in Washington State where assisted suicide is legal.  She is a former Law Clerk to the Washington State Supreme Court.  She is President of Choice is an Illusion, a 501(c)(4) nonprofit corporation.  Choice is an Illusion welcomes everyone opposed to assisted suicide and euthanasia regardless of your views on other issues.  See www.margaretdore.com  www.choiceillusion.org  

[1] See https://choiceisanillusion.files.wordpress.com/2014/10/29-year-old-woman_-why-im-taking-my-own-life.pdf (regarding Ms. Maynard's intention to have her family present, with one of her goals being “to put myself through less physical and emotional pain and my family as well”). (Emphasis added).  
[2] ORS 127.800 s.1.01(12).
[3] 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? The Seattle Weekly, January 14, 2009. For un-formatted online version, go here: http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty  For pdf, go here: https://choiceisanillusion.files.wordpress.com/2013/10/terminal-uncertainty.pdf

Thursday, October 2, 2014

The Perils of Assisted Suicide

11:15 a.m. EDTOctober 2, 2014


This story illustrates a fundamental problem with legalizing assisted suicide. The assistant can have his or her own agenda to encourage someone to kill themselves.

Bradley D. Williams, Hamilton, Mont.

Monday, March 3, 2014

Family members banned from care facilities threaten legal action

People who say they're being prevented from visiting family members at long-term care facilities in Alberta, but not told why, are asking the government to step in.

'I was threatened by the physician," said Huguette Hebert, who was banned for a day from seeing her husband staying at a Covenant Health facility in Edmonton, after she asked to stay in the room while he was changed.

She said she wanted to check for bedsores.

"It's time that somebody does something at the government level, like the minister of health," she said at a news conference Thursday. "You know my name, I really request that you intervene now."

Hebert is one of many Albertans who've had problems seeing their loved ones at continuing care facilities, says lobby group Public Interest Alberta.

Shauna McHarg hasn't seen her father in his care facility for two years ­ and has severely restricted visiting hours with her mother.

"They give no reason," she said. "My parents are aging. This started in 2010. It needs to end immediately."

McHarg appealed to the Ombudsman and the Privacy Commissioner, but Covenant Health refuses to release the reason why she was banned, even fighting the matter in court last week.

People banned from facilities should have more options, said the PIA lawyer Allan Garber.

"These decisions are being made without the due process of law," he said. "And that is a fundamental problem. Especially when we know the people on the other side are frail, elderly people."

Covenant Health said it bans visitors only on rare occasions and only when it believes safety of the patients is in jeopardy.

But the facilities have all the power, leaving banned family members with little recourse, said PIA executive director Bill Moore-Kilgannon.

"They cannot just ban people from seeing their loved ones without a strict process, evidence and guidelines," he said.

"If the government is not willing to act to empower families with real due process, then we will explore taking legal action to represent the rights of these families to be together," Moore-Kilgannon said.

Monday, January 27, 2014

"Is there a way to allow a person to end his life without making someone else a criminal?"

By Margaret Dore, Esq.*

A legislator considering an assisted suicide law asked me this question: "Is there a way to allow a person to end his life without making someone else a criminal?"

This was my (slightly edited) response:

People take their lives all the time.  One of my cousins shot himself and another threw himself in front of a train.  There was no criminality involved.  Also, if people are in pain, palliative care laws allow medical personnel to give patients copious amounts of drugs, including up to sedation, which can hasten the patient's death. This is the principal of double effect.  This is legal.  For more information, read theAffidavit of Kenneth Stevens, MD, page 3, paragraph 13.

There is also palliative care abuse in which no one seems to be held accountable, except for maybe one case in California where doctors relied on a wealthy patient's daughters, who said that their father was really bad off and didn't want treatment, which was not the case.  At least, that's what's claimed by the man's son. See William Dotinga, "Grim Complaint Against Kaiser Hospital," Court House News Service, February 6, 2012.

I've had like 15-20 contacts in the past year by people upset about their family member being suddenly off'd by medical personnel and/or having DNR's put on family members/friends without the patient's consent.  My caregiver friends also talk about guarding their patients in the hospital.  Here are some letters from Montana.  http://www.montanansagainstassistedsuicide.org/2013/04/dont-give-doctors-more-power-to-abuse.html

Here's a letter from Washington State where assisted suicide is legal. The letter talks about doctors being quick with the morphine and also regarding the conduct of an adult son shortly after our assisted suicide law was passed ("an adult child of one of our clients asked about getting the pills [to kill the father].  It wasn't the father saying that he wanted to die"). http://www.montanansagainstassistedsuicide.org/2012/07/dear-montana-board-of-medical-examiners.html  Here's a letter from a wife about how she was afraid to leave her husband alone after a doctor pitched assisted suicide to her husband. http://www.montanansagainstassistedsuicide.org/2013/01/i-was-afraid-to-leave-my-husband-alone.html

There is also the issue that people who say they want to die don't mean it, as with any suicide.  See http://www.montanansagainstassistedsuicide.org/p/what-people-mean-when-they-say-they.html

I've had two clients whose fathers signed up for the Oregon/Washington assisted suicide acts.  With the first case, one side of the family wanted the father to use the act and the other side didn't.  He spent the last months of his life torn over whether of not he should kill himself.  His daughter was also traumatized.  He died a natural death.  There is a Swiss study that you might be interested in, that 1 out of 5 family members were traumatized by witnessing the legal assisted suicide of a family member.  See http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf

In my other case, the father had two suicide parties and it's not clear that it was voluntary.  My client, his son, was told that his dad had said "You're not killing me, I'm going to bed").  Regarding the next day, my client was told that his dad was already high on alcohol when he drank the lethal dose.  But then the person telling him this changed his story.  In Montana, Senator Jeff Essman, made a relevant observation regarding this point:
"[All] the protections [in Oregon's law] end after the prescription is written.  [The proponents] admitted that the provisions in the Oregon law would permit one person to be alone in that room with the patient. And in that situation, there is no guarantee that that medication is self-administered.
So frankly, any of the studies that come out of the state of Oregon's experience are invalid because no one who administers that drug . . . to that patient is going to be turning themselves in for the commission of a homicide."
Senate Judiciary Hearing on SB 167 on February 10, 2011

I, however, doubt that a person in Oregon could be prosecuted.  If you read the act carefully, there is no requirement of patient consent to administration of the lethal dose, and to the extent that's ambiguous, there's the rule of lenity.  In Washington State, prosecutors are required to report assisted suicide deaths as "Natural" - no matter what - at least, that's what the regulation says: http://www.doh.wa.gov/portals/1/Documents/5300/DWDAMedCoroner.pdf   How can you prosecute someone for homicide if the death is required to be reported as "Natural?"

Here in Washington, we have already had some informal proposals to expand the scope of our assisted suicide act.  One in particular disturbed me.  A Seattle Times column suggested euthanasia as a solution for people unable to support themselves, which would be involuntary euthanasia.  See Jerry Large, "Planning for old age at a premium," March 8, 2012, which states:
"After Monday's column,  . . . a few [readers] 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."  (Emphasis added)
So, if you worked hard and paid taxes all your life and then your company pension plan goes belly up, this is how you want society to pay you back?

As a Democrat, I see us as looking out for the little guy, not passing laws to protect perpetrators, healthcare systems, etc. from legitimate claims.  I hope that you will vote against any effort to legalize assisted suicide/euthanasia.

Thank you for writing me back.

Margaret Dore, Esq.