Showing posts with label Oregon. Show all posts
Showing posts with label Oregon. Show all posts

Sunday, December 30, 2012

Assisted Suicide's Dangerous Illusion of Control

http://www.calgaryherald.com/opinion/columnists/Johnston+Assisted+suicide+dangerous+illusion+control/7716999/story.html

By Will Johnston, MD

The daughters are beside themselves. One sat in my office recently, telling me about her father’s trips to the bank that are draining his savings. He gets angry when his daughters challenge him.

The money — thousands of dollars, slowly saved from a meagre pension and needed for his care — seems to be going to a recently acquired girlfriend some years younger than himself. He speaks almost no English. The situation was detected by chance when a daughter gave him a ride to the bank and saw his bank book.

Some time ago, I performed a competency assessment on a socially isolated older person who had been placed in a nursing home. An unrelated neighbour had listed the person’s home for sale and was receiving inquiries before a relative became aware.

On another occasion, an older woman had adequate resources to stay in her attractive home and employ a live-in caregiver. A family member, an heir and beneficiary, arranged to have her met at her door by an ambulance crew with a gurney. She was told that if she did not co-operate, the police would be called. She submitted and was transported to a dingy nursing home that she described as a prison. Her home was sold.

A colleague recalls being on duty in an emergency room several years ago when an older bachelor came in desperately ill and confused, accompanied by his niece and nephew.

“He’s had a good life. He wouldn’t want any treatment,” his only relatives (and presumably heirs) attested. With ordinary care and rehydration, the older man walked out of hospital a week later.

Each of these scenarios is different, and none of them grace a research paper, but all of them are the real face of elder abuse. I could list 10 more from my own experience. Government of Canada policy recognizes the epidemic of elder abuse and the unusual difficulty of detecting it, often because the victim resists the revelation of abuse.

I routinely see people induced to do things and accept arrangements that are contrary to their own interests. People can be surprisingly naive.

High profile assisted suicide cases might at first seem to be about another kind of person, a sophisticated and clear-minded sort, immune to undue influence. I suggest that this presumption is also naive.

We all take our cues from those around us. It only takes a few words to promote suicide. If the law is changed, an obligation to mention the legal fact of assisted suicide will be created. Some patients will experience even the most perfunctory acknowledgment of assisted suicide as an inducement to it.
If state-sanctioned suicide becomes part of the atmosphere in our hospitals, a presumption in that direction will be created. I predict the same erosion of medical diligence that many of us on the front lines have already watched happen when caregivers choose to see a patient as having finished all useful life. How much more will this be the case when the patient’s present fear and loss of hope feed smoothly into an official assisted-suicide regime?

Some people would throw away months or years of life, and some would miss good medical care or medical advances they would have wanted to enjoy.

Consider the case of Jeanette Hall, who wanted to use Oregon’s assisted suicide law and is grateful, 12 years later, that her doctor directed her toward treatment rather than suicide.
One of Dr. Ken Stevens’ Oregonian patients was not so lucky — part way into his cancer treatment, he became despondent and was given suicide pills by another doctor.

I know someone, happy to be alive, who had alarming symptoms and a clear diagnosis of Lou Gehrig’s disease more than a decade ago. The symptoms inexplicably resolved. Huntington’s disease, a factor in a recent high-profile suicide in Toronto, moved closer to a treatment recently in a stem cell experiment.

If a legal assisted suicide offer is always dangling, variations in the competence and diligence of doctors create arbitrary forces that move choice and control to others, not the patient.

When you or your loved one goes to the hospital, you need to be able to trust that an assisted-suicide-minded doctor or nurse will not be steering you or them toward death. People can be offered the illusion of control and autonomy when the choices are really being shaped by others.

When empowered medical personnel — and right-to-die activists — choose their own opinions about your quality of life, and have been given constitutional protection to counsel, facilitate and steer you toward suicide, you and your loved ones will not be safe.

The choices created by legal assisted suicide may end up being someone else’s, not yours. The speculative legal changes being offered are dangerous and irresponsible. Parliament rejected them firmly two years ago. We will all be safer if our courts do the same.

Dr. Will Johnston is chair of the Euthanasia Prevention Coalition of BC
Read more: http://www.calgaryherald.com/Johnston+Assisted+suicide+dangerous+illusion+control/7716999/story.html#ixzz2GZkbdvWG

Wednesday, October 24, 2012

Legal Assisted Suicide Can Cause Anguish

By Margaret Dore

I am a lawyer in Washington State USA where assisted suicide is legal.  I am also President of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide.

In 2011, a study was released in Switzerland where assisted-suicide is legal.  The study found that approximately 1 out of 5 family members or friends who were present at an assisted suicide were traumatized.  They "experienced full or sub-sthreshold [Post Traumatic Stress Disorder] related to the loss of a close person through assisted suicide."[1]

This is consistent with what I have observed with clients whose parents have participated in the Washington/Oregon death with dignity acts.  With one client, the doctor had suggested assisted-suicide to the parent.  After that, one branch of the family wanted the parent to use the lethal dose, while the other did not.  The parent spent much of his final days struggling over whether or not to kill himself.  This was instead of making the best of the time that he had left.  My client was also traumatized.  In that case, the parent died a natural death.

With another case, it's unclear that the assisted-suicide death was voluntary.  My client lives with that memory.


Legal assisted suicide is sold as a peaceful and loving death.  It may be anything but.

* * *

[1] B. Wagner, J. Muller, A. Maercker, "Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide," European Psychiatry 27 (2012) 542-546, available at http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf

Saturday, September 22, 2012

Leblanc case: Oregon Health Plan Steers Patients to Suicide

Yesterday, the Canadian Department of Justice filed evidence in Leblanc v. Canada, including the affidavit of Oregon doctor Ken Stevens.  Therein, Dr. Stevens talks about his patient, Jeanette Hall.  He also describes how with legal assisted suicide, the Oregon Health Plan steers patients to suicide.  His affidavit concludes:

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


Please find the full text of his affidavit below.  To view a hard copy of his affidavit with supporting documentation, click here

Tuesday, August 14, 2012

Oregon & Washington: Users of Assisted Suicide are Seniors with Money

By Margaret Dore, Esq.
Updated August 14, 2012
Originally published on
 Mass Against Assisted Suicide

This week, a New York Times article expressed "surprise" regarding the users of assisted suicide:  "They are overwhelmingly white, well educated and financially comfortable."[1]  They are also age 65 and older.[2]  In other words, users are older people with money, which would be the middle class and above, a group disproportionately at risk of financial abuse.[3]

The Oregon and Washington assisted suicide acts, and the similar Massachusetts proposal, do not protect users from this abuse. Indeed, the terms of these acts encourage financial abuse.  These acts allow heirs and other persons who will benefit from an elder's death to actively participate in the lethal dose request.[4]  There is also no oversight when the lethal dose is administered, not even a witness is required.[5]  This creates the opportunity for an heir, or someone else who will benefit from the person's death, to administer the lethal dose to that person without his consent.  Even if he struggled, who would know?


Under the Washington act and the Massachusetts' proposal, the death certificate is required to reflect a natural death.[6]  In Oregon, a natural death is listed by custom.[7]  A concerned nephew, learning that his aunt has suddenly died and that she had a new will favoring a ne'er do will son, will thereby be mislead as to what actually happened.

This does not mean that all deaths under the Oregon and Washington acts are  abusive or without consent.  What it means is that these laws, and the similar Massachusetts proposal, invite abuse and have a distinct lack of transparency.  In Oregon, not even law enforcement is allowed to access state-collected information about these deaths.[8]  Even if the person struggled, who would know?

In the New York Times article, a description of the patient's wife indicates her discomfort with her husband's decision:  "[S]he does not want the pills in the house, and he agrees.  'It just feels so negative," she said."[9]

For more information about specific problems with the Massachusetts' proposal, click here and here.  For a "fact check" on the proposal, click here.

* * *

[1]  Katie Hafner, "In Ill Doctor, a Surprise Reflection of Who Picks Assisted Suicide," New York Times, August 11, 2012.
[2]  See e.g., the most current official report from Oregon, "Oregon Death with Dignity Act--2011" ("Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70 years"), available athttp://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf
[3]  The MetLife Study of Elder Financial Abuse, "Crimes of Occasion, Desperation, and Predation Against America's Elders," June 2011 (a follow up to MetLife's 2009 "Broken Trust: Elders, Family, and Finances"), available athttp://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf
.
[4]  See Memo to Joint Judiciary Committee (regarding Bill H.3884, now ballot measure No. 2), Section III.A.2. ("Someone else is allowed to speak for the patient") and 
and Section II.C. ("One of the [two] witnesses [on the lethal dose request form] is allowed to be an heir who will benefit financially from the patient's death"), available at http://www.massagainstassistedsuicide.org/p/memo-to-joint-judiciary-committee.html
[5]  See above memo at Section III.A.1("No witnesses at the death").  See also entire proposed Massachusetts Act at http://choiceisanillusion.files.wordpress.com/2011/10/ma-initiative.pdf
[6]  See proposed Massachusetts Act at Section 4 (2) ("The attending physician may sign the patient's death certificate which shall list the underlying terminal disease as the cause of death").  Washington's act, RCW 70.245.040(2) has this same language. 
[7]  See e.g., Charles Bentz, "Oregon Doctor's Letter to Massachusetts Medical Society," posted November 28, 2011 ("His death certificate listed the cause of death as melanoma.  The public record is not accurate. My depressed patient did not die from his cancer, but at the hands of a once-trusted colleague."), available at http://www.massagainstassistedsuicide.org/2011/11/oregon-doctors-letter-to-massachusetts.html#more 
[8]  See E-mail from Alicia A. Parker, Mortality Research Analyst, Center for Health Statistics, Oregon Health Authority, January 4, 2012 ("We have been contacted by law enforcement and legal representatives in the past, but
have not provided identfying information of any type"), available at http://epcdocuments.files.wordpress.com/2012/08/alicia-a-parker.pdf
[9]  Katie Hafer, above at note 1.

Saturday, April 21, 2012

Dore v Morris: Assisted suicide debate deals with abuse, compassion

http://www.kamloopsnews.ca/article/20120419/KAMLOOPS0101/120419759/-1...
Lawyer cautions against legislating through courts

By Mike Youds, Daily News Staff Reporter
 
Margaret Dore (L) and Wanda Morris (R)

A right to medically assisted suicide may sound compassionate and just, but beware the details when it comes to the act itself, a U.S. lawyer warned Wednesday in a debate at TRU.

Margaret Dore shared some of her experiences with assisted suicide in Washington State, where the practice became legal through a ballot measure four years ago.


 "A lot of people think this is a great idea until they start thinking and reading about how you do it," she told an audience of about 30 people in the Irving K. Barber Centre.

In effect, laws in Washington and Oregon empower people who may choose to abuse the responsibility, Dore said.

"Your heir can be there to help you sign up. Once the legal dose leaves the pharmacy, there is no oversight whatsoever."

Monday, January 2, 2012

"If euthanasia were legal, the wife, not wanting to die, would still be a victim"

The Danger of Euthanasia
By Alex Schadenberg, Ottawa Citizen January 2, 2012
 
Re: Time to rethink euthanasia, Dec. 29.

Marcel Lavoie implies that legalizing euthanasia would stop violent deaths in the elderly, such as the death of Doreen Flann by stabbing.

In many of these deaths, the perpetrator-husband also kills himself for a murder-suicide.
In Oregon, where assisted-suicide has been legal since 1997, murdersuicide has not been eliminated. Indeed, murder-suicide follows the national pattern.

Moreover, according to Donna Cohen, an expert on murder-suicide, the typical case involves a depressed, controlling husband who shoots his ill wife: "The wife does not want to die and is often shot in her sleep. If she was awake at the time, there are usually signs that she tried to defend herself."

If euthanasia were legal, the wife, not wanting to die, would still be a victim.

Our laws against assisted suicide and euthanasia are in place to protect vulnerable people. Assisted suicide and/or euthanasia should not be legalized in Canada.

[For more indepth information, see Dominique Bourget, MD, Pierre Gagne, MD, Laurie Whitehouse, PhD, "Domestic Homicide and Homicide-Suicide:  The Older Offender," Journal of the American Academy of Psychiatry and the Law, September 2010 (Canadian study);  Don Colburn, "Recent murder-suicides follow the national pattern," The Oregonian, November 17, 2009; and “Murder-suicides in Elderly Rise: Husbands commit most murder-suicides – without wives’ consent” ]

Alex Schadenberg, London
Executive Director, Euthanasia Prevention Coalition

Thursday, December 29, 2011

"If euthanasia were legal, the wife, not wanting to die, would still be a victim"

Dear Editor:

Marcel Lavoie implies that legalizing euthanasia would stop violent deaths in the elderly, such as the death of Doreen Flann by stabbing at the hands of her husband, Ian. [“Time to rethink euthanasia,” Dec. 29th
]. In many of these deaths, the perpetrator-husband also kills himself for a murder-suicide.   

In Oregon where assisted-suicide has been legal since 1997, murder-suicide has not been eliminated. Indeed, murder-suicide follows “the national pattern.” Moreover, according to Donna Cohen, an expert on murder-suicide, the typical case involves a depressed, controlling husband who shoots his ill wife:
 
“The wife does not want to die and is often shot in her sleep. If she was awake at the time, there are usually signs that she tried to defend herself.”
 
If euthanasia were legal, the wife, not wanting to die, would still be a victim.

Our laws against assisted suicide and euthanasia are in place to protect vulnerable people. Assisted suicide and/or euthanasia should not be legalized in Canada.
 
Link to a Canadian study published in September 2010 - http://www.jaapl.org/content/38/3/305.full
 
[Note to editor: You may be interested in these articles: Don Colburn, "Recent murder-suicides follow the national pattern," The Oregonian, November 17, 2009,  and “Murder-suicides in Elderly Rise: Husbands commit most murder-suicides – without wives’ consent.”
 
Alex Schadenberg
Executive Director
Euthanasia Prevention Coalition
Box 25033
London ON, Canada, N6C 6A8
1-877-439-3348

Tuesday, November 1, 2011

The Carter Case and Assisted Suicide: A Recipe for Elder Abuse and a Threat to Individual Rights

For shorter print versions of this article, click here and here.
For talking points, click here.

Will Johnston, MD
Margaret Dore, JD
Alex Schadenberg
November 1, 2011
"Those who believe that legal
assisted suicide . . . will assure their
autonomy and choice are naive."

William Reichel, MD
Montreal Gazette,
May 30, 2010[1]

A.  Introduction

Carter vs. Attorney General of Canada brings a constitutional challenge to Canada's laws prohibiting assisted suicide and euthanasia.[2]  Carter also seeks to 
legalize these practices as a medical treatment.[3]  Last year, a bill in Parliament seeking a similar result was overwhelmingly defeated.[4] 

This article's focus is physician-assisted suicide.

Legalizing this practice would be a recipe for elder abuse.  Legalization would also empower the Canadian health care system to the detriment of individual patient rights.  There would be other problems.

B.  Parliament Rejected Assisted Suicide

On April 21, 2010, Parliament defeated Bill C-384, which would have legalized physician-assisted suicide and euthanasia in Canada.[5]  The vote was 228 to 59.[6]
C.  The Carter Case

Friday, September 9, 2011

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 wife for 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 “second opinion” 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.

What People Mean When They Say They Want to Die


 (originally published as a Statement for the BBC)
For a print version, click here
by William Toffler, MD
______________________________________________________

There has been a profound shift in attitude in my state since the voters of Oregon narrowly embraced assisted suicide 11 years ago.  A shift that, I believe, has been detrimental to our patients, degraded the quality of medical care, and compromised the integrity of my profession. 

Since assisted suicide has become an option, I have had at least a dozen patients discuss this option with me in my practice.  Most of the patients who have broached this issue weren't even terminal. 

One of my first encounters with this kind of request came from a patient with a progressive form of multiple sclerosis.  He was in a wheelchair yet lived a very active life. In fact, he was a general contractor and quite productive.  While I was seeing him, I asked him about how it affected his life.  He acknowledged that multiple sclerosis was a major challenge and told me that if he got too much worse, he might want to “just end it.” “ It sounds like you are telling me this because you might ultimately want assistance with your own assisted suicide- if things got a worse,” I said.  He nodded affirmatively, and seemed relieved that I seemed to really understand.

I told him that I could readily understand his fear and his frustration and even his belief that assisted suicide might be a good option for him. At the same time, I told him that should he become sicker or weaker, I would work to give him the best care and support available. I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his assisted-suicide.  He simply said, "Thank you."The truth is that we are not islands.  How physicians respond to the patient’s request has a profound effect, not only on a patient's choices, but also on their view of themselves and their inherent worth.

'I was afraid to leave my husband alone'”

Letter from Oregon resident, Kathryn Judson, Published in the Hawaii Free Press, February 15, 2011.  To view the original letter, click here and scroll down towards the bottom of the page.   

Dear Editor,

Hello from Oregon.

When my husband was seriously ill several years ago, I collapsed in a half-exhausted heap in a chair once I got him into the doctor's office, relieved that we were going to get badly needed help (or so I thought).

To my surprise and horror, during the exam I overheard the doctor giving my husband a sales pitch for assisted suicide. 'Think of what it will spare your wife, we need to think of her' he said, as a clincher.

Now, if the doctor had wanted to say 'I don't see any way I can help you, knowing what I know, and having the skills I have' that would have been one thing. If he'd wanted to opine that certain treatments weren't worth it as far as he could see, that would be one thing. But he was tempting my husband to commit suicide. And that is something different.

I was indignant that the doctor was not only trying to decide what was best for David, but also what was supposedly best for me (without even consulting me, no less).

We got a different doctor, and David lived another five years or so. But after that nightmare in the first doctor's office, and encounters with a 'death with dignity' inclined nurse, I was afraid to leave my husband alone again with doctors and nurses, for fear they'd morph from care providers to enemies, with no one around to stop them.

It's not a good thing, wondering who you can trust in a hospital or clinic. I hope you are spared this in Hawaii.

Sincerely,

Kathryn Judson, Oregon

" If my doctor had believed in assisted suicide, I would be dead"

I'm so glad doctor didn't assist me with thoughts of suicide
http://www.tcpalm.com/news/2010/oct/19/letter-im-so-glad-doctor-didnt... 

Letter, Tuesday, October 19, 2010

I disagree with Marshall Frank's column, "Florida ready for its own Death with Dignity Act, to give terminally ill patients a choice." Here in Oregon we have such a law. In other words, assisted suicide is legal. Our law was enacted via 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 doing it. I tried to ask my doctor, but he didn't really answer me. I did not want to suffer. I wanted to die and I wanted my doctor to help me. Instead, he encouraged me to not give up and ultimately I decided to fight. I had both chemotherapy and radiation. I am so happy to be alive!

It is now nearly 10 years later. If my doctor had believed in
assisted suicide, I would be dead. I thank him and all my doctors for helping me choose "life with dignity." Assisted suicide should not be legal. Don't make Oregon's mistake.


Jeanette Hall
King City, Ore.