tag:blogger.com,1999:blog-80548664193049700972024-03-12T09:26:36.313-06:00New MexicoA non-profit corporation opposed to assisted suicide, euthanasia and other forms of imposed death, worldwideUnknownnoreply@blogger.comBlogger17125tag:blogger.com,1999:blog-8054866419304970097.post-48559289672984586642020-08-05T04:30:00.003-06:002021-03-02T18:54:12.391-07:00Boy Driven to Suicide By Social Isolation <div style="text-align: right;">
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To view full article, <a href="https://meaww.com/11-year-old-new-mexico-boy-killed-himself-landon-fuller-coronavirus-social-isolation-parents-reveal" target="_blank">click here</a>.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrR0sJjrbnjO3d2d2GyE5itb2hzwjfTjWac83DxhO7NzovdAyMYUmkxxGUklAOBklsoY3kruMz6VX-G_dTBolYgmjDlDKRRacbUqfz6RRuGMBnNZIsKaQSRNNbTmDTDxiLUwQbY9lDzcI/s1600/Photo+landon-162+x+146.jpg" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="146" data-original-width="162" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrR0sJjrbnjO3d2d2GyE5itb2hzwjfTjWac83DxhO7NzovdAyMYUmkxxGUklAOBklsoY3kruMz6VX-G_dTBolYgmjDlDKRRacbUqfz6RRuGMBnNZIsKaQSRNNbTmDTDxiLUwQbY9lDzcI/s1600/Photo+landon-162+x+146.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Landon Fuller</td></tr>
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HOBBS, NEW MEXICO: The parents of an 11-year-old boy who killed himself this past April say they believe he was driven to suicide by the social isolation brought about by the coronavirus pandemic.<br />
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To everyone who knew him, Landon Fuller was the curious and intelligent young boy who loved Marvel, DC, Dragon Ball Z, Naruto, Pokemon, Harry Potter, and the innumerable other things that those his age thrived upon, according to a <a href="https://www.gofundme.com/f/landon-ray-fuller-memorial-services" target="_blank">GoFundMe</a> page.<span><a name='more'></a></span><br />
But without warning, Landon rode to a field near his Hobbs, New Mexico, home in April and took his own life. His parents, Katrina and James Fuller, recently spoke about his death and said they still don't know what drove him to take such an extreme measure. They said the only clues they got came from his journal, which indicated that the social isolation necessitated by Covid-19 had taken a heavier toll than they could have imagined....<br />
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Now, the Fullers urge other parents to talk to their children even if they seem fine. "I hope his story can at least save at least one life. If so, then his death wasn’t in vain," Katrina said.</div>
Adminhttp://www.blogger.com/profile/13314132820263802243noreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-45460181826569045242019-03-12T22:58:00.000-06:002019-08-01T17:36:13.948-06:00House Quashes "Right to Die" Bill (HB 90)<span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;">By Robert Nott </span><br />
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<tr><td class="tr-caption" style="text-align: center;">Rep. Deborah Armstrong</td></tr>
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<span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;">Sante Fe New Mexican</span><br />
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<span style="font-family: inherit;"><br style="color: #222222; font-family: Arial, Helvetica, sans-serif;" /><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;">One of this legislative session’s most controversial bills has been tabled for the 2019 legislative session....</span></span><br />
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<span style="font-family: inherit;"><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;">Though the bill, known as the Elizabeth Whitefield End of Life Options Act, made it through two House committees this year, it was quietly tabled in the House of Representatives in late February.</span></span><br />
<span style="font-family: inherit;"></span><br style="color: #222222; font-family: Arial, Helvetica, sans-serif;" />
<span style="font-family: inherit;"><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;">On Tuesday, [Rep. Deborah] Armstrong wrote in an email that the bill was tabled “at my request.”</span></span><br />
<a name='more'></a><span style="font-family: inherit;"><br style="color: #222222; font-family: Arial, Helvetica, sans-serif;" /><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;">“At the time we are just a few votes shy to pass the bill,” she said.</span></span><br />
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<span style="font-family: inherit;"><br style="color: #222222; font-family: Arial, Helvetica, sans-serif;" /><br style="color: #222222; font-family: Arial, Helvetica, sans-serif;" /><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;">“What we do have, though, is the drive and the commitment to keep building momentum, to keep reaching out to legislators on both sides of the aisle and to keep educating people about medical aid-in-dying. … something like this takes time.” ... </span><br style="color: #222222; font-family: Arial, Helvetica, sans-serif;" /><br style="color: #222222; font-family: Arial, Helvetica, sans-serif;" /><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;">But opponents cite moral and religious objections and argue the bill, if it became law, could lead to potential abuse.</span></span><br />
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<span style="font-family: inherit;"><span style="color: #222222; font-family: "arial" , "helvetica" , sans-serif;"><a href="https://www.santafenewmexican.com/news/legislature/house-quashes-right-to-die-bill/article_041a0f54-8371-5c30-8e62-e2bc36802a76.html" target="_blank">Click here</a> to read the full article. </span></span>Adminhttp://www.blogger.com/profile/13314132820263802243noreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-55324774745611114502019-01-31T12:58:00.000-07:002019-08-03T19:11:43.406-06:00Act Highlights (HB 90 & SB 153)<div style="text-align: center;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4A67gITAuL8mPL4Nqan3nVjLWmyfZWLXqKf7UBvT3oz6eunI8ZlUrXgv0sv0GeHkkgEGPLDQ_HvNDnu7CqX8NNksrpdjOuwuvUJq1ZuYgV9Jdl4FbU7GW3zEnwx9Q2hnwzH5R1Prs_J8/s1600/state-flag-of-new-mexico_144.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="96" data-original-width="144" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4A67gITAuL8mPL4Nqan3nVjLWmyfZWLXqKf7UBvT3oz6eunI8ZlUrXgv0sv0GeHkkgEGPLDQ_HvNDnu7CqX8NNksrpdjOuwuvUJq1ZuYgV9Jdl4FbU7GW3zEnwx9Q2hnwzH5R1Prs_J8/s1600/state-flag-of-new-mexico_144.jpg" /></a><br />
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<a href="https://choiceisanillusion.files.wordpress.com/2019/01/highlightshb90andsb153.pdf" target="_blank">Click here</a> to view pdf version. </div>
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<b>1. The Act</b><br />
<span style="white-space: pre;"> </span><br />
The Act (Whitefield End of Life Option Act, <a href="https://nmlegis.gov/Sessions/19%20Regular/bills/house/HB0090.pdf" target="_blank">HB 90</a> as amended, and <a href="https://nmlegis.gov/Sessions/19%20Regular/bills/senate/SB0153.pdf" target="_blank">SB 153</a>)<b> </b>seeks to legalize medical “aid in dying,” a traditional euphemism for active euthanasia and physician-assisted suicide.[1]<br />
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<b>2. Who is Especially at Risk?</b><br />
<span style="white-space: pre;"> </span><br />
Individuals with money, meaning the middle class and above.<br />
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<b>3. Assisting Persons Can Have an Agenda</b><br />
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Persons assisting a suicide or euthanasia can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton in Oregon, which has a similar law. Two days after his death by legal assisted suicide, she sold his home and deposited the proceeds into bank accounts for her own benefit.[2] Consider also Graham Morant, recently convicted of counseling his wife to kill herself in Australia, to get the life insurance. The Court found:<br />
<blockquote class="tr_bq">
[Y]ou counseled and aided your wife to kill herself because you wanted ... the 1.4 million.[3]<br />
<a name='more'></a></blockquote>
Medical professionals too can have an agenda. Michael Swango, MD, now incarcerated, got a thrill from killing his patients.[4] Consider also Harold Shipman, a doctor in the UK, who not only killed his patients, but stole from them and in one case made himself a beneficiary of the patient’s will.[5]<br />
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<b>4. “Even If the Patient Struggled, Who Would Know?”</b><br />
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The Act has no required oversight over administration of the lethal dose, not even a witness is required to be present at the death.[6] The drugs used are water or alcohol soluble, such that they can be injected into a sleeping or restrained person without consent.[7] Alex Schadenberg, Executive Director for the Euthanasia Prevention Coalition, puts it this way:<br />
<blockquote class="tr_bq">
With assisted suicide laws in Washington and Oregon [and with the proposed Act], perpetrators can . . . take a “legal” route, by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over administration. Even if a patient struggled, “who would know?” (Emphasis added).[8]</blockquote>
<b>5. Cover for Murder</b><br />
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With the lack of witnesses to say otherwise, perpetrators will be able report deaths as “self-administered.” Per the Act, this will require death certificates to list a terminal illness as the cause of death. See the Act, Section 7, “Death Certificate - Cause of Death.” The official legal cause of death will be a terminal illness (not murder) as a matter of law.<br />
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<b>6. “Eligible” Persons May Have Years or Decades to Live</b><br />
<span style="white-space: pre;"> </span><br />
The Act applies to persons with a terminal illness, which is expected to result in death “within six months” (HB 90, as amended). Oregon’s law has a similar criteria, which is interpreted to include chronic conditions such as diabetes mellitus, better known as diabetes. This is because the six months to live is determined without treatment. Oregon doctor, William Toffler, explains:<br />
<blockquote class="tr_bq">
In Oregon, people with chronic conditions are “terminal,” if without their medications, they have less than six months to live. This is significant when you consider that a typical insulin-dependent 20 year-old will live less than a month without insulin. </blockquote>
<blockquote class="tr_bq">
Such persons, with insulin, are likely to have decades to live; in fact, most diabetics have a normal life span given appropriate control of their blood sugar. [9]</blockquote>
<b>Footnotes</b><br />
<b><br /></b>
[1] Craig A. Brandt, “Model Aid-in-Dying Act,” Iowa Law Review, 1989 Oct; 75(1): 125-215, (“Subject: Active Euthanasia ....”), at <a href="https://repository.library.georgetown.edu/handle/10822/738671">https://repository.library.georgetown.edu/handle/10822/738671</a> and Maria T. CeloCruz, “Aid-in-Dying: Should We Decriminalize Physician-Assisted Suicide and Physician-Committed Euthanasia?,” American Journal of Law and Medicine 1992 (“Subject: Active Euthanasia ....”) at <a href="https://repository.library.georgetown.edu/handle/10822/744116">https://repository.library.georgetown.edu/handle/10822/744116</a><br />
[2] KTVZ.com, “Sawyer Arraigned on State Fraud Charges,” at <a href="https://choiceisanillusion.files.wordpress.com/2016/10/sawyer-arraigned-a-63.pdf">https://choiceisanillusion.files.wordpress.com/2016/10/sawyer-arraigned-a-63.pdf</a><br />
[3] R v Morant , 11/02/18, p. 11, ¶ 78, at <a href="https://archive.sclqld.org.au/qjudgment/2018/QSC18-251.pdf">https://archive.sclqld.org.au/qjudgment/2018/QSC18-251.pdf</a><br />
[4] Charlie Leduff, “<a href="https://www.nytimes.com/2000/09/07/nyregion/prosecutors-say-doctor-killed-to-feel-a-thrill.html" target="_blank">Prosecutors Say Doctor Killed to Feel a Thrill</a>,” <i>The New York Times</i>, 09/07/00 (“Basically, Dr. Swango liked to kill people. By his own admission in his diary, he killed because it thrilled him.”)<br />
[5] David Batty, “Q & A: Harold Shipman,” The Guardian, 08/25/05, at <a href="https://www.theguardian.com/society/2005/aug/25/health.shipman">https://www.theguardian.com/society/2005/aug/25/health.shipman</a><br />
[6] See HB 90 and SB 153, in their entirety.<br />
[7] In Oregon, the drugs used include Secobarbital, and Pentobarbital (Nembutal) , which are water and alcohol soluble. See <a href="http://www.drugs.com/pr/seconal-sodium.html">http://www.drugs.com/pr/seconal-sodium.html</a> and <a href="http://www.drugs.com/pro/nembutal.html">http://www.drugs.com/pro/nembutal.html</a><br />
[8] Alex Schadenberg, Letter to the Editor, “Elder abuse a growing problem,” <i>The Advocate</i>, Official Publication of the Idaho State Bar, October 2010<br />
[9] Toffler Declaration, at <a href="https://choiceisanillusion.files.wordpress.com/2019/01/toffler-decl-new-mexico-01-23-19.pdf">https://choiceisanillusion.files.wordpress.com/2019/01/toffler-decl-new-mexico-01-23-19.pdf</a>Adminhttp://www.blogger.com/profile/13314132820263802243noreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-29251392137805370452019-01-30T01:41:00.000-07:002019-08-01T02:49:00.673-06:00Dore Memo Urging No Vote on HB 90<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsPjC43bUlhluZvN8TqGgAMEI2NuJuf5CZMqmgRxttFTqrinA0rFeIttMeX5qq-D2R40KwfA4VSNp59RAng_iWTWzxMGYXnZdQuWYHhSlPf4_c44GGj359pIWVtPCF6QIUNPGKqg3vnmo/s1600/Photo+Roundhouse+367+x+245.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="245" data-original-width="367" height="133" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsPjC43bUlhluZvN8TqGgAMEI2NuJuf5CZMqmgRxttFTqrinA0rFeIttMeX5qq-D2R40KwfA4VSNp59RAng_iWTWzxMGYXnZdQuWYHhSlPf4_c44GGj359pIWVtPCF6QIUNPGKqg3vnmo/s200/Photo+Roundhouse+367+x+245.jpg" width="200" /></a><b>I.<span style="white-space: pre;"> </span>INTRODUCTION</b><br />
<b><br /></b>
I am a lawyer and president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia.[1] The Act, HB 90, seeks to legalize medical “aid in dying,” a traditional euphemism for active euthanasia and physician-assisted suicide.[2]<br />
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HB 90 is based on similar statutes in Oregon and Washington State. If enacted, it will apply to people with years or decades to live. It will create new paths of abuse and exploitation.[3]<br />
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Individuals with money, meaning the middle class and above, will be especially at risk. I urge you to vote “No” on HB 90.<br />
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<b>II.<span style="white-space: pre;"> </span>DEFINITIONS</b><br />
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<b>A. <span style="white-space: pre;"> </span>Physician-Assisted Suicide; Assisted Suicide; and Euthanasia</b><br />
<b><br /></b>
The American Medical Association (AMA) defines physician-assisted suicide as occurring when “a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act.”[4] For example:<br />
<blockquote class="tr_bq">
[T]he physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide.[5]</blockquote>
Assisted suicide is a general term in which an assisting person is not necessarily a physician. Euthanasia is the administration of a lethal agent “by another person.”[6]<br />
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<b>B. Withholding or Withdrawing Treatment </b><br />
<br />
Withholding or withdrawing treatment (“pulling the plug”) is not euthanasia if the purpose is to remove burdensome treatment, as opposed to an intent to kill the patient. More importantly, the individual will not necessarily die. Consider this quote from Washington State regarding a man removed from a ventilator:<br />
<blockquote class="tr_bq">
<span style="white-space: pre;"> </span>[I]nstead of dying as expected, [he] slowly began to get better.[7]</blockquote>
<b>III. ASSISTING PERSONS CAN HAVE AN AGENDA</b><br />
<br />
Persons assisting a suicide or euthanasia can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton in Oregon. Two days after his death by legal assisted suicide, she sold his home and deposited the proceeds into bank accounts for her own benefit.[8] Consider also Graham Morant, recently convicted of counseling his wife to kill herself in Australia, to get the life insurance.[9] The Court found:<br />
<blockquote class="tr_bq">
[Y]ou counseled and aided your wife to kill herself because you wanted ... the 1.4 million.[10]</blockquote>
Medical professionals too can have an agenda. Michael Swango, MD, now incarcerated, got a thrill from killing his patients.[11] Consider also Harold Shipman, a doctor in the UK, who not only killed his patients, but stole from them and in one case made himself a beneficiary of the patient’s will.[12]<br />
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<b>IV.<span style="white-space: pre;"> </span>PUSH BACK AGAINST ASSISTED SUICIDE</b><br />
<b><br /></b>
<b>A.<span style="white-space: pre;"> </span>Last Year, Utah Passed a Law Making Assisted Suicide a Felony </b><br />
<br />
Last year, Utah amended its manslaughter statute to clarify that aiding suicide is a felony.[13] The bill, HB 86, passed the legislature by a 2 to 1 margin.[14]<br />
<br />
<b>B.<span style="white-space: pre;"> </span>Two Years Ago, Alabama Passed an Act Banning Assisted </b><br />
<b> Suicide</b><br />
<br />
Two years ago, Alabama enacted an “Assisted Suicide Ban Act,” which renders any person who deliberately assists a suicide, guilty of a felony.[15] The Act passed by an overwhelming majority.[16]<br />
<br />
<b>C.<span style="white-space: pre;"> Five </span>Other States Have Strengthened Their Laws Against </b><br />
<b> Assisted Suicide</b><br />
<br />
In the last eight years, five other states have strengthened their laws against assisted suicide. These states are Arizona, Louisiana, Georgia, Idaho and Ohio.[17]<br />
<br />
<b>V.<span style="white-space: pre;"> </span>HOW THE ACT WORKS</b><br />
<b><br /></b>
The Act has a lethal dose request process, which includes a lethal dose request form.[18]<br />
<br />
Once the lethal dose is issued by the pharmacy, there is no oversight. No doctor, not even a witness, is required to be present at the death.[19]<br />
<br />
<b>VI. “ELIGIBLE” PERSONS MAY HAVE YEARS OR DECADES TO LIVE</b><br />
<br />
<b>A. <span style="white-space: pre;"> </span>If New Mexico Follows Oregon, the Act Will Apply to Young </b><br />
<b> Adults With Chronic Conditions Such as Insulin Dependent </b><br />
<b> Diabetes</b><br />
<span style="white-space: pre;"> </span><br />
The Act applies to persons with a terminal illness, which is expected to result in death within six months. The Act states:<br />
<blockquote class="tr_bq">
“[T]erminal illness” means a disease or condition that is incurable and irreversible and that, in accordance with reasonable medical judgment, will result in death within six months.<span style="white-space: pre;"> [20]</span></blockquote>
Oregon’s law has a similar definition:<br />
<blockquote class="tr_bq">
“Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.[21]</blockquote>
In Oregon, this similar definition is interpreted to include chronic conditions such as diabetes mellitus, better known as diabetes.[22] This is because the six months to live is determined without treatment. Oregon doctor, William Toffler, explains:<br />
<blockquote class="tr_bq">
In Oregon, people with chronic conditions are “terminal,” if without their medications, they have less than six months to live.[23]</blockquote>
Dr. Toffler adds:<br />
<blockquote class="tr_bq">
This is significant when you consider that a typical insulin-dependent 20 year-old will live less than a month without insulin. Such persons, with insulin, are likely to have decades to live; in fact, most diabetics have a normal life span given appropriate control of their blood sugar.[24]</blockquote>
If the proposed Act is enacted and New Mexico follows Oregon’s interpretation of terminal disease, medical “aid in dying” will be legalized for people with chronic conditions such as insulin dependent diabetes. Such persons can have decades to live.<br />
<br />
<b>B.<span style="white-space: pre;"> </span>Predictions of Life Expectancy Can Be Wrong<span style="white-space: pre;"> </span></b><br />
<br />
“Eligible” persons may also have years or decades to live because predictions of life expectancy can be wrong. This is true due to actual mistakes (the test results got switched) and because predicting life expectancy is not an exact science.[25]<span style="white-space: pre;"> </span>Consider John Norton, diagnosed with ALS at age 18.[26] He was told that he would get progressively worse (be paralyzed) and die in three to five years.[27] Instead, the disease progression stopped on its own.[28] In a 2012 affidavit, at age 74, he states:<br />
<blockquote class="tr_bq">
If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.[29]</blockquote>
<b>C.<span style="white-space: pre;"> </span>Treatment Can Lead to Recovery</b><br />
<br />
Consider also Jeanette Hall, who was diagnosed with cancer in 2000 and made a settled decision to use Oregon’s law.[30] Her doctor convinced her to be treated instead.[31] In a 2018 declaration, she states:<br />
<blockquote class="tr_bq">
It has now been 18 years since my diagnosis. If [my doctor] had believed in assisted suicide, I would be dead. Assisted suicide should not be legal.[32]</blockquote>
<b>VII. THE ACT WILL CREATE A PERFECT CRIME</b><br />
<br />
<b>A.<span style="white-space: pre;"> </span>The Definition of “Self-Administer” Does Not Require a </b><br />
<b> Qualified Individual to Know or Understand That He or She Is T</b><b>aking a Lethal Dose</b><br />
<br />
The Act states:<br />
<blockquote class="tr_bq">
"self-administer" means taking an affirmative, conscious, voluntary action to give oneself a pharmaceutical substance[33] </blockquote>
With this definition, the qualified individual is not required to know or understand that the pharmaceutical substance is a lethal dose.<br />
<br />
<b>B. <span style="white-space: pre;"> </span>The Cause of Death Will Be a Terminal Illness</b><br />
<br />
The Act, Section 7, titled <i>“Death Certificate–Cause of Death,”</i> states:<br />
<blockquote class="tr_bq">
The cause of death of a qualified individual who is deceased pursuant to self-administration of medical aid in dying medication [a lethal dose] pursuant to the Elizabeth Whitefield End of Life Options Act shall be the qualified individual's underlying terminal illness. (Emphasis added).[34]</blockquote>
The significance of requiring a terminal illness to be listed as the cause of death on the death certificate is that it will create an inability to prosecute. Even if the qualified individual thought that he or she was taking a cold medication instead of the lethal dose, the official legal cause of death will be a terminal illness (not murder) as a matter of law.<br />
<br />
<b>VIII. DR. SHIPMAN AND THE CALL FOR DEATH CERTIFICATE </b><br />
<b> REFORM</b><br />
<b><br /></b>
According to a 2005 article in the UK’s Guardian newspaper, there was a public inquiry regarding Dr. Shipman’s conduct, which determined that he had “killed at least 250 of his patients over 23 years.”[35] The inquiry also found:<br />
<blockquote class="tr_bq">
that by issuing death certificates stating natural causes, the serial killer [Shipman] was able to evade investigation by coroners.[36]</blockquote>
According to a subsequent article in 2015, proposed reforms included having a medical examiner review death certificates, so as to improve patient safety.[37] Instead, the instant Act moves in the opposite direction to require a legal coverup in which doctors and other perpetrators will be able to kill patients with impunity.<br />
<br />
<b>IX.<span style="white-space: pre;"> </span>“EVEN IF A PATIENT STRUGGLED, WHO WOULD KNOW?”</b><br />
<b><br /></b>
The Act has no required oversight over administration of the lethal dose.[38] In addition, the drugs used are water and or alcohol soluble, such that they can be injected into a sleeping or restrained person without consent.[39] Alex Schadenberg, Executive Director for the Euthanasia Prevention Coalition, puts it this way:<br />
<blockquote class="tr_bq">
With assisted suicide laws in Washington and Oregon [and with the proposed Act], perpetrators can . . . take a “legal” route, by getting an elder to sign a lethal dose request.<i> Once the prescription is filled, there is no supervision over administration. Even if a patient struggled, “who would know?”</i> (Emphasis added).[40]</blockquote>
<b>X.<span style="white-space: pre;"> </span>EUTHANASIA WILL BE ALLOWED</b><br />
<br />
The Act legalizes medical “aid in dying,” which is a traditional euphemism for active euthanasia.[41] The Act also describes the lethal dose as medication.[42] Generally accepted medical practice allows a doctor, or a person acting under the direction of a doctor, to administer medication.[43] Euthanasia is the administration of a lethal agent “by another person.”[44]<br />
<br />
If for the purpose of argument, euthanasia is not allowed, it will nonetheless occur due to the Act’s complete lack of oversight over administration of the lethal dose and motives such as life insurance and inheritance money.[45] Consider also the quote below from an article in the New England Journal of Medicine, regarding a study of assisted suicide versus euthanasia.[46] Problems were experienced more frequently with assisted suicide, which led to euthanasia:<br />
<blockquote class="tr_bq">
The physician decided to administer a lethal medication in 21 of the cases of assisted suicide (18 percent), which thus became cases of euthanasia. The reasons for this decision included problems with completion (in 12 cases) and the inability of the patient to take all the medications (in 5).[47]</blockquote>
<b>XI. TRAUMA TO FAMILY MEMBERS AND FRIENDS</b><br />
<br />
<b>A. <span style="white-space: pre;"> </span>The Swiss Study: Physician-Assisted Suicide Can Be </b><br />
<b> Traumatic for Family Members and Friends</b><br />
<br />
In 2010, a European research study addressed trauma suffered by persons who witnessed legal physician-assisted suicide in Switzerland.[48] The study found that one out of five family members or friends present was traumatized, with the most severe mental health problems occurring 14 to 24 months post loss.[49] An article describing the study states that these people,<br />
<blockquote class="tr_bq">
experienced full or sub-threshold PTSD (Post Traumatic Stress Disorder) related to the loss of a close person through assisted suicide.[50]</blockquote>
<b>B. <span style="white-space: pre;"> </span>My Clients Suffered Trauma in Oregon and Washington State</b><br />
<br />
In Oregon and Washington State, I have had two cases where my clients and their family member patients suffered severe emotional trauma due to legal assisted suicide. In the first case, one side of the family wanted the father/patient to take the lethal dose, while the other side did not. The father spent the last months of his life caught in the middle and torn over whether or not he should kill himself. My client, his adult daughter, was severely traumatized. The father did not take the lethal dose and died a natural death.<br />
<br />
In the other case, it’s not clear that administration of the lethal dose was voluntary. A man who was present told my client that his (my client's) father had refused to take the lethal dose when it was delivered, stating: "You're not killing me. I'm going to bed." The man also said that my client’s father took the lethal dose the next night when he (the father) was already intoxicated on alcohol. The man subsequently changed his story.<br />
<br />
My client, although he was not present, was severely traumatized over the incident, and also by the sudden loss of his father. He also followed the pattern of the Swiss cases described above, becoming especially traumatized about a year and a half after the death. <span style="white-space: pre;"> </span><br />
<span style="white-space: pre;"> </span><br />
<b>XI. CONCLUSION</b><br />
<br />
If enacted, HB 90 will apply to people with years or decades to live. This will be especially true if New Mexico follows Oregon practice to determine life expectancies without treatment. Young adults with chronic conditions, such as insulin dependent diabetes, will be considered terminal and therefore "eligible" for assisted suicide/euthanasia.<br />
<br />
Assisting persons, including doctors and family members, can have an agenda, with the more obvious reasons being inheritance and life insurance, but also, as in the case of Dr. Swango, the thrill of seeing someone die. The lack of any required oversight at the deaths, coupled with the required falsification of the death certificate will provide cover for murder. Families and individuals will be traumatized.<br />
<br />
Don’t make Oregon and Washington’s mistake. I urge you to vote “No” on HB 90.<br />
<br />
Respectfully Submitted,<br />
<span style="white-space: pre;"> </span><br />
Margaret Dore, Esq., MBA<span style="white-space: pre;"> </span><br />
Law Offices of Margaret K. Dore, P.S.<span style="white-space: pre;"> </span><br />
Choice is an Illusion, a nonprofit corporation<span style="white-space: pre;"> </span><br />
<a href="http://www.margaretdore.com/">www.margaretdore.com</a><br />
<a href="http://www.choiceillusion.org/">www.choiceillusion.org</a><br />
1001 4th Avenue, Suite 4400<br />
Seattle, WA 98154<br />
206 697 1217<br />
<br />
<b>Appendix</b><br />
<br />
[1] See <a href="http://www.margaretdore.org/">www.margaretdore.org</a>, <a href="http://www.choiceillusion.org/">www.choiceillusion.org</a> and the <a href="https://choiceisanillusion.files.wordpress.com/2019/03/margarets-cv.pdf" target="_blank">CV</a> attached hereto in the Appendix, at pages 1 through 4.<br />
[2] <a href="https://choiceisanillusion.files.wordpress.com/2019/03/house-bill-90.pdf" target="_blank">The Act</a>, as recently amended, is attached in the Appendix at pages 101 through 116. The Act can also be viewed at: <a href="https://nmlegis.gov/Sessions/19%20Regular/Amendments_In_Context/HB0090.pdf">https://nmlegis.gov/Sessions/19%20Regular/Amendments_In_Context/HB0090.pdf</a><br />
[3] Craig A. Brandt, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/model-aid-in-dying-act-active-euthanasia.pdf" target="_blank">“Model Aid-in-Dying Act,”</a> Iowa Law Review, 1989 Oct; 75(1): 125-215, (“Subject: Active Euthanasia ....”), at <a href="https://repository.library.georgetown.edu/handle/10822/738671">https://repository.library.georgetown.edu/handle/10822/738671</a>, attached in the Appendix, page 5; and Maria T. CeloCruz, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/aid-in-dying-should-we-decriminalize.pdf" target="_blank">“Aid-in-Dying: Should We Decriminalize Physician-Assisted Suicide and Physician-Committed Euthanasia?,”</a> American Journal of Law and Medicine 1992 (“Subject: Active Euthanasia ....”) at <a href="https://repository.library.georgetown.edu/handle/10822/744116">https://repository.library.georgetown.edu/handle/10822/744116</a>, attached in the Appendix, page 6 <br />
[4] AMA Principles of Medical Ethics, § 5.7, Physician-Assisted Suicide, attached in the Appendix, at page 7.<br />
[5] Id.<br />
[6] Id., § 5.8, Euthanasia (lower half of the page)<br />
[7] Nina Shapiro, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/terminal-uncertainty-article.pdf" target="_blank">“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?,”</a> The Seattle Weekly, 01/13/09; in the Appendix, beginning at page 8; quote at page 10.<br />
[8] KTVZ.com, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/sawyer-arraigned-ktvz-oregon.pdf" target="_blank">“Sawyer Arraigned on State Fraud Charges,” </a>Appendix page 11.<br />
[9] <a href="https://choiceisanillusion.files.wordpress.com/2019/03/graham-robert-morant.pdf" target="_blank">R v Morant </a>[2018] QSC 251, Order, 11/02/18, pp. 1 & 11, ¶ 78, available at <a href="https://archive.sclqld.org.au/qjudgment/2018/QSC18-251.pdf">https://archive.sclqld.org.au/qjudgment/2018/QSC18-251.pdf</a>, Appendix pages 12 and 13.<br />
[10] Id., <a href="https://choiceisanillusion.files.wordpress.com/2019/03/order-page-11.pdf" target="_blank">Order page 11</a>, ¶ 78; attached in the Appendix at page 13.<br />
[11] Charlie Leduff, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/ny-times-killed-to-feel-a-thrill-1.pdf" target="_blank">“Prosecutors Say Doctor Killed to Feel a Thrill,</a>” The New York Times, 09/07/00 (“Basically, Dr. Swango liked to kill people. By his own admission in his diary, he killed because it thrilled him.”) Excerpts attached in the Appendix at pages 14-16. See also: CBSNEWS.COM STAFF, “Life in Jail for Poison Doctor,” 07/12/00, <a href="http://www.cbsnews.com/news/life-in-jail-for-poison-doctor">www.cbsnews.com/news/life-in-jail-for-poison-doctor</a><br />
[12]<span style="white-space: pre;"> </span> David Batty, “Q & A: Harold Shipman,” The Guardian, 08/25/05, at <a href="https://www.theguardian.com/society/2005/aug/25/health.shipman">https://www.theguardian.com/society/2005/aug/25/health.shipman</a>, attached in the Appendix, pages 17 to 19. See also Fiona Guy, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/doctors-and-nurses-who-kill.pdf" target="_blank">“Healthcare Serial Killers: Doctors and Nurses Who Kill,”</a> Crime Traveller, (2015, Sept 09), excerpts in the Appendix, pages 20 to 23, available at <a href="https://www.crimetraveller.org/2018/06/healthcare-medical-serial-killers">https://www.crimetraveller.org/2018/06/healthcare-medical-serial-killers</a><br />
[13] <span style="white-space: pre;"> </span> <a href="https://le.utah.gov/~2018/bills/static/HB0086.html">https://le.utah.gov/~2018/bills/static/HB0086.html</a><br />
[14]<span style="white-space: pre;"> </span> HB 86 passed the House 51 to 18, and the Senate, 19 to 5. For more information, see <a href="https://le.utah.gov/~2018/bills/static/HB0086.html">https://le.utah.gov/~2018/bills/static/HB0086.html</a> and click “status.”<br />
[15]<span style="white-space: pre;"> </span> See Alabama: Assisted Suicide Ban Act to Go Into Effect,” <a href="http://www.choiceillusion.org/2017/07/alabama-assisted-suicide-ban-act-to-go.html">http://www.choiceillusion.org/2017/07/alabama-assisted-suicide-ban-act-to-go.html</a><br />
[16]<span style="white-space: pre;"> </span> Scroll down to view roll calls: <a href="https://legiscan.com/AL/bill/HB96/2017">https://legiscan.com/AL/bill/HB96/2017</a><br />
[17]<span style="white-space: pre;"> </span> See: AP, “Brewer signs bill targeting assisted suicide,” Arizona Capitol Times, 04/30/14, attached in the Appendix, page 25; AP, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/la-assisted-suicide-ban-strengthened.pdf" target="_blank">“La. assisted-suicide ban strengthened,”</a> The Daily Comet, 04/24/12, Appendix, page 26; Georgia HB 1114, attached at A-27; <a href="https://choiceisanillusion.files.wordpress.com/2019/03/choice-idaho-strengthens-law-against-assisted-suicide.pdf" target="_blank">“Idaho Strengthens Law Against Assisted Suicide,”</a> attached in the Appendix, page 28 (”The bill explicitly provides that causing or aiding a suicide is a felony”); and Ohio §3795.04, Assisted Suicide, added by the 131st Ohio General Assembly, effective 03/21/17, <a href="http://codes.ohio.gov/orc/3795">http://codes.ohio.gov/orc/3795</a><br />
[18]<span style="white-space: pre;"> </span> The form is part of<a href="https://choiceisanillusion.files.wordpress.com/2019/03/house-bill-90.pdf" target="_blank"> the Act</a>, Section 3, attached at pages 105 to 107.<br />
[19]<span style="white-space: pre;"> </span> See <a href="https://choiceisanillusion.files.wordpress.com/2019/03/house-bill-90.pdf" target="_blank">the Act</a> in its entirety, in the Appendix at pages 101 to 116.<br />
[20]<span style="white-space: pre;"> </span><a href="https://choiceisanillusion.files.wordpress.com/2019/03/house-bill-90.pdf" target="_blank"> HB 90</a>, Section 2.K., in the Appendix at page A-103.<br />
[21]<span style="white-space: pre;"> </span> <a href="https://choiceisanillusion.files.wordpress.com/2019/03/oregon-revised-statute-diabetes.pdf" target="_blank">Or. Rev. Stat. 127.800 s.1.01(12)</a>, in the Appendix at page 33.<br />
[22]<span style="white-space: pre;"> </span> “Diabetes” is listed as an underlying illness sufficient for assisted suicide in Oregon government reports. See for example, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/oregon-report-2017-diabetes.pdf" target="_blank">the report excerpt</a> in the Appendix at page 35 (Toffler page A-4).<br />
[23]<span style="white-space: pre;"> </span> <a href="https://choiceisanillusion.files.wordpress.com/2019/03/declaration-of-william-toffler.pdf" target="_blank">Declaration of William Toffler,</a> ¶¶ 5 & 6, in the Appendix at page 30.<br />
[24]<span style="white-space: pre;"> </span> Id.<br />
[25]<span style="white-space: pre;"> </span> See: Jessica Firger, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/cbs-news-12-million-misdiagnosed.pdf" target="_blank">“12 million Americans misdiagnosed each year,”</a> CBS NEWS, 4/17/14, at <a href="https://www.cbsnews.com/news/12-million-americans-misdiagnosed-each-year-study-says">https://www.cbsnews.com/news/12-million-americans-misdiagnosed-each-year-study-says</a>, attached in the Appendix at page 39; and Nina Shapiro, <a href="https://choiceisanillusion.files.wordpress.com/2019/03/terminal-uncertainty-article.pdf" target="_blank">“Terminal Uncertainty,”</a> excerpts attached in the Appendix at pages 8 to 10.<br />
[26]<span style="white-space: pre;"> </span> <a href="https://choiceisanillusion.files.wordpress.com/2019/03/affidavit-of-john-norton.pdf" target="_blank">Affidavit of John Norton</a>, attached in the Appendix, at pages 40 to 42.<br />
[27]<span style="white-space: pre;"> </span> Id., ¶ 1.<br />
[28]<span style="white-space: pre;"> </span> Id., ¶ 4<span style="white-space: pre;"> </span><br />
[29]<span style="white-space: pre;"> </span> Id., ¶ 5.<br />
[30]<span style="white-space: pre;"> </span> <a href="https://choiceisanillusion.files.wordpress.com/2019/03/declaration-of-kenneth-stevens.pdf" target="_blank">Affidavit of Kenneth Stevens, MD</a>, attached in the Appendix at pages 43 to 45, Jeanette discussed at pages 43 and 44. Hall declaration attached in the Appendix at page 46.<br />
[31] <span style="white-space: pre;"> </span> Id.<br />
[32]<span style="white-space: pre;"> </span> <a href="https://choiceisanillusion.files.wordpress.com/2019/03/declaration-of-jeanette-hall.pdf" target="_blank">Declaration of Jeanette Hall</a>, ¶4, in the Appendix at page 46.<br />
[33]<span style="white-space: pre;"> </span> <a href="https://choiceisanillusion.files.wordpress.com/2019/03/house-bill-90.pdf" target="_blank">The Act</a>, Section 2.I., attached in the Appendix, page 103.<br />
[34]<span style="white-space: pre;"> </span><a href="https://choiceisanillusion.files.wordpress.com/2019/03/house-bill-90.pdf" target="_blank"> The Act</a>, attached hereto, in the Appendix at page 109.<br />
[35] <span style="white-space: pre;"> </span> <a href="https://choiceisanillusion.files.wordpress.com/2019/03/the-guardian-harold-shipman.pdf" target="_blank">David Batty</a>, supra, attached hereto, in the Appendix at pages 17-19, quote set forth at page 19.<br />
[36]<span style="white-space: pre;"> </span> Id., Appendix page 15, second paragraph titled <a href="https://choiceisanillusion.files.wordpress.com/2019/03/ny-times-killed-to-feel-a-thrill.pdf" target="_blank">“What are its findings?”</a><br />
[37]<span style="white-space: pre;"> </span> Press Association,<a href="https://choiceisanillusion.files.wordpress.com/2019/03/the-guardian-death-certificate-reform-delays-incomprehensible.pdf" target="_blank"> “Death certificate reform delays ‘incomprensible,’”</a> The Guardian, January 21, 2015, Appendix pages 49 and 50.<br />
[38]<span style="white-space: pre;"> </span> See the proposed <a href="https://choiceisanillusion.files.wordpress.com/2019/03/house-bill-90.pdf" target="_blank">Act</a>, attached in the Appendix, pages 101 to 116.<br />
[39]<span style="white-space: pre;"> </span> In Oregon, the drugs used include Secobarbital, Pentobarbital (Nembutal) and Phenobarbital. See the Oregon government report excerpt, Appendix page 36 (listing these drugs). Secobarbital and Pentobarbital are soluble in water and alcohol. See <a href="http://www.drugs.com/pr/seconal-sodium.html">http://www.drugs.com/pr/seconal-sodium.html</a> and <a href="http://www.drugs.com/pro/nembutal.html">http://www.drugs.com/pro/nembutal.html</a>. Phenobarbital is soluble in alcohol. See <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2977013">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2977013</a><br />
[40]<span style="white-space: pre;"> </span> Alex Schadenberg, Letter to the Editor, “Elder abuse a growing problem,” The Advocate, Official Publication of the Idaho State Bar, October 2010<br />
[41]<span style="white-space: pre;"> </span> Again see Craig A. Brandt, “Model Aid-in-Dying Act,” Iowa Law Review, 1989 Oct; 75(1): 125-215, (“Subject: Active Euthanasia ....”), at <a href="https://repository.library.georgetown.edu/handle/10822/738671">https://repository.library.georgetown.edu/handle/10822/738671</a>, which is attached as Appendix page 5.<br />
[42]<span style="white-space: pre;"> </span> The Act states:<br />
<i>"medical aid in dying" means the medical practice wherein a health care provider prescribes medication</i> to a qualified individual who may self-administer that medication to end that individual's life in accordance with the provisions of the Elizabeth Whitefield End of Life Options Act (Emphasis added).<br />
The Act, Section 10.B.(2), Appendix page 115.<br />
[43]<span style="white-space: pre;"> </span> Oregon doctor, Kenneth Stevens, MD, testifies:<br />
<i>Generally accepted medical practice allows a doctor, or a person acting under the direction of a doctor, to administer prescription drugs to a patient.</i> Common examples of persons acting under the direction of a doctor, include: nurses and other healthcare professionals who act under the direction of a doctor to administer drugs to a patient in a hospital setting; parents who act under the direction of a doctor to administer drugs to their children in a home setting; and adult children who act under the direction of a doctor to administer drugs to their parents in a home setting. (Emphasis added).<br />
<a href="https://choiceisanillusion.files.wordpress.com/2019/03/declaration-of-kenneth-stevens.pdf" target="_blank">Declaration of Kenneth Stevens, MD</a>, January 19, 2016, Appendix page 45.<br />
[44]<span style="white-space: pre;"> </span> <a href="https://choiceisanillusion.files.wordpress.com/2019/03/ama-code-of-medical-ethics-opn-5.8.pdf" target="_blank">AMA Principles of Medical Ethics, § 5.8</a>, Euthanasia, Appendix page 7 (lower half of the page).<br />
[45]<span style="white-space: pre;"> </span> See prior discussion regarding Graham Morant, Harold Shipman, Michael Swango and other similar perpetrators, beginning at For yet another example, see Andrew Gregory, “Euthanasia patient fought back as doctor tried to give her lethal injection,” Mirror Online, 01/27/17, at <a href="https://www.mirror.co.uk/news/world-news/euthanasia-patient-fought-back-doctor-9707709">https://www.mirror.co.uk/news/world-news/euthanasia-patient-fought-back-doctor-9707709</a><br />
[46]<span style="white-space: pre;"> </span> Johanna H. Groenewoud, M.D., “Clinical Problems with the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands,” The New England Journal of Medicine, 02/54/00, available at <a href="https://www.nejm.org/doi/full/10.1056/NEJM200002243420805">https://www.nejm.org/doi/full/10.1056/NEJM200002243420805</a><br />
[47]<span style="white-space: pre;"> </span> Id.<br />
[48]<span style="white-space: pre;"> </span> “Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2010) 542-546, available at <a href="http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf">http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf</a><br />
[49]<span style="white-space: pre;"> </span> Id.<br />
[50]<span style="white-space: pre;"> </span> Id.Adminhttp://www.blogger.com/profile/13314132820263802243noreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-7099332842902948582017-04-07T20:01:00.000-06:002017-04-07T20:02:25.220-06:00Assisted suicide bill - it deserved to die<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqDbq2VKCaL7mHeaRWUac78whK5jYNeg_XcOVFXLTTSWgm7LM-NxXovjlgICmumZAMSl-O8xBUwNmkdHtA6Q8g_uv_ZC8uweVIp-svjCLDMSnFipXis4HsBTUn5c5k9TjNWBXdlnoEgS8/s1600/Photo+John+Kelly+Head+Shot.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqDbq2VKCaL7mHeaRWUac78whK5jYNeg_XcOVFXLTTSWgm7LM-NxXovjlgICmumZAMSl-O8xBUwNmkdHtA6Q8g_uv_ZC8uweVIp-svjCLDMSnFipXis4HsBTUn5c5k9TjNWBXdlnoEgS8/s200/Photo+John+Kelly+Head+Shot.jpg" width="133" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">John Kelly</td></tr>
</tbody></table>
<a href="http://www.santafenewmexican.com/opinion/my_view/reader-view-assisted-suicide-bill-it-deserved-to-die/article_249e9f50-bd12-5cd1-ba9c-33f689ca9534.html">http://www.santafenewmexican.com/opinion/my_view/reader-view-assisted-suicide-bill-it-deserved-to-die/article_249e9f50-bd12-5cd1-ba9c-33f689ca9534.html</a><br />
<br />
By John Kelly | Posted: Monday, March 20, 2017 7:00 pm<br />
<br />
Thanks to the state Senate’s rejection of the assisted suicide bill, Senate Bill 252, residents of New Mexico can breathe easier. As Sen. Craig Brandt said during last week’s debate, “This bill is dangerous. Doctors make mistakes every day.”<br />
<a name='more'></a><br />
<br />
CBS News reported in 2014 that 12 million Americans are misdiagnosed yearly. About 15 percent of people given less than six months to live are not “terminally ill.” Thousands of people “graduate” from hospice yearly. Assisted suicide programs turn the best result under hospice — learning that you weren’t “terminal” after all — into the tragedy of dying with years or decades of life remaining. This reality alone should be enough to stop any assisted suicide proposal cold. We cannot predict the future. The “choice” promised by assisted suicide is an illusion.<br />
<br />
Assisted suicide hit the news in 2011, when two doctors petitioned District Court Judge Nan G. Nash to declare assisted suicide constitutional. A few months later, Santa Fe resident Aja Riggs joined the lawsuit after doctors gave her slim chance of surviving aggressive uterine cancer. Judge Nash’s 2014 ruling for the plaintiffs was overturned on appeal. Then the state Supreme Court unanimously ruled that there was no constitutional right to assisted suicide. More than five years later, Aja Riggs’ cancer is in remission.<br />
<br />
During the Senate debate, senators warned that “undue influence” would lead to wrongful deaths. One out of every 10 older New Mexicans is estimated to be abused every year, mostly by adult children and spouses. A caregiver or heir to an estate could help sign a person up, pick up the prescription and then administer the lethal dose without worry of investigation. To receive immunity, they could simply claim to have acted in “good faith.”<br />
<br />
With no official witness required at the death, we can’t know whether someone self-administered the drugs.<br />
<br />
As a progressive, I am heartened that seven Democrats joined Republicans in defeating the measure.<br />
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John B. Kelly is a Boston-based disability rights activist and writer. He is the director of Second Thoughts Massachusetts: Disability Rights Advocates against Assisted Suicide. The group’s website is <a href="http://www.second-thoughts.org/">www.second-thoughts.org</a>.Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-12950029186891658902017-03-29T20:09:00.001-06:002017-03-29T20:09:35.196-06:00Assisted suicide wrong Rx for NM<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
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<tr><td class="tr-caption" style="text-align: center;">William Toffler, MD</td></tr>
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<a data-saferedirecturl="https://www.google.com/url?hl=en&q=https://www.abqjournal.com/978031/assisted-suicide-wrong-rx-for-nm.html&source=gmail&ust=1490925131315000&usg=AFQjCNHZhYIpUyS5sLWTSlFfSxXMRwhyOw" href="https://www.abqjournal.com/978031/assisted-suicide-wrong-rx-for-nm.html" rel="noreferrer" style="background-color: white; color: #1155cc; font-family: arial, sans-serif; font-size: 12.8px;" target="_blank">https://www.abqjournal.com/<wbr></wbr>978031/assisted-suicide-wrong-<wbr></wbr>rx-for-nm.html</a><br />
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<span style="background-color: white; color: #262626;"><span style="font-family: inherit;">I am a professor emeritus of family medicine at Oregon Health & Science University in Portland, Ore. I have lived and practiced medicine in Oregon for almost 37 years.</span></span><br />
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<span style="font-family: inherit;">There has been a profound shift in attitude in my state since the voters of Oregon narrowly embraced assisted suicide 20 years ago. This shift has been detrimental to our patients, degraded the quality of medical care and compromised the integrity of my profession.</span></div>
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<span style="font-family: inherit;">Proponents claim our law is working well. This is not true. Doctors engaging in this practice do not accurately report the cause of death on the death certificate. Instead, they are required by state law to fabricate the cause of death, stating that the cause is “natural.” Just before assisted suicide was to be implemented, the legislature implemented a system of two different death certificates (one that is public with no medical information, and a private one). Thus, review and tracking by anyone outside of the Oregon Health Division is impossible.</span></div>
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<span style="font-family: inherit;">Doctors who self-report data to OHD are rarely present when a patient takes the overdose. Thus, all “reassuring” reports from Oregon are biased by the conflict of interest of participants who are themselves promoters of assisted suicide. The information is never independently verified for accuracy.</span></div>
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<span style="font-family: inherit;">Many individuals who have been labeled “terminal” and given overdoses by their doctors were actually found to be depressed, yet the doctor who prescribed their lethal dose had not recognized the depression. In fact, 25 percent of all requestors met the criteria for major depressive disorder and 23 percent met the criteria for anxiety disorder. Rather than being treated, these patients were given an overdose. In 2015, only 5 out of 218 individuals had a referral for psychiatric/psychological evaluation.</span></div>
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<span style="font-family: inherit;">One of my first encounters with a request for suicide assistance came from a patient with progressive multiple sclerosis. He was a general contractor and quite productive. He acknowledged that MS was a major challenge and told me that, if he got much worse, he might want to “just end it.”</span></div>
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<span style="font-family: inherit;">“It sounds like you are telling me this because you might ultimately want assistance with your own suicide if things got worse,” I said. He nodded affirmatively and seemed relieved that I understood.</span></div>
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<span style="font-family: inherit;">I told him that I understood his fear and even his belief that physician-assisted suicide might be a good option for him. I told him that, if he became sicker, I would give him the best care available. I told him that, no matter how debilitated he might become, his life would always be inherently valuable and I did not recommend his suicide. He simply said “Thank you.”</span></div>
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<span style="font-family: inherit;">In Oregon, I regularly receive notices that treatments for my patients – even some pain medications – won’t be paid for by the state health plan. At the same time, doctor-assisted suicide is fully covered and sanctioned by the state of Oregon.</span></div>
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<span style="font-family: inherit;">While the so-called “safeguards” in Oregon have failed to prevent many reported abuses, the proposed New Mexico legislation, House Bill 171, didn’t even require the flimsy protections written into Oregon’s legislation. Had this legislation passed and been enacted, it is likely the abuses would exceed those documented in Oregon.</span></div>
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<span style="font-family: inherit;">My hope is that New Mexicans will stand firmly with the 45 states who have not embraced assisted suicide. As a society, we should continue to reject legalization of assisted suicide. Don’t make Oregon’s mistake.</span></div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-26359752936747535472016-08-10T22:35:00.001-06:002016-08-14T22:11:03.290-06:00New Mexico Supreme Court States Assisted Suicide Is Not A Civil Right, Euthanasia Inevitable<div dir="ltr" style="margin-bottom: 0pt; margin-top: 0pt;">
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<tr><td class="tr-caption" style="text-align: center;">Annette Hanson, MD</td></tr>
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<span style="font-family: inherit;"><span style="line-height: 20.24px; white-space: pre-wrap;">Originally published July 7, 2016 in Clinical Psychiatry News, updated July 9, 2016, by </span><span style="line-height: 22.08px;">Annette Hanson, MD</span></span><br />
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<span style="font-family: inherit; line-height: 22.08px;"><span style="line-height: 1.38;"><span style="color: black; font-size: 14.6667px; vertical-align: baseline; white-space: pre-wrap;">New Mexico [has become] the latest state to throw out a challenge to a law banning physician assisted </span></span><span style="line-height: 1.38;"><span style="color: black; font-size: 14.6667px; vertical-align: baseline; white-space: pre-wrap;">suicide. In </span><span style="color: black; font-size: 14.6667px; vertical-align: baseline; white-space: pre-wrap;"><i>Morris v. Brandenburg</i></span><span style="color: black; font-size: 14.6667px; vertical-align: baseline; white-space: pre-wrap;">, proponents of the right-to-die movement claimed that medical aid-in-dying was a fundamental right, meaning that any law which restricted the right should be presumed to be invalid unless the state had a compelling reason for the restriction. In a unanimous decision, the New Mexico Supreme Court held that there was no such right under that state's constitution, and that even if the right had existed the state had several compelling reasons to restrict it</span></span></span><br />
<a name='more'></a><span style="font-family: inherit; line-height: 22.08px;"><span style="line-height: 1.38;"><span style="color: black; font-size: 14.6667px; vertical-align: baseline; white-space: pre-wrap;">: "to protect the integrity and ethics of the medical profession; to protecting vulnerable groups—including the poor, the elderly, and disabled persons—from the risk of subtle coercion and undue influence in end-of-life situations, including pressures associated with the substantial financial burden of end-of-life health care costs; and to protect against voluntary or involuntary euthanasia because if physician aid in dying is a constitutional right, it must be made available to everyone, </span><span style="color: black; font-size: 14.6667px; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">even when a duly appointed surrogate makes the decision</span><span style="color: black; font-size: 14.6667px; vertical-align: baseline; white-space: pre-wrap;">, and </span><span style="color: black; font-size: 14.6667px; text-decoration: underline; vertical-align: baseline; white-space: pre-wrap;">even when the patient is unable to self-administer the life-ending medication</span><span style="color: black; font-size: 14.6667px; vertical-align: baseline; white-space: pre-wrap;">." (1)</span></span></span></div>
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<span style="font-family: inherit;"><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Let me repeat that last point:</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: italic; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">If aid in dying is a constitutional right, then medical euthanasia is inevitable, even for people unable to consent.</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> In other words, if a patient is too physically or mentally disabled to commit suicide on his or her own, a physician would be obligated to kill the patient.</span></span></div>
<span style="font-family: inherit;"><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Proponents will dismiss this last statement as alarmist and unfounded. They will point to a twenty year history of legalized aid-in-dying in Oregon and insist there has never been a problem and no attempt to expand the practice to include euthanasia.</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">What they don't mention is that such an attempt would be politically disastrous for the right-to-die movement. In 2015, 25 states and the District of Columbia considered legalization bills. (2) After careful consideration and debate, these bills failed in every state except California, and in that state it passed only because of an extraordinary and unusual legislative maneuver. The bill initially failed in regular session, but passed in special session when the California Medical Association (CMA) shifted to a neutral stance. That shift would never have happened if CMA members had been aware of the legal inevitability of euthanasia. At this stage of the political process the goal of the right-to-die movement is to get laws on the books in as many states as possible before pushing for more.</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The New Mexico opinion echoes a similar decision issued this past May by a New York appellate court. The plaintiffs in that case were three terminally-ill New Yorkers and five doctors, as well as two euthanasia advocacy groups. The arguments were virtually identical to those made in New Mexico, asserting a fundamental right to medical aid-in-dying based upon personal autonomy. They additionally sought an exception to New York criminal law, which defined assisted suicide as second degree manslaughter. In Myers v. Schneiderman the court observed that no appellate court had ever found medical aid-in-dying to be a fundamental right and that no new developments justified a change in this interpretation. (3) While the court acknowledged some change in public opinion as reflected in telephone surveys, they correctly gave little weight to this argument: "</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 700; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Plaintiffs fail to allege whether those public polls reflect the opinion of people who are fully informed of the arguments espoused by those who caution against permitting aid-in-dying</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">, such as those articulated in the New York State Task Force on Life and the Law."</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">This task force issued the following recommendation in their 1994 report When Death is Sought: Assisted Suicide and Euthanasia in the Medical Context (4): "The Task Force members unanimously recommend that existing law should not be changed to permit assisted suicide or euthanasia. Legalizing assisted suicide and euthanasia would pose profound risks to many individuals who are ill and vulnerable. The Task Force members concluded that the potential dangers of this dramatic change in public policy would outweigh any benefit that might be achieved (p. 120)."</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">The New York bill aid-in-dying bill did not progress out of committee by the time the session ended in June.</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Lastly, both of these cases concluded that medical aid-in-dying was suicide. In Myers, Judge Mazzarelli stated, "The word 'suicide' has a straightforward meaning and a dictionary is hardly necessary…it is the act or instance of taking one's own life voluntarily and intentionally. Whatever label one puts on the act that plaintiffs are asking us to permit, it unquestionably fits that literal description."</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Regardless of the label used—aid-in-dying, assisted suicide, or self-deliverance—it is not a civil right.</span></span><br />
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<span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><span style="font-family: inherit;">* * * </span></span></div>
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<span style="font-family: inherit;"><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">Dr. Hanson is a forensic psychiatrist and co-author of Shrink Rap: Three Psychiatrists Explain Their Work. The opinions expressed are those of the author only, and do not represent those of any of Dr. Hanson's employers or consultees, including the Maryland Department of Health and Mental Hygiene or the Maryland Division of Correction.</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"> </span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">1. http://www.nmcompcomm.us/nmcases/nmsc/slips/SC35,478.pdf</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">2. https://www.deathwithdignity.org/assisted-dying-chronology/</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">3. http://www.nycourts.gov/reporter/3dseries/2016/2016_03457.htm</span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;"><br class="kix-line-break" /></span><span style="background-color: transparent; color: black; font-size: 14.6667px; font-style: normal; font-weight: 400; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;">4. https://www.health.ny.gov/regulations/task_force/reports_publications/when_death_is_sought/ (page 120)</span></span></div>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-83455198311312529212016-07-01T00:44:00.000-06:002019-08-03T18:55:34.122-06:00Decision Allowing Assisted Suicide Overturned<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
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<tr><td class="tr-caption" style="text-align: center;">New Mexico Supreme Court</td></tr>
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Today, the New Mexico Supreme Court upheld a criminal statute prohibiting "assisting suicide" as constitutional when applied to "physician aid in dying," meaning physician-assisted suicide. The 5-0 <a href="http://www.nmcompcomm.us/nmcases/nmsc/slips/SC35,478.pdf" target="_blank">decision</a> states in part:</div>
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[W]e agree with the legitimate concern that recognizing a right to physician aid in dying will lead to voluntary or involuntary euthanasia because if it is a right, it must be made available to everyone, even when a duly appointed surrogate makes the decision, and even when the patient is unable to self-administer the life-ending medication. . . .</blockquote>
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[The] statute is neither unconstitutional or its face nor as it is applied to Petitioners. . . . <i>[W]e reverse the district court's contrary conclusion</i> and remand to the district court for proceedings consistent with this opinion. (Emphasis added). [pp. 31 & 57]</blockquote>
Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-35775751541477369472014-05-23T12:13:00.001-06:002014-05-23T12:14:44.459-06:00Oregon Doctor Finds Fault with State's Law<span class="Apple-style-span" style="font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><a href="http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/oregon_doctor_finds_fault_with_states_law/" style="color: #463026; text-decoration: none;"><span style="color: #3d85c6; font-family: Verdana, sans-serif;">http://www.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/oregon_doctor_finds_fault_with_states_law/</span></a></span></span><span class="Apple-style-span" style="font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;"> </span></span></span><span class="Apple-style-span" style="font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"> </span></span><br />
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<span style="font-family: Verdana, sans-serif;">I am a doctor practicing medicine in Oregon and Washington, where physician-assisted suicide is legal. I disagree with Scot Lehigh that these suicides are not like other suicides in which “a healthy person [takes] his life for reasons of despair, depression, or hopelessness’’ (“Death with dignity in Mass.,’’ Op-ed, Sept. 23).</span><br />
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<span style="font-family: Verdana, sans-serif;">First, doctors can be wrong. So, what looks like a few months to live can be years. For a good article on this subject, see Nina Shapiro’s January 2009 "<a href="http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty/" style="color: #463026; text-decoration: none;"><span style="color: #3d85c6;">Terminal Uncertainty</span></a>" in the Seattle Weekly.</span><br />
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<span style="font-family: Verdana, sans-serif;">Second, despair, depression, and hopelessness <em>are </em>a part of assisted suicide. A few years ago, a patient of mine who was undergoing cancer treatment with a specialist became depressed, and expressed a wish for assisted suicide.</span><br />
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<span style="font-family: Verdana, sans-serif;">In most jurisdictions, suicidal ideation is interpreted as a cry for help. In Oregon, the only help my patient got was a lethal prescription intended to kill him. Don’t make our mistake. Keep assisted suicide out of Massachusetts.</span><br />
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<span style="font-family: Verdana, sans-serif;">Dr. Charles J. Bentz</span></div>
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<em><span style="font-family: Verdana, sans-serif;">Portland, Ore.</span></em></div>
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<em><span style="font-family: Verdana, sans-serif;">The writer is an associate professor of medicine in the division of general medicine and geriatrics at Oregon Health & Science University.</span></em></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-45974466357626814382014-05-23T12:12:00.002-06:002014-05-23T12:15:16.326-06:00What People Mean When They Say They Want to Die<div class="post-body entry-content" id="post-body-6719861616809048075" itemprop="description articleBody" style="position: relative; width: 470px;">
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<span style="font-family: Verdana, sans-serif; font-size: xx-small;">(originally published as a Statement for the BBC)</span></div>
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<span style="font-family: Verdana; font-size: xx-small;">For a print version, <a href="http://www.margaretdore.com/pdf/What_people_mean_001.pdf" style="color: #463026; text-decoration: none;"><span style="color: #3d85c6;">click here</span></a>. </span></div>
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<span style="font-family: Verdana, sans-serif;">by William Toffler, MD</span></div>
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<span style="font-family: Verdana, sans-serif;">______________________________________________</span></div>
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<span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">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. </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">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. </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">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. </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">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."</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">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.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">When a patient says, "I want to die"; it may simply mean, "I feel useless." </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">When a patient says, "I don't want to be a burden"; it may really be a question, "Am I a burden?" </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">When a patient says, "I've lived a long life already"; they may really be saying, "I'm tired. I'm afraid I can't keep going."</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">And, finally, when a patient says, "I might as well be dead"; they may really be saying, "No one cares about me." </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">Many studies show that assisted suicide requests are almost always for psychological or social reasons. In Oregon there has never been any documented case of assisted suicide used because there was actual untreatable pain.[6] As such, assisted suicide has been totally unnecessary in Oregon. </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">Sadly, the legislation passed in Oregon does not require that the patient have unbearable suffering, or any suffering for that matter. The actual Oregon experience has been a far cry from the televised images and advertisements that seduced the public to embrace assisted suicide. In statewide television ads in 1994, a woman named Patty Rosen claimed to have killed her daughter with an overdose of barbiturates because of intractable cancer pain. This claim was later challenged and shown to be false. Yet, even if it had been true, it would be an indication of inadequate medical care- not an indication for assisted suicide. </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">Astonishingly, there is not even inquiry about the potential gain to family members of the so-called "suicide" of a "loved one." This could be in the form of an inheritance, a life insurance policy, or, perhaps even simple freedom from previous care responsibilities. </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">Most problematic for me has been the change in attitude within the healthcare system itself. People with serious illnesses are sometimes fearful of the motives of doctors or consultants. Last year, a patient with bladder cancer contacted me. She was concerned that an oncologist might be one of the "death doctors." She questioned his motives—particularly when she obtained a second opinion from another oncologist which was more sanguine about her prognosis and treatment options. Whether one or the other consultant is correct or not, such fears were never an issue before assisted suicide was legalized. </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">In Oregon, I regularly receive notices that many important services and drugs for my patients-even some pain medications-won't be paid for by the State health plan. At the same time, assisted suicide is fully covered and sanctioned by the State of Oregon and by our collective tax dollars.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;"></span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">I urge UK leaders to reject the seductive siren of assisted suicide. Oregon has tasted the bitter pill of barbiturate overdoses and many now know that our legislation is hopelessly flawed. I believe Great Britain, the birthplace of Dame Cicely Saunders, and the Hospice movement, and a model to the rest of the world, deserves better.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, sans-serif;"><span class="Apple-style-span" style="font-size: 15px; line-height: 20px;"><br /></span></span></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-64555240290614920012014-05-23T12:11:00.004-06:002014-05-23T12:15:29.642-06:00Don't Follow Oregon's Lead: Say No to Assisted Suicide<span class="Apple-style-span" style="color: #303030; font-family: Verdana; font-size: 13px; line-height: 18px;"><a href="http://www.margaretdore.com/info/Bentz_Letter.pdf" style="color: #463026; text-decoration: none;">http://www.margaretdore.com/info/Bentz_Letter.pdf</a></span><br />
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<span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">I am an internal medicine doctor, practicing in Oregon where assisted suicide is legal. I write in support of Margaret Dore's article, "<i>Aid in Dying: Not Legal in Idaho; Not About Choice."</i> I would also like to share a story about one of my patients.<br /><br /><x -tab="-tab"></x>I was caring for a 76 year-old man who came in with a sore on his arm<span style="color: blue;">.</span> 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.<br /><br /><x -tab="-tab"></x>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.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;"><x -tab="-tab"></x>I told her that assisted-suicide was not appropriate for this patient and that I did NOT concur. I was very concerned about my patient's mental state, and I told her that addressing his underlying issues would be better than simply giving him a lethal prescription. Unfortunately, my concerns were ignored, and approximately two weeks later my patient was dead from an overdose prescribed by this doctor. His death certificate, filled out by this doctor, listed the cause of death as melanoma.<br /><br /><x -tab="-tab"></x>The public record is not accurate. My patient did not die from his cancer, but at the hands of a once-trusted colleague. This experience has affected me, my practice, and my understanding of what it means to be a physician. What happened to this patient, who was weak and vulnerable, raises several important questions that I have had to answer, and that the citizens of Idaho should also consider:<br /><br /><x -tab="-tab"> <strong> *</strong> If assisted suicide is made legal in Idaho, will you be able to trust your doctors, insurers and HMOs to give you and your family members the best care? I referred my patient to specialty care, to a doctor I trusted, and the outcome turned out to be fatal.<br /><x -tab="-tab"> </x><br /><x -tab="-tab"> </x><b>*</b> How will financial issues affect your choices? In Oregon, patients under the Oregon Health Plan have been denied coverage for treatment and offered coverage for suicide instead.<i> See e.g.</i> KATU TV story and video at</x></span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><a eudora="autourl" href="http://www.katu.com/home/video/26119539.html" style="color: #463026; text-decoration: none;"><span style="font-family: Verdana, sans-serif;">http://www.katu.com/home/video/26119539.html</span></a></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;"> (about Barbara Wagner). Do you want this to be your choice?<br /><br /><b><x -tab="-tab"> </x>*</b> If your doctor and/or HMO favors assisted suicide, will they let you know about all possible options or will they simply encourage you to kill yourself? The latter option will often involve often less actual work for the doctor and save the HMO money.<br /><br /><x -tab="-tab"></x>In most states, suicidal ideation is interpreted as a cry for help. In Oregon, the only help my patient received was a lethal prescription, intended to kill him.<br /><br /><x -tab="-tab"></x>Is this where you want to go? Please learn the real lesson from Oregon. Despite all of the so-called safeguards in our assisted suicide law, numerous instances of coercion, inappropriate selection, botched attempts, and active euthanasia have been documented in the public record.<br /><br /><x -tab="-tab"></x>Protect yourselves and your families. Don't let legalized assisted suicide come to Idaho.<br /><br />Charles J. Bentz MD, FACP<br />Clinical Associate Professor of Medicine, Division of General Medicine and Geriatrics Oregon Health & Sciences University<br />Portland Oregon</span></span></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-32210660362766554882014-05-23T12:11:00.002-06:002014-05-23T12:15:45.180-06:00"The mere presence of legal assisted-suicide steers patients to suicide"<span class="Apple-style-span" style="color: #303030; font-family: Verdana, sans-serif; font-size: 15px; line-height: 20px;">November 27, 2011</span><br />
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<span class="Apple-style-span" style="color: #303030;"><b><br /><span style="font-family: Verdana, sans-serif; font-size: 15px; line-height: 20px;">To Massachusetts Medical Society </span></b></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">Dear House of Delegates Officers and Other Interested Parties:<br /><br />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).<br /><br />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.<br /><br />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.<br /><br />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.<br /><br /> [Support for this letter regarding Barbara Wagner and Randy Stroup can be found in these articles: <span style="color: #3d85c6;"><a href="http://www.katu.com/news/26119539.html" style="color: #463026; text-decoration: none;" target="_blank"><span style="color: #3d85c6;">http://www.katu.com/news/26119539.html</span></a></span> &<a href="http://abcnews.go.com/Health/story?id=5517492&page=1" style="color: #463026; text-decoration: none;" target="_blank"><span style="color: #3d85c6;">http://abcnews.go.com/Health/story?id=5517492&page=1</span></a> My patient’s letter in the Boston Globe describing her being alive 11 years later can be read here:</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><a href="http://articles.boston.com/2011-10-04/bostonglobe/30243525_1_suicide-doctor-ballot-initiative" style="color: #463026; text-decoration: none;" target="_blank"><span style="color: #3d85c6; font-family: Verdana, sans-serif;">http://articles.boston.com/2011-10-04/bostonglobe/30243525_1_suicide-doctor-ballot-initiative</span></a></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;"><span style="color: #3d85c6;"> </span> ]<br /><br />Kenneth R.Stevens, Jr., MD<br />Sherwood, OR </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 20px;"><span style="font-family: Verdana, sans-serif;">Professor Emeritus and former Chair, Radiation Oncology Department, Oregon Health & Science University, Portland, Oregon</span></span></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-47313184188265445242014-05-23T12:10:00.003-06:002014-05-23T12:15:58.948-06:00"If Dr Stevens had believed in assisted suicide, I would be dead"<span class="Apple-style-span" style="font-family: Verdana, Geneva, sans-serif; font-size: 15px; line-height: 21px;"><a href="http://www.ravallirepublic.com/news/opinion/mailbag/article_e05fa28b-dd72-5688-a321-654cc86fc213.html?print=true&cid=print" style="color: #576e16; text-decoration: none;"><span style="font-size: xx-small;"><span style="color: #2288bb;">http://www.ravallirepublic.com/news/opinion/mailbag/article_e05fa28b-dd72-5688-a321-654cc86fc213.html?print=true&cid=print</span></span></a></span><br />
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<span style="font-family: Verdana, sans-serif;">November 28, 2012 </span></div>
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<span style="font-family: Verdana, sans-serif;">Thank you for publishing the letter by Dr. Ken Stevens describing how he talked his patient out of doing assisted suicide in Oregon. I am that patient and he did save my life.</span><br />
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<span style="font-family: Verdana, sans-serif;">In 1997, I voted for the initiative that legalized assisted suicide in Oregon.</span></div>
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<span style="font-family: Verdana, sans-serif;"><span style="font-family: Verdana, sans-serif;">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 did not want to suffer, and I did not want to do radiation. I wanted Stevens to help me, but he didn’t really answer me.</span><br /><br /><span style="font-family: Verdana, sans-serif;">Instead, he encouraged me to not give up and ultimately I decided to fight the cancer. I had both chemotherapy and radiation. I am so happy to be alive!</span><br /><br /><span style="font-family: Verdana, sans-serif;">It is now 12 years later. If Dr. Stevens 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.</span><br /><br /><span style="font-family: Verdana, sans-serif;">Thank you so much.</span><br /><br /><em><span style="font-family: Verdana, sans-serif;">Jeanette Hall,</span></em><br /><em><span style="font-family: Verdana, sans-serif;">King City, Oregon</span></em></span></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-75533114067964301932014-05-23T12:10:00.001-06:002014-05-23T12:29:59.060-06:00"I was afraid to leave my husband alone"<span class="Apple-style-span" style="color: #303030; font-family: Verdana, sans-serif; font-size: 13px; line-height: 18px;">Letter from Oregon resident, Kathryn Judson, Published in the Hawaii Free Press, February 15, 2011. </span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-size: xx-small;">To view the original letter, <a href="http://hawaiifreepress.com/main/ArticlesDailyNews/tabid/65/articleType/ArticleView/articleId/3647/February-2011-Letters-to-the-Editor.aspx" style="color: #463026; text-decoration: none;"><span style="color: #3d85c6;">click here and scroll down towards the bottom of the page</span></a>. </span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, sans-serif; font-size: 13px; line-height: 18px;"> </span><br />
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<span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">Dear Editor,</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">Hello from Oregon.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">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).</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">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.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">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.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">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).</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">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.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">It's not a good thing, wondering who you can trust in a hospital or clinic. I hope you are spared this in Hawaii.</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">Sincerely,</span></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><br /></span><span class="Apple-style-span" style="color: #303030; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;">Kathryn Judson, Oregon</span></span></div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-46642980580190181442014-01-27T22:56:00.001-07:002014-01-27T22:56:31.071-07:00"Is there a way to allow a person to end his life without making someone else a criminal?"<div style="background-color: white; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18.479999542236328px; text-align: right;">
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<br style="background-color: white; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18.479999542236328px;" /><span style="background-color: white; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18.479999542236328px;">A legislator considering an assisted suicide law asked me this question: </span><span style="background-color: white; font-family: Verdana, Geneva, sans-serif; font-size: 13px; line-height: 18.479999542236328px; text-align: center;">"Is there a way to allow a person to end his life without making someone else a criminal?"</span><br />
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This was my (slightly edited) response:<br /><br />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 the <a href="http://choiceisanillusion.files.wordpress.com/2013/07/signed-stevens-aff-9-18-12-as-filed.pdf" style="color: #3d85c6; text-decoration: none;" target="_blank">Affidavit of Kenneth Stevens, MD</a>, page 3, paragraph 13.<br /><br />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, "<a href="http://www.courthousenews.com/2012/02/06/43641.htm" style="color: #3d85c6; text-decoration: none;" target="_blank">Grim Complaint Against Kaiser Hospital</a>," Court House News Service, February 6, 2012.<br /><br />I've had like 15-20 contacts in the past year by people upset about their family member<b> </b>being suddenly off'd<b> </b>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. <a eudora="autourl" href="http://www.montanansagainstassistedsuicide.org/2013/04/dont-give-doctors-more-power-to-abuse.html" style="color: #3d85c6; text-decoration: none;">http://www.montanansagainstassistedsuicide.org/2013/04/dont-give-doctors-more-power-to-abuse.html</a><br /><br />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"). <a href="http://www.montanansagainstassistedsuicide.org/2012/07/dear-montana-board-of-medical-examiners.html" style="color: #3d85c6; text-decoration: none;">http://www.montanansagainstassistedsuicide.org/2012/07/dear-montana-board-of-medical-examiners.html</a> 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. <a eudora="autourl" href="http://www.montanansagainstassistedsuicide.org/2013/01/i-was-afraid-to-leave-my-husband-alone.html" style="color: #3d85c6; text-decoration: none;">http://www.montanansagainstassistedsuicide.org/2013/01/i-was-afraid-to-leave-my-husband-alone.html</a><br /><br />There is also the issue that people who say they want to die don't mean it, as with any suicide. See <a eudora="autourl" href="http://www.montanansagainstassistedsuicide.org/p/what-people-mean-when-they-say-they.html" style="color: #3d85c6; text-decoration: none;">http://www.montanansagainstassistedsuicide.org/p/what-people-mean-when-they-say-they.html</a><br /><br />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 <a eudora="autourl" href="http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf" style="color: #3d85c6; text-decoration: none;">http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf</a><br /><br />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:<br /><blockquote class="tr_bq">
"[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.</blockquote>
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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."</blockquote>
<a href="http://www.margaretdore.com/pdf/senator_essmann_sb_167_001.pdf" style="color: #3d85c6; text-decoration: none;" target="_blank">Senate Judiciary Hearing on SB 167 on February 10, 2011</a><br /><br />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: <a eudora="autourl" href="http://www.doh.wa.gov/portals/1/Documents/5300/DWDAMedCoroner.pdf" style="color: #3d85c6; text-decoration: none;">http://www.doh.wa.gov/portals/1/Documents/5300/DWDAMedCoroner.pdf</a> How can you prosecute someone for homicide if the death is required to be reported as "Natural?"<br /><br />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 <i>Seattle Times</i> column suggested euthanasia as a solution for people unable to support themselves, which would be involuntary euthanasia. See Jerry Large, "<a href="http://seattletimes.nwsource.com/text/2017693023.html" style="color: #3d85c6; text-decoration: none;" target="_blank">Planning for old age at a premium</a>,"<i> </i>March 8, 2012, which states:<br /><blockquote class="tr_bq">
"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. <i>At least a couple mentioned euthanasia as a solution</i>." (Emphasis added)</blockquote>
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?<br /><br />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.<br /><br />Thank you for writing me back.<br /><br />Margaret Dore</div>
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Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-9832923739489197882012-08-03T16:16:00.002-06:002012-08-03T16:16:16.322-06:00WelcomeA lawsuit has been filed in New Mexico seeking to legalize assisted suicide (aid in dying).Unknownnoreply@blogger.comtag:blogger.com,1999:blog-8054866419304970097.post-24421767322574421592009-01-14T18:35:00.000-07:002019-08-03T18:45:24.506-06:00Terminal Uncertainty: What if the Doctors Are Wrong?<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhd5nDMEs0wA5xTo6UQenRmCOdsCWrx7zxVTZAOy4ciloq6Ct1MExODy-iU5ahRM3n3giz8iDKqXCD6Dj9ja4uER14mMeO7lmtSFyYZJvdowHJOpX4Adqut-zd3XGiXJXUeW_Ddfe3BbF0/s1600/Photo+Balloon+Grand+Canyon.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="180" data-original-width="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhd5nDMEs0wA5xTo6UQenRmCOdsCWrx7zxVTZAOy4ciloq6Ct1MExODy-iU5ahRM3n3giz8iDKqXCD6Dj9ja4uER14mMeO7lmtSFyYZJvdowHJOpX4Adqut-zd3XGiXJXUeW_Ddfe3BbF0/s1600/Photo+Balloon+Grand+Canyon.jpg" /></a></td></tr>
<tr><td class="tr-caption" style="font-size: 12.8px; text-align: center;"><span style="background-color: white; text-align: start;"><span style="font-size: small;">Since the day she was given two to four months<br /> to live, Clayton has gone with her children on a<br />series of vacations, including a tour<br /> of the Southwest</span></span><span style="font-size: small;">.</span></td></tr>
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<span style="background-color: white;"><span style="font-family: inherit;">She noticed the back pain first. Driving to the grocery store, Maryanne Clayton would have to pull over to the side of the road in tears. Then 62, a retired computer technician, she <span style="font-family: inherit;">went to</span></span></span><span style="font-family: inherit;"><span style="background-color: white;"> see a doctor in the Tri-Cities, where she lived. The diagnosis was grim. She already had Stage IV lung cancer, the most advanced form there is. Her tumor had metastasized up her spine. The doctor gave Clayton two to four months to live.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">That was almost four years ago.</span></span><br />
<a name='more'></a><span style="font-family: inherit;"><br style="background-color: white;" /><span style="background-color: white;">Prodded by a son who lives in Seattle, Clayton sought treatment from Dr. Renato Martins, a lung cancer specialist at Fred Hutchinson Cancer Research Center. Too weak to endure the toxicity of chemotherapy, she started with radiation, which at first made her even weaker but eventually built her strength. Given dodgy prospects with the standard treatments, Clayton then decided to participate in the clinical trial of a new drug called pemetrexate.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Her response was remarkable. The tumors shrunk, and although they eventually grew back, they shrunk again when she enrolled in a second clinical trial. (Pemetrexate has since been approved by the FDA for initial treatment in lung cancer cases.) She now comes to the Hutch every three weeks to see Martins, get CT scans, and undergo her drug regimen. The prognosis she was given has proved to be "quite wrong."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"I just kept going and going," says Clayton. "You kind of don't notice how long it's been." She is a plain-spoken woman with a raspy voice, a pink face, and grayish-brown hair that fell out during treatment but grew back newly lustrous. "I had to have cancer to have nice hair," she deadpans, putting a hand to her short tresses as she sits, one day last month, in a Fred Hutchinson waiting room. Since the day she was given two to four months to live, Clayton has gone with her children on a series of vacations, including a cruise to the Caribbean, a trip to Hawaii, and a tour of the Southwest that culminated in a visit to the Grand Canyon. There she rode a hot-air balloon that hit a snag as it descended and tipped over, sending everybody crawling out.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"We almost lost her because she was having too much fun, not from cancer," Martins chuckles.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Her experience underscores the difficulty doctors have in forecasting how long patients have to live—a difficulty that is about to become even more pertinent as the Washington Death With Dignity Act takes effect March 4. The law, passed by initiative last November and modeled closely on a 14-year-old law in Oregon, makes Washington the only other state in the country to allow terminally ill patients to obtain lethal medication. As in Oregon, the law is tightly linked to a prognosis: Two doctors must say a patient has six months or less to live before such medication can be prescribed.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">The law has deeply divided doctors, with some loath to help patients end their lives and others asserting it's the most humane thing to do. But there's one thing many on both sides can agree on. Dr. Stuart Farber, head of palliative care at the University of Washington Medical Center, puts it this way: "Our ability to predict what will happen to you in the next six months sucks.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"In one sense, six months is an arbitrary figure. "Why not four months? Why not eight months?" asks Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, adding that medical literature does not define the term "terminally ill." The federal Medicare program, however, has determined that it will pay for hospice care for patients with a prognosis of six months or less. "That's why we chose six months," explains George Eighmey, executive director of Compassion & Choices of Oregon, the group that led the advocacy for the nation's first physician-assisted suicide law. He points out that doctors are already used to making that determination.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">To do so, doctors fill out a detailed checklist derived from Medicare guidelines that are intended to ensure that patients truly are at death's door, and that the federal government won't be shelling out for hospice care indefinitely. The checklist covers a patient's ability to speak, walk, and smile, in addition to technical criteria specific to a person's medical condition, such as distant metastases in the case of cancer or a "CD4 count" of less than 25 cells in the case of AIDS.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">No such detailed checklist is likely to be required for patients looking to end their lives in Washington, however. The state Department of Health, currently drafting regulations to comply with the new law, has released a preliminary version of the form that will go to doctors. Virtually identical to the one used in Oregon, it simply asks doctors to check a box indicating they have determined that "the patient has six months or less to live" without any additional questions about how that determination was made.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Even when applying the rigid criteria for hospice eligibility, doctors often get it wrong, according to Nicholas Christakis, a professor of medicine and sociology at Harvard University and a pioneer in research on this subject. As a child, his mother was diagnosed with Hodgkin's disease. "When I was six, she was given a 10 percent chance of living beyond three weeks," he writes in his 2000 book, Death Foretold: Prophecy and Prognosis in Medical Care. "She lived for nineteen remarkable years...I spent my boyhood always fearing that her lifelong chemotherapy would stop working, constantly wondering whether my mother would live or die, and both craving and detesting prognostic precision.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"Sadly, Christakis' research has shown that his mother was an exception. In 2000, Christakis published a study in the British Medical Journal that followed 500 patients admitted to hospice programs in Chicago. He found that only 20 percent of the patients died approximately when their doctors had predicted. Unfortunately, most died sooner. "By and large, the physicians were overly optimistic," says Christakis.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">In the world of hospice care, this finding is disturbing because it indicates that many patients aren't being referred early enough to take full advantage of services that might ease their final months. "That's what has frustrated hospices for decades," says Wayne McCormick, medical director of Providence Hospice of Seattle, explaining that hospice staff frequently don't get enough time with patients to do their best work.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Death With Dignity advocates, however, point to this finding to allay concerns that people might be killing themselves too soon based on an erroneous six-month prognosis. "Of course, there is the occasional person who outlives his or her prognosis," says Robb Miller, executive director of Compassion & Choices of Washington. Actually, 17 percent of patients did so in the Christakis study. This roughly coincides with data collected by the National Hospice and Palliative Care Organization, which in 2007 showed that 13 percent of hospice patients around the country outlived their six-month prognoses.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">It's not that prognostication is completely lacking in a scientific basis. There is a reason that you can pick up a textbook and find a life expectancy associated with most medical conditions: Studies have followed populations of people with these conditions. It's a statistical average. To be precise, it's a median, explains Martins. "That means 50 percent will do worse and 50 percent will do better."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Doctors also shade their prognoses according to their own biases and desires. Christakis' study found that the longer a doctor knew a patient, the more likely their prognosis was inaccurate, suggesting that doctors who get attached to their patients are reluctant to talk of their imminent demise. What's more, Christakis says, doctors see death "as a mark of failure."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Oncologists in particular tend to adopt a cheerleading attitude "right up to the end," says Brian Wicks, an orthopedic surgeon and past president of the Washington State Medical Association. Rather than talk about death, he says, their attitude is "Hey, one more round of chemo!"</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">But it is also true that one more round of chemo, or new drugs like the one that helped Clayton, or sometimes even just leaving patients alone, can help them in ways that are impossible to predict. J. Randall Curtis, a pulmonary disease specialist and director of an end-of-life research program at Harborview Medical Center, recalls treating an older man with severe emphysema a couple of years ago. "I didn't think I could get him off life support," Curtis says. The man was on a ventilator. Every day Randall tested whether the patient could breathe on his own, and every day the patient failed the test. He had previously made it clear that he did not want to be kept alive by machines, according to Curtis, and so the doctor and the man's family made the wrenching decision to pull the plug.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">But instead of dying as expected, the man slowly began to get better. Curtis doesn't know exactly why, but guesses that for that patient, "being off the ventilator was probably better than being on it. He was more comfortable, less stressed." Curtis says the man lived for at least a year afterwards.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Curtis also once kept a patient on life support against his better judgment because her family insisted. "I thought she would live days to weeks," he says of the woman, who was suffering from septic shock and multiple organ failure. Instead she improved enough to eventually leave the hospital and come back for a visit some six or eight months later.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"It was humbling," he says. "It was not amazing. That's the kind of thing in medicine that happens frequently."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Every morning when Heidi Mayer wakes up, at 5 a.m. as is her habit, she says "Howdy" to her husband Bud—very loudly. "If he says 'Howdy' back, I know he's OK," she explains.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"There's always a little triumph," Bud chimes in. "I made it for another day.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"It's been like this for years. A decade ago, after clearing a jungle of blackberries off a lot he had bought adjacent to his secluded ranch house south of Tacoma, Bud came down with a case of pneumonia. "Well, no wonder he's so sick," Heidi recalls the chief of medicine saying at the hospital where he was brought. "He's in congestive heart failure."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Then 75, "he became old almost overnight," Heidi says. Still, Bud was put on medications that kept him going—long enough to have a stroke five years later, kidney failure the year after that, and then the onset of severe chest pain known as angina. "It was scary," says Heidi, who found herself struggling at 3 a.m. to find Bud's veins so she could inject the morphine that the doctor had given Bud for the pain. Heidi is a petite blond nurse with a raucous laugh. She's 20 years younger than her husband, whom she met at a military hospital, and shares his cigar-smoking habit. Bud was a high-flying psychiatrist in the '80s when he became the U.S. Assistant Secretary of Defense, responsible for all Armed Forces health activities.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">After his onslaught of illnesses, Bud says, his own prognosis for himself was grim. "Looking at a patient who had what I had, I would have been absolutely convinced that my chance of surviving more than a few months was very slim indeed."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Bud's doctor eventually agreed, referring him to hospice with a prognosis of six months. That was a year and a half ago. Bud, who receives visits from hospice staff at home, has since not gotten much worse or much better. Although he has trouble walking and freely speaks of himself as "dying," he looks like any elderly grandfather, sitting in a living room decorated with mounted animal heads, stuffing tobacco into his pipe and chatting about his renewed love of nature and the</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">letter he plans to write to Barack Obama with his ideas for improving medical care. Despite his ill health, he says the past few years have been a wonderful, peaceful period for him—one that physician-assisted suicide, which he opposes, would have cut short.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">A year after he first began getting visits from the Franciscan Hospice, the organization sent Dr. Bruce Brazina to Mayer's home to certify that he was still really dying. It's something Brazina says he does two to four times a week as patients outlive their six-month prognoses. Sometimes, Brazina says, patients have improved so much he can no longer forecast their imminent death. In those cases, "we take them off service"—a polite way of saying that patients are kicked off hospice care, a standard procedure at all hospices due to Medicare rules. But Brazina found that Mayer's heart condition was still severe enough to warrant another six-month prognosis, which the retired doctor has just about outlived again.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"It's getting to the point where I'm a little embarrassed," Mayer says.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">What's going on with him is a little different than what happened to Randall Curtis' patients or to Maryanne Clayton. Rather than reviving from near death or surviving a disease that normally kills quickly, Mayer is suffering from chronic diseases that typically follow an unpredictable course. "People can be very sick but go along fine and stable," Brazina explains. "But then they'll have an acute attack." The problem for prognosis is that doctors have no way of knowing when those attacks will be or whether patients will be able to survive them.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">When a group of researchers looked specifically at patients with three chronic conditions—pulmonary disease, heart failure, and severe liver disease—they found that many more people outlived their prognosis than in the Christakis study. Fully 70 percent of the 900 patients eligible for hospice care lived longer than six months, according to a 1999 paper published in the Journal of the American Medical Association.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Given these two studies, it's no surprise that in Oregon some people who got a prescription for lethal medication on the basis of a six-month prognosis have lived longer. Of the 341 people who put themselves to death as of 2007 (the latest statistics available), 17 did so between six months and two years after getting their prescription, according to state epidemiologist Katrina Hedberg. Of course, there's no telling how long any of the 341 would have lived had they not killed themselves. The Department of Health does not record how long people have lived after getting prescriptions they do not use, so there's no telling, either, whether those 200 people outlived their prognosis. Compassion & Choices of Oregon, which independently keeps data on the people whom it helps navigate the law, says some have lived as long as eight years after first inquiring about the process (although it doesn't track whether they ever received the medication and a six-month prognosis).</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">The medical field's spotty track record with prognosis is one reason Harborview's Curtis says he is not comfortable participating in physician-assisted suicide. It's one thing to make a six-month prognosis that will allow patients access to hospice services, he says, and quite another to do so for the purpose of enabling patients to kill themselves. "The consequences of being wrong are pretty different," he says.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Under the law, doctors and institutions are free to opt out, and several Catholic institutions like Providence Hospice of Seattle have already said they will do so. Medical director McCormick finds the idea of patients killing themselves particularly troubling because "you can't predict what's going to happen or who's going to show up near the end of your life." He says he has watched people make peace with loved ones or form wonderful new connections. He's preparing a speech in case patients ask about the new law: "I will stop at nothing to ensure that you're comfortable. I won't shorten your life, but I will make it as high-quality as possible."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Thomas Preston, a retired cardiologist who serves as medical director of Compassion & Choices of Washington, says he has in mind a different kind of speech: "You have to understand that this prognosis could be wrong. You may have more than six months to live. You may be cutting off some useful life."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">He also says he will advise doctors to be more conservative than the law allows. "If you think it's going to be six months, hold off on it [writing a prescription]—just to be sure." Instead, he'll suggest that doctors wait until they think a patient has only one or two months to live.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">The UW's Farber leans toward a different approach. While he says he hasn't yet decided whether he himself will write fatal prescriptions, he plans at least to refer patients to others who will. Given that prognostic precision is impossible, he says, "I personally just let go of the six months." Instead, he says he would try to meet what he sees as the "spirit of the law" by assessing that someone is "near" the end of their life, so that he could say to them, "You're really sick and you're not going to get better."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Knowing exactly when someone is going to die, he continues, is not as important as knowing when someone "has reached the point where their life is filled with so much suffering that they don't want to be alive."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Randy Niedzielski reached that point in the summer of 2006, according to his wife Nancy. Diagnosed with brain cancer in 2000, the onetime Lynnwood property manager had been through several rounds of chemotherapy and had lived years longer than the norm. But the cancer cells had come back in an even more virulent form and had spread to his muscle system. "He would have these bizarre muscle contractions," Nancy recalls. "His feet would go into a cone shape. His arms would twist in weird angles." Or his chest would of its own volition go into what Nancy calls a "tent position," rising up from his arms. "He'd just be screaming in pain."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Randy would have liked to move to Oregon to take advantage of the Death With Dignity Act there, according to Nancy. But he didn't have time to establish residency as required. That was about six weeks before his death.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Nancy, who has become an advocate for physician-assisted suicide, says that typically people are only weeks or days away from death when they want to kill themselves. Oregon's experience with people hanging onto their medicine for so long, rather than rushing to use it as soon as they get a six-month prognosis, bears this out, she says: "A patient will know when he's at the very end of his life. Doctors don't need to tell you."</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Sometimes, though, patients are not so near the end of their life when they're ready to die. University of Washington bioethics professor Helene Starks and Anthony Back, director of palliative care at the Seattle Cancer Care Alliance, are two of several researchers who in 2005 published a study that looked at 26 patients who "hastened" their death. A few were in Oregon, but most were in Washington, and they brought about their own demise mostly either by refusing to eat or drink or by obtaining medication illegally, according to Back and Starks. Three of these patients had "well over six months" of remaining life, Starks says, perhaps even years.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">The paper, published in the Journal of Pain and Symptom Management, quotes from an interview with one of these patients before she took her life. Suffering from a congenital malformation of the spine, she said it had reached the point that her spine or neck could be injured even while sitting. "I'm in an invisible prison," she continued. "Every move I make is an effort. I can't live like this because of the constant stress, unbearable pain, and the knowledge that it will never be any better.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"Under the law, she would not be eligible for lethal medication. Her case was not considered "terminal," according to the paper. But for patients like her, the present is still unbearable. Former governor Booth Gardner, the state's most visible champion of physician-assisted suicide, would have preferred a law that applied to everyone who viewed their suffering this way, regardless of how long they were expected to live. He told The New York Times Magazine, for a December 2007 story, that the six-month rule was a compromise meant to help insure the passage of Initiative 1000. Gardner has Parkinson's disease, and now can talk only haltingly by phone. In an interview he explained that he has been housebound of late due to several accidents related to his lack of balance.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Researchers who have interviewed patients, their families, and their doctors have found, however, that pain is not the central issue. Fear of future suffering looms larger, as does people's desire to control their own end.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">"It comes down to more existential issues," says Back. For his study of Washington and Oregon patients, he interviewed one woman who had been a successful business owner. "That's what gave her her zest for life," Back says, and without it she was ready to die.</span><br style="background-color: white;" /><br style="background-color: white;" /><span style="background-color: white;">Maryanne Clayton says she has never reached that point. Still, she voted for the Death With Dignity Act. "Why force me to suffer?" she asks, adding that if she were today in as much pain as she was when first diagnosed with lung cancer, she might consider taking advantage of the new law. But for now, she still enjoys life. Her 35-year-old son Eric shares a duplex with her in the Tri-Cities. They like different food. But every night he cooks dinner on his side, she cooks dinner on her side, and they eat together. And one more day passes that proves her prognosis wrong.</span></span><br />
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<span style="font-family: inherit;"><span style="background-color: white;">Nina Shapiro, Seattle Weekly, 01-14-2008</span></span>Adminhttp://www.blogger.com/profile/13314132820263802243noreply@blogger.com