Tuesday, January 1, 2013

Assisted suicide in Washington and Oregon: A recipe for elder abuse and cloaked in secrecy

The following article was written by Seattle lawyer, Margaret Dore and published on December 31 on the Missoulian website under the title: Oregon, Washington assisted suicide laws include no protections for patients. Margaret Dore indicated that she had titled the article: Assisted suicide in Washington and Oregon: A recipe for elder abuse and cloaked in secrecy.
Margaret Dore

By Margaret Dore, Esq.

I disagree with Susan Hancock’s description of how the Washington and Oregon assisted suicide laws work.  (Dec. 20, guest column)  I disagree that assisted suicide cannot be forced upon an unwilling person.

The Oregon and Washington assisted suicide acts have a formal application process. The acts allow an heir, who will benefit from the patient’s death, to actively participate in this process.

Once the lethal dose is issued by the pharmacy, there is no oversight. For example, there is no witness required at the death. Without disinterested witnesses, the opportunity is created for an heir, or for another person who will benefit from the patient’s death, to administer the lethal dose to the patient without his consent. One method would be by injection when the patient is sleeping. The drugs used in Oregon and Washington are water soluble and therefore injectable. If the patient woke up and struggled, who would know?

The Washington and Oregon acts require the state health departments to collect statistical information for the purpose of annual reports. According to these reports, users of assisted-suicide are overwhelmingly white and generally well-educated. Many have private insurance. Most are age 65 and older. Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.

The forms used to collect the statistical information do not ask about abuse. Moreover, not even law enforcement is allowed to access information about a particular case. Alicia Parkman a mortality research analyst at the Center for Health Statistics, Oregon Health Authority, wrote me: 
“We have been contacted by law enforcement and legal representatives in the past, but have not provided identifying information of any type.“
Assisted suicide in Washington and Oregon is a recipe for elder abuse and cloaked in secrecy. Don’t make our mistake.

Supporting documentation below.

Margaret Dore, Esq. Seattle, Washington

[1] See, for example, Margaret Dore, "'Death with Dignity': What Do We Advise Our Clients?," King County Bar Association, Bar Bulletin, May 2009 (describing Washington's application process and other aspects of Washington's law), at:  https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm

[2] The drugs used, Secobarbital and Pentobarbital (Nembutal), are set forth in the Oregon and Washington annual reports. See, e.g., Table 1 to Oregon's most recent report listing these drugs, page 2, at:  http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14-tbl-1.pdf

[3] Secobarbital and Pentobarbital are  water and alcohol soluable, such that they can be injected without consent, for example, to a sleeping individual. See "Secobarbital Sodium Capsules, Drugs.Com, at:  http://www.drugs.com/pro/seconal-sodium.html or http://www.drugs.com/pro/nembutal.html

[4] See the most current official report from Washington State, "Washington State Department of Health 2011 Death with Dignity Act Report, Executive Summary ("Of the 94 participants in 2011 who died, . . . 94% were white, non-Hispanic . . .75 percent had at least some college education"), available at: http://www.doh.wa.gov/portals/1/Documents/5300/DWDA2011.pdf. See also the most current official report from Oregon, also for 2011 ("most [users] were white (95.6%) [and] well-educated (48.5% had at least a baccalaureate degree) . . .", available at:  http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year14.pdf

[5] See Washington's report, table 2 (46% had private insurance only, or a combination of private and Medicaid/Medicare). See Oregon's report ("patients who had private insurance (50.8%) was lower in 2011 than in previous years (68.0%). . .")

[6] See Washington's report, Table 2 (74% were aged 65 or older). See Oregon's report, page 2 ("Of the 71 DWDA deaths during 2011, most (69.0%) were aged 65 years or older; the median age was 70 years").

[7] Educated persons are generally financially better off than non-educated persons; persons with private insurance often have current or past employment; seniors generally are relatively well off. See "Broken Trust: Elders, Family, and Finances, a Study on Elder Financial Abuse Prevention, by the MetLife Mature Market Institute, the National Committee for the Prevention of Elder Abuse, and the Center for Gerontology at Virginia Polytechnic Institute, March 2009, Executive Summary, page 4 ("Elders' vulnerabilities and larger net worth make them a prime target for financial abuse").  Available at:  http://www.metlife.com/assets/cao/mmi/publications/studies/mmi-study-broken-trust-elders-family-finances.pdf

[8] The Met Life Study of Elder Financial Abuse, "Crimes of Occasion, Desperation, and Predation Against America's Elders," June 2011, page 2, key findings ("The annual financial loss by victims of elder financial abuse is estimated to be at least $2.9 billion dollars, a 12% increase from the $2.6 billion estimated in 2008").  Available at:  http://www.metlife.com/assets/cao/mmi/publications/studies/2011/mmi-elder-financial-abuse.pdf

[9] The reporting forms focus on "ingestion" of the lethal dose and whether the patient "took" or "consumed" the lethal dose, none of which necessarily require a voluntary or consensual act. Oregon's reporting forms can be accessed here: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/mdintdat.pdf

[10] Ms Parkman's e-mail to me can be viewed here: http://choiceisanillusion.files.wordpress.com/2012/10/alicia-a-parkman-no-law-enforcement-access.pdf

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