Saturday, June 15, 2019

American Medical Association opposes assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Fabulous news. 

The American Medical Association (AMA) has overwhelmingly upheld its opposition to assisted suicide.

After years of deliberation the (AMA) delegates, at their House of delegates meeting, supported the assisted suicide report of the Council on Ethical and Judicial Affairs (CEJA) by a vote of 360 to 190 and re-affirmed their position opposing assisted suicide by a overwhelming vote of 392 to 162.

Joyce Frieden, reporting for Medscape on the deliberations stated that the delegates supported two opinions. That being:
... Code of Medical Ethics Opinion 5.7, which states that "permitting physicians to engage in assisted suicide would ultimately cause more harm than good. Physician-assisted suicide is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks. Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life."

... E-1.1.7 of the AMA's Principles of Medical Ethics, states that "Physicians are expected to uphold the ethical norms of their profession, including fidelity to patients and respect for patient self-determination ... Preserving opportunity for physicians to act (or to refrain from acting) in accordance with the dictates of conscience in their professional practice is important for preserving the integrity of the medical profession as well as the integrity of the individual physician, on which patients and the public rely. Thus physicians should have considerable latitude to practice in accord with well-considered, deeply held beliefs that are central to their self-identities."
Frieden, reporting for Medscape, stated that Diane Gowski, MD, of Clearwater, Florida, an alternate delegate for the Society of Critical Care Medicine and speaking on behalf of the Chest Caucus stated:
"We would not give our patients a gun or revolver ... so we should not be supplying them with lethal drugs. Physician-assisted suicide violates natural moral law. We urge the AMA to stand firm, as any change from the current position will only confuse the public as to the intention and role of their physicians."
Dr Shane Macaulay
According to Frieden Shane Macaulay, MD, of Kirkland, Wash., speaking for the Washington delegation stated:
"Oregon legalized assisted suicide in 1997 with repeated assurances that it would stay contained and would not become euthanasia," he said. "Just last month, the Oregon state House of Representatives approved a bill to allow patient death by lethal injection, showing the inevitable progression from assisted suicide to euthanasia once physicians have accepted the idea that taking a patient's life is permissible." 
"In Canada, assisted suicide and euthanasia were legalized only 3 years ago, and in the 3 years we've debated this topic here, euthanasia has become a runaway contagion in Canada, with over 4,000 deaths last year." 
"These alarming developments show us that the wheels are coming off bus on assisted suicide. We do not have the luxury of time to continue to fail to act on the CEJA report while the real-world situation deteriorates. Unless we're willing to embrace widespread euthanasia, we must accept the CEJA report and reaffirm this policy now as a firewall against what is [happening in] Canada."
At a 2016 meeting of the AMA, delegates voted to ask CEJA to review the AMA policy on assisted suicide.

In May 2018, CEJA upheld the AMA policy on assisted suicide, but in June 2018, AMA delegates asked CEJA to continue reviewing its policy on assisted suicide.

In October 2018, CEJA adjusted the language of its policy while upholding that the AMA maintain its opposition to assisted suicide. In November 2018, AMA delegates once again decided to ask CEJA to continue reviewing the AMA policy on assisted suicide.

After three years of intense review of its assisted suicide policy, AMA delegates overwhelmingly upheld that assisted suicide is incompatible with the physician's role as healer.

Maine Governor comes out pro-suicide and signs assisted suicide bill.

This article was published by the National Review online on June 14, 2019

Wesley J Smith
By Wesley J Smith

Maine Governor Janet Mills (D) just signed a bill legalizing assisted suicide. That means she is pro, at least some, suicides.

But her statement justifying her signing goes even further, and in my view, crosses the line to full-bore pro-suicide advocacy. From the Courthouse News Service story:
“It is not up to the government to decide who may die and who may live, when they shall die or how long they shall live,” Mills said in a statement. “While I do not agree that the right of the individual is so absolute, I do believe it is a right that should be protected in law…
That’s a very opened-ended statement. If government has no right “to decide who may die and who may live, when they shall die or how long they shall live,” we might as well kiss government-sponsored suicide-prevention programs goodbye. We should tell cops not to pull people off bridge precipices. And no more forced hospitalizations for treatment of those found beyond a reasonable doubt to be a danger to their own lives.

Mills also said that she hopes that assisted suicide is committed “sparingly” and that the state “should respect the life of every citizen.” Talk about hollow rhetoric! When committing suicide is depicted as a “right,” on what basis would the exercise of that liberty be rarely used?

Mills also bowed to supporting hospice and palliative care. But hospice is about living. In contrast, assisted suicide is about dying. Moreover, suicide prevention is one of hospice’s core services — which legalizing assisted suicide substantially undermines. Indeed, where it is legal, most victims of doctor-prescribed death in hospice never receive any suicide prevention at all.

Perhaps Mills was clueless about the import of her words. And I have no doubt she opposes the suicides of teenagers and people with a transitory or impulsive desire to die.

But that isn’t the same thing as being anti-suicide. When a governor supports some suicides — which she clearly does — that is pro-suicide. When a governor affixes her signature to a law granting the state’s imprimatur to suicide facilitation, that is pro-suicide. Indeed, when a governor proclaims that government should have no role in saving the lives of all suicidal people, there is nothing else to call it.

Monday, June 10, 2019

American Medical Association overwhelmingly upholds its opposition to assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

I have great news

The American Medical Association (AMA) upheld its opposition to assisted suicide by a vote of 65% to 35% today. 

The AMA overwhelmingly maintained that:
“Physician-assisted suicide and euthanasia are fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks”
At a 2016 meeting of the AMA, delegates voted to ask the Council on Ethical and Judicial Affairs (CEJA) to review the AMA policy on assisted suicide.

In May 2018, CEJA upheld the AMA policy on assisted suicide, but in June 2018, AMA delegates once again asked CEJA to continue reviewing its policy on assisted suicide.

In October 2018, CEJA adjusted the language of its recommendation while upholding that the AMA maintain its opposition to assisted suicide. In November 2018, AMA delegates once again decided to ask CEJA to continue reviewing the AMA policy on assisted suicide.

After three years of intense review of its assisted suicide policy, AMA delegates overwhelmingly upheld that assisted suicide is incompatible with the physician's role as healer.

Dr William Reichel: Rejecting assisted suicide is a wise decision.

(Sadly the Maine Governor signed the assisted suicide bill).

I have studied assisted suicide since 1984, mostly at Georgetown University Medical Center. I am a Past President of the American Geriatrics Society and I have published a number of papers on this subject, the most important one in The Lancet in 1989. I also discuss this subject in my text Reichel's Care of the Elderly, 7th Edition, Cambridge University Press.

I am strongly opposed to assisted suicide because it may be performed for the wrong reasons. Would a selfish family member want to receive the inheritance sooner than the projected estimated time for that relative's illness? Or can the medical system selfishly want to avoid a prolonged hospital or nursing home stay? Would a doctor want to make it easier by not getting a second opinion that some states require? The literature from the Netherlands and Belgium describe many violations of government policy including not stating the true cause of death and even not getting the patient's permission.

I imagine that you may be very overwhelmed with this issue and others. But I urge you to please consider what I have shared with you. I feel certain that you will think back and realize that rejecting assisted suicide for Maine is a wise decision.

William Reichel, M.D. 

Affiliated Scholar 
Center for Clinical Bioethics 
Georgetown University Medical Center Washington, D.C.

Euthanasia and Physician-Assisted Suicide are Unethical Acts.

The following article was published in the May 2019 edition of the World Medical Association Journal. (Link)

This article is written by Dr's Ewan Galigher, Maria Gigolini, Alana Cormier, Sinéad Donnelly, Catherine Ferrier, Vladimir A Gorshkov-Cantacuzéme, Sheila Harding, Mark Komrad, Edmond Kyrillos, Timothy Lau, Rene Leiva, Renata Leong, Sephora Tang and John Quinlan.

The World Medical Association (WMA), the voice of the international community of physicians, has always firmly opposed euthanasia and physician-assisted suicide (E&PAS) and considered them unethical practices and contrary to the goals of health care and the role of the physician [1]. In response to suggested changes to WMA policy on this issue, an extensive discussion took place among WMA Associate Members. We, representing a voice of many of those involved in this discussion, contend that the WMA was right to hold this position in the past and must continue to maintain that E&PAS are unethical.
 

The Central Issue Under Debate is the Ethics of E&PAS
 

The question is whether it is ethical for a doctor to intentionally cause a patient’s death, even at his or her considered request. The fact that E&PAS has been legalized in some jurisdictions and that some member societies support these practices has no bearing on the ethical question. What is legal is not necessarily ethical. The WMA already recognizes this distinction, for example, by condemning the participation of physicians in capital punishment even in jurisdictions where it is legal. The WMA should be consistent in this principle also with respect to E&PAS.

E&PAS Fundamentally Devalues the Patient
 

This devaluation is built into the very logic of E&PAS. To claim that E&PAS is compassionate is to suggest that a patient’s life is not worth living, that her existence is no longer of any value. Since the physician’s most basic tasks and considerations are to ‘always bear in mind the obligation to respect human life’ and ‘the health and well-being of the patient’ [2, 3], E&PAS must be opposed. E&PAS distorts the notion of respect for the patient. On the one hand it claims to help suffering persons, while on the other hand it eliminates them. This is a profound internal contradiction; the ethical priority is to respect the fundamental intrinsic worth of the person as a whole.
 

E&PAS Puts Patients at Risk
 

Patients are autonomous agents but are not invulnerable to their need for affirmation from others, including their physician. Amidst the overwhelming fears of those who suffer (4, 5), a free autonomous decision to die is an illusion. Particular concern exists for those who may feel their life has become a burden due to changing perceptions of the dignity and value of human life in all its different stages and conditions, and an explicit or implicit offer of E&PAS by a physician profoundly influences the patient’s own thinking. The troubles of human relationships within families, the presence of depression, and problems of abuse and physician error in an already stressed medical system, make muddy waters even more turbulent [6]. Evidence shows that societies cannot always defend the most vulnerable from abuse if physicians become life-takers instead of healers [1, 6]. The power of the therapeutic relationship cannot be underestimated in the creation of patient perceptions and choices.

E&PAS Totally Lacks Evidence as ‘Medical Treatment’


The consequences of E&PAS are unknown as both physicians and patients have no knowledge of what it is like to be dead. Advocates of E&PAS place blind faith in their own assumptions about the nature of death and whether or not there is an afterlife when arguing that euthanasia is beneficial. E&PAS is therefore a philosophical and quasi-religious intervention, not a medical intervention informed by science. Doctors should not offer therapy when they have no idea of its effects—to offer E&PAS is to offer an experimental therapy without any plans for follow-up assessment. Therefore, key elements in any medical intervention such as informed consent are simply not possible without knowing what stands on the other side of death. Rather than a standard medical discussion of alternatives based on scientific data or clinical experience, the discussion must leave the clinical domain and enter the domain of speculation. This is not an exercise in informed-consent. This is not the accepted medical ethics of medical practice. All this is, in part, why E&PAS cannot be a medical procedure.
 

These Weighty Moral Considerations are Supported by the Ethical Intuition of the Global Medical Community
 

Only a small minority of physicians support E&PAS. The vast majority of doctors around the world wish only to foster the will to live and to cope with illness and suffering, not to facilitate acts of suicide or to create ambiguity around what constitutes a medical treatment. We must remember that
the four regional WMA symposia demonstrated that most doctors would never be willing to participate in euthanasia. Even the insistence of E&PAS proponents on (a) using ambiguous language such as ‘Medical Assistance in Dying’ to describe their practice and (b) avoiding mention of E&PAS
on death certificates suggests that they share to some degree this fundamental ethical intuition about killing patients.
 

Acceptance of E&PAS Undermines Boundaries Between End-Of-Life Care Practices That do not Intend Death (palliative care, withholding/withdrawing lifesustaining therapy) and Those that do Intend Death (E&PAS)
 

Confusion is created at a societal level about what constitutes “medical treatment,” especially when language such as “medical assistance in dying” or “voluntary assisted dying” is used. This renders the reality of such acts and their application unclear. As many patients share our conviction that deliberately causing death is wrong, a misunderstanding of the distinction between E&PAS and palliative care may lead to rejection of palliative care or insistence on futile life-sustaining therapies. The availability of E&PAS also distracts from the priority of providing social services and palliative care to those who are sick and dying [7].

The WMA’s Code of Ethics Strongly Influences Standards for the Practice of Medicine Around the World and Neutrality on E&PAS by the WMA Would be Interpreted Globally as Tacit Approval
 

A change in the WMA statement would imply a tacit endorsement of E&PAS and render the WMA complicit with such practices [8, 9]. Neutrality by professional medical organisations on E&PAS is perceived by society, governments and the international pro-euthanasia lobby as that organisation’s acceptance of them as medical practice, rather than as a response to a societal/political agenda. Those who seek international approval to justify these practices will create a silencing of the majority of the community, which has real medical, societal and ethical concerns around E&PAS and their effects on society internationally.
 

WMA policy on E&PAS reflects that which is in place in hundreds of jurisdictions with widely divergent legal and political traditions. While it may be tempting to placate some member societies so as to avoid dissension, we must not destabilize medical ethics around the world. We must continue to characterize E&PAS as unethical even if it conflicts with the demands of the state or influential groups backed by the law. We must not let imperfect law trump good medical ethics. Undoubtedly many doctors who perform E&PAS believe themselves to be acting nobly; but it does not follow that they should expect others to affirm their views or not to oppose them; nor are they wronged by existing WMA policy. Any society that insists on transforming suicide from a freedom to a right, should stand up a different profession with the duty to fulfil that new right, as killing does not belong in the House of Medicine.
 

Neutrality on E&PAS has Serious Consequences for Physicians who Refuse to Participate 

In jurisdictions where E&PAS is legalized, physicians who adhere to the long-standing Hippocratic ethical tradition are suddenly regarded as outliers, as conscientious objectors to be tolerated and ultimately excluded from the profession [10]. A neutral stance by the WMA would compromise the position of the many medical practitioners around the world who believe these practices to be unethical and not part of health care. In some jurisdictions it is illegal not to refer for these practices, creating a dystopic situation where the doctor who practises quality end-of-life care needs to conscientiously object in order to do so, and may be coerced to refer for E&PAS. Neutrality from the WMA would promote the contravention of the rights and ethical practice of these doctors, undermining their ethical medical position at the behest of a societal demand that can fluctuate with time.
 

In sum, the changes currently being debated, arising from political, social, and economic factors, have been rejected time and again and most recently by the overwhelming consensus of WMA regions. The present debate represents a crucially important moment for the WMA that must not be squandered. Given the influence of the WMA and the profound moral issues at stake, neutrality should not be an option. The WMA policy must continue to stand as a beacon of clarity to the world, bringing comfort to patients and support to physicians around the globe. The WMA should not be coerced into promoting euthanasia and assisted suicide by making its stance neutral.
 

References 
1. Leiva R, Friessen G, Lau T. Why Euthanasia is Unethical and Why We Should Name it as Such. WMJ. 2018 Dec; 64 (4) pages 33-37. [Cited 2019 Feb 05]. https://www.wma.net/wpcontent/uploads/2019/01/wmj_4_2018_WEB.pdf
2. WMA INTERNATIONAL CODE OF MEDICAL ETHICS. WMA [Internet] [cited2019 Feb 05]. https://www.wma.net/policiespost/wma-international-code-of-medicalethics
3. WMA DECLARATION OF GENEVA. WMA [Internet] [cited 2019 Feb 05]. https://www.wma.net/policies-post/wma-declarationof-geneva
4. Zaorsky NG et al. Suicide among cancer patients. Nat Commun. 2019 Jan 14;10 (1):207. [cited 2019 Feb 05]. https://www.nature.com/articles/s41467-018-08170-1
5. Rodríguez-Prat A et al. Understanding patients’ experiences of the wish to hasten death: an updated and expanded systematic review and meta-ethnography. BMJ Open. 2017 Sep 29;7(9):e016659. [Cited 2019 Feb 05].https://bmjopen.bmj.com/content/7/9/e016659.long
6. Miller DG, Kim SYH. Euthanasia and physician-assisted suicide not meeting due care criteria in the Netherlands: a qualitative review of review committee judgements. BMJ Open. 2017 Oct 25;7(10):e017628. [cited 2019 Feb 05].https://bmjopen.bmj.com/content/7/10/e017628. long
7. The Canadian Society of Palliative Care Physicians-KEY MESSAGES RE HASTENED DEATH [Internet] [cited 2019 Feb 05]. https://www.cspcp.ca/wp-content/uploads/2015/10/CSPCP-Key-Messages-FINAL.pdf
8. Sulmasy DP, Finlay I, Fitzgerald F, et al. Physician-assisted suicide: why neutrality by organized medicine is neither neutral nor appropriate. J Gen Intern Med 2018; 33: 1394-1399.
9. Canadian Medical Association softens stand on assisted suicide. Globe and Mail. AUGUST 19, 2014 [Internet] [cited 2019 Feb 05]. https://www.theglobeandmail.com/news/national/canadian-medical-association-softens-stance-onassisted-suicide/article20129000/
10. Euthanasia in Canada: A Cautionary Tale. WMJ 2018 Oct; 64 (3), p 17-23. [cited 2019 Feb 05].https://www.wma.net/wp-content/uploads/2018/10/WMJ_3_2018-1.pdf (Institutional affiliations are provided for identification purposes only and do not imply endorsement by the institutions.)

Tell Governor Mills to veto the Maine assisted suicide bill.

I have bad news: 
Governor Janet Mills signed LD 1313 into law. We had hoped that she would Kill the Bill but now she has agreed to allow doctors to kill patients.  Alex Schadenberg
By Mark Hodges (EPC researcher)

Last week the Maine House of Representatives and Senate passed a bill that would legalize doctors to proscribe lethal drugs to patients who ask to be killed.

Democratic Governor Janet Mills has ten days to sign LD 1313 into law. Mills said. 
“I’m not really sure about it,”   
“I’m still talking to people on both sides.”
But even if she does nothing, after those ten days it will become law automatically. We need you to tell Gov. Mills to veto the assisted suicide bill.

Governor Janet Mills
1 State House Station 
Augusta, ME 04333
Tel: 207-287-3531 
Fax: 207-287-1034
Email: governor@maine.gov

The Democratic-controlled state House approved the death bill by one vote, 73 to 72. The Democratic-controlled state Senate was also close, with a 19 to 16 vote.

Those who oppose assisted suicide say the one-margin vote is yet another example of how important it is to vote for candidates that oppose assisting suicide. The one vote margin also shows how divided the state of Maine is on assisted suicide.

Alex Schadenberg
Assisted suicide bill LD 1313 professes to defend individual “choice” and autonomy“ but in reality these bills deceptively give physicians, the right in law, to prescribe lethal drugs to patients,” Euthanasia Prevention Coalition Executive Director Alex Schadenberg explained. 

“People are needing care and support, not lethal drugs.”
Linda Milliken wrote in the Portland Press Herald.
“Physician-assisted suicide destroys the doctor-patient relationship, as doctors now become agents of death, rather than comforters and healers,” 
Opponents of assisted suicide have pointed out multiple problems with the legislation, including defining “terminal disease” so broadly as to qualify someone with diabetes as eligible for a lethal dose.

Under the proposed law, patients with treatable conditions are considered “terminal” if they decide not to accept effective medication.

The Maine law is similar to Oregon’s assisted suicide law. An Oregon Health Authority representative admitted they interpret “terminal disease” as including treatable conditions:
“If the patient does not receive treatment or medication (for whatever reason) and is left with a terminal illness, then s/he would qualify for the Death With Dignity Act. I think you could also argue that even if the treatment/medication could actually cure the disease, and the patient cannot pay for the treatment, then the disease remains incurable.”
Nancy Elliot
Former three-term New Hampshire State Representative Nancy Elliot 
stated

“One of the biggest problems is people who qualify for Assisted Suicide are not necessarily dying. Think of a 21-year-old otherwise healthy insulin dependent diabetic. He qualifies if he rejects his insulin. This would be the same for many other people with serious conditions, who take prescription medications.”
Not Dead Yet’s Mike Reynolds cited
Oregon’s doctors have written suicide prescriptions for individuals whose medical basis for eligibility for assisted suicide was listed as diabetes,” 
“People could qualify as ‘terminal’ who have epilepsy, ongoing infections and other illnesses that can be managed with medication.”
Milliken noted in a New York Times article which reported, 
“According to psychiatric experts, the vast majority of people requesting suicide are suffering from treatable depression, and no longer want to kill themselves once their underlying depression is resolved.” 
“Once the depression lifts and people can think more clearly, the therapists say, those who were determined to kill themselves are thankful to be alive, despite their pain or grim prognosis.” 
Elliot points out.
“With Assisted Suicide on the table these mistakes can be deadly. What about the five percent rate of incorrect medical diagnosis?” 
At a hearing in Massachusetts, John Norton testified that “as a young man he was diagnosed with ALS. He stated that had Assisted Suicide been legal at that time he would have used it. A few years in, the disease’s progression just stopped. Now in his late 70s he stated he has had a great life with children and a grandchild. With Assisted Suicide on the table he would have lost all of that.” 
Critics also note that Maine’s assisted suicide bill allows someone besides the patient to administer the lethal drugs. It defines “self-administer” as the patient voluntarily “ingesting” the poison –a phrase that other pro-euthanasia states interpret very loosely.

Schadenberg explains.
“In Washington State, ‘to ingest’ means ‘to absorb,’ thus enabling another person to administer the lethal drugs, so long as it is ‘absorbed,’” 
Schadenberg points out a potential lack of impartiality in the death decision. 
“The bill requires two witnesses (to the suicide request), but one may be a relative or an heir,” he says. “Clearly, a conflict of interest may exist.” 
“The written request must be witnessed by two individuals, only one of whom may be entitled to any portion of the patient’s estate upon death. The second witness could be a close friend of the potential heir,”  
“This places victims of elder abuse and domestic abuse in great danger since they are unlikely to share their fears with outsiders or to reveal that they are being pressured by family members to ‘choose’ assisted suicide.”
Conflict of interest in assisted suicide is greatest among health insurance companies. Instances have been publicized where an insurer refuses to pay for expensive but life-saving treatment, yet will pay for a suicide prescription.

Dr Brian Callister
When Nevada physician Brian Callister transferred patients to California and Oregon, where assisted suicide is legal, each patient’s insurer actually asked if he’d suggested assisted suicide – although neither had a terminal illness.

And critics say LD 1313 has no provision for protective oversight against abuse. Once a death doctor writes the lethal prescription, there is no supervision in actually taking the life-ending drugs.

If the person administering the drugs was invested in the patient’s death, such as an heir, the patient could change his or her mind, or even struggle, yet once the poison is “absorbed,” no one would know.

Reynolds told the Bangor Daily News.
“Once the prescription is picked up from the pharmacy, there is absolutely no oversight in the law to protect the ill person from someone else who wants to hurry their death along, be it an insurance carrier, an heir or a caregiver,” 
Reynolds continued
“A friend or relative – even an heir – can ‘encourage’ an elder to make the request, sign the forms as a witness, pick up the prescription, and even administer the drug (with or without consent), because no objective witness is required at death.”
Opponents add that there is no provision for objective, third-party documentation. The same doctor who prescribes poison for his or her patient is the very one who is responsible to report the results of his death procedure.

Schadenberg assessed.
“Self-reporting systems are designed to cover-up abuse. By law, the same doctor is the judge, the jury and the executioner.”
Reynolds concluded.
“The only real protections in the law are for people other than the patient, foreclosing any realistic potential for investigation of foul play,” 
In fact, research proves assisted suicide can result in tremendous suffering by the patient, including “burning patients’ mouths and throats, causing some to scream in pain.” In other instances, “deaths stretched out hours in some patients — and up to 31 hours in one case.”

Reynolds told the Press Herald,
“This is not a ‘dignified’ death,”“It can take up to 104 hours for people to die.”
Newspaper editor John Balentine noted that the bill’s oft-repeated mantra. Balentine told The Forecaster.  
“Death With Dignity,” “purposefully avoids the word ‘suicide.’”
“Suicide is anything but dignified, because that person’s hopes and dreams are snuffed forever,” 
“The associated physical decay triggered by death is tragic and disgusting, far from dignified.” 
“Choosing…death…is also not dignified. Choosing life, rather than death, is dignified. Suffering through pain can be dignified. Giving up is not dignified.”
Balentine concluded.
“I’m always skeptical of those who use linguistic subterfuge to lobby their cause. Those employing the term ‘death with dignity’ are doing just that when lobbying for assisted suicide,”  “Here’s hoping Gov. Mills sees through the Legislature’s misguided – and undignified – political tactics.”
The Maine bill, called by supporters the “Maine Death With Dignity Act,” actually says that a lethal prescription is not suicide, and official death certificates must be falsified to list the patient’s medical condition as the cause of death:
“Actions taken in accordance with this Act do not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide under the law. State reports may not refer to acts committed under this Act as ‘suicide’ or ‘assisted suicide’…State reports must refer to acts committed under this Act as obtaining and self-administering life-ending medication. A patient’s death certificate…must list the underlying terminal disease as the cause of death.”
In other words, “the death certificate is falsified to reflect a natural death,” Elliot summarized.
“All the information is sealed and unavailable to the public.”
Critics also conclude that Maine’s proposed legislation is discriminatory. Assisted suicide not only stifles hope, encourages despair, and takes advantage of the vulnerable, it devalues certain groups of human beings, pushing them into an early death.

Diane Coleman
Not Dead Yet President Diane Coleman 
explains
“Assisted suicide sets up a double standard, with suicide prevention for some and suicide assistance for others, depending on their health or disability,” 
“If such distinctions were based on race or ethnicity, we’d call it bigotry.” 
“The dangers of mistake, coercion and abuse it poses to old, ill and disabled people are rooted in a profound and still largely unacknowledged devaluation of our lives.”
Stephanie Woodward
Stephanie Woodward, Director of Advocacy at the Center for Disability Rights, charged.

People with disabilities and certain illnesses and the elderly “will receive a fast pass, because our lives are viewed as less worthy,” 
Reynolds agreed.
“Assisted-suicide laws are the most blatant forms of discrimination based on disability in our society today,” 
Bishop Robert Deeley of Portland came out vehemently against the bill on principle. Hsaid. 
“To allow doctors to prescribe deadly prescriptions to hasten a person’s death would be a horrendous wound to the dignity of the human person,” 
The Maine bishop predicted consequences of the law would include 
“the elderly feeling undue pressure to view this as an option to prevent being a burden to others, a desensitization of the value of human life, as well as teaching young adults that people can be disposable.”
Elliot opined
“These laws are abusive in their very nature. To suggest to someone that they should kill themselves is abuse,” 
“It would be like saying, ‘You are worthless and should die.’”
Reynolds warned
“We should all be concerned about what kind of message a government sponsored, medically administered program of assisted suicide sends to anyone facing difficult times.”
“Kill the bill, not the patient.”

The American Nurses Association Maine, the Maine Medical Association, the Maine Hospice Council, the Maine Right to Life, the American Cancer Society Action Network, the Roman Catholic Diocese of Portland the Maine Osteopathic Association, all oppose the Maine legislation.

Suicide activists have tried several times to legalize assisted suicide in Maine. In 2015, a suicide measure was defeated in the state Senate by only one vote. A similar bill failed in the state House in 2017. An attempt was made in 2018 to put the issue to a popular vote.

Assisted suicide was first legalized in Oregon in 1997 after the U.S. Supreme Court essentially ruled the issue was up to the states. Since then, the state of Washington (2008), Vermont (2013 in an even less restrictive measure), California (2015, currently in effect but being fought in court), Colorado (2016), Washington D.C. (2017), Hawaii (2018), and most recently New Jersey (2019) have legalized doctor-prescribed death.  In 2009, Montana's state supreme court did not legalize assisted suicide but created a defense of consent, if a physician is prosecuted for assisted suicide. 

New Jersey Catholic Governor Phil Murphy signed his state’s killing bill in April. He said that while his faith opposed assisted suicide, 
“after careful consideration, internal reflection, and prayer.” 
“as a public official I cannot deny this alternative to those who may reach a different conclusion.”
We need you to tell Gov. Mills to veto the assisted suicide bill.

Governor Janet Mills
1 State House Station Augusta, ME  04333
Tel: 207-287-3531 or Fax: 207-287-1034
Email: governor@maine.gov

Similar bills are pending in several states with New York being the greatest concern.

Sunday, June 9, 2019

Nancy Elliott: Letter to Governor Janet MIlls (Maine)

(Sadly, the Maine Governor signed the assisted suicide bill).

Dear Governor Mills,

Nancy Elliott, Chair EPC - USA
Please veto LD 1313, HPO948, which would enact Assisted Suicide.

I am a Former 3 term New Hampshire State Representative, and the Chair of Euthanasia Prevention Coalition (EPC) USA.

The three groups that are the target for Assisted Suicide are the sick, the elderly and the disabled. While there are many other problems with this kind of law, I am going to focus in on these three.

It is said this is only for the sick and dying. One of the biggest problems is people who qualify for Assisted Suicide are not necessarily dying. Think of a 21-year-old otherwise healthy insulin dependent diabetic. He qualifies if he rejects his insulin. This would be the same for many other people with serious conditions, who take prescription medications. What about all the curable cancers? They qualify. What about the 5% of incorrect medical diagnosis? With Assisted Suicide on the table these mistakes can be deadly.

I was at a hearing for Assisted Suicide in Massachusetts a few years back when a gentleman named John Norton gave evidence, that as a young man he was diagnosed with ALS. He stated that had Assisted Suicide been legal at that time he would have used it. A few years in, the disease’s progression just stopped. Now in his late 70’s he stated he has had a great life with children and a grandchild. With Assisted Suicide on the table he would have lost all of that.

Steering is a big deal with all three of the groups that I mentioned. At that same Massachusetts hearing, a doctor stated that Assisted Suicide laws were something he was in favor of. He continued with his points and ended by saying that He felt it was the responsibility for a good doctor “to guide people to make the right choice”. I do not think he intended to say that but, is there any doubt that this pro suicide doctor would try to persuade his patients to follow his wishes concerning their Assisted Suicide.

These laws are abusive in their very nature. To suggest to someone that they should kill themselves is abuse. My husband was terminally ill, and I went to a lot of doctor appointments with him. If medical personnel were to suggest Assisted Suicide to him, he would have been devastated. While he never would have done that, but it would be like saying to him, “You are worthless and should die. That is abuse! The proponents say that would never happen, but that did happen to an Oregon to a woman named Kathryn Judson. She had gone to a doctor’s appointment with her seriously ill husband and exhaustedly sunk into a chair where she overheard the doctor pitching Assisted Suicide to her husband with the clincher, “Think of your wife.” They left and never came back. The husband went on to live another five years

Next seniors are at risk and very easily fall victim to coercion as the process is very open to that. In most states, heirs can be there for the request and even speak. Anyone can pick up the lethal dose. Once in the house all oversight is gone, there is no witness required at the death. Even if they struggled who would know. If that is not enough, the death certificate is falsified to reflect a natural death. All the information is sealed and unavailable to the public. Even if someone suspected foul play, the death certificate says no crime here. Taking advantage of seniors is epidemic in the US. Look at the case of Thomas Middleton. He made Tami Sawyer his trustee and moved into her home. Within a month he was dead by Oregon’s Assisted Suicide law. Two day after his death Ms. Sawyer listed his house and sold it and deposited the money into three companies she owned with her husband. We will never know how much coercion or foul play took place in this case.

Finally, those with a disability are at risk. Most people that “qualify” for Assisted Suicide at that point in their life have a disability. Many with long term disabilities have been labeled terminal all their lives. Without meds, treatments, and assistance they would not survive. This is about disability. If you have a disability you are encouraged to give up, commit suicide. If, on the other hand, you are young and healthy, you are given suicide counselling. This is discrimination against people with disabilities. Why should they trust that they will not be coerced into Assisted Suicide, when they are already discouraged to seek treatments and are not treated fairly? When you think about it this is a law that is written just for them. It is a “special” carve out, for the sick, elderly and disabled.

In closing, I just want to add that Assisted Suicide has been rejected in over 100 legislative, ballot initiative and judicial attempts in the USA, including my state New Hampshire where it was a bipartisan vote. The more it is studied the more uncomfortable people become with it.

Nancy Elliott
Chair – Euthanasia Prevention Coalition USA

An Open Letter to Maine Governor Mills: Veto Assisted Suicide Law LD 1313

(Sadly, the Maine Governor signed the assisted suicide bill). 

This letter was published by Not Dead Yet on June 6, 2019.

Dear Governor Mills:

Diane Coleman, Not Dead Yet
The disability community appeals to you to veto LD 1313, which would legalize a public policy of assisted suicide.

Many people are unaware of the fact that every major national disability organization that has taken a position on assisted suicide laws opposes them. These include over a dozen prominent groups, many of which have undersigned this urgent appeal:

ADAPT
American Association of People with Disabilities
Assn of Programs for Rural Independent Living
Autistic Self Advocacy Network
Disability Rights Education and Defense Fund
National Council on Disability
National Council on Independent Living
National Organization of Nurses with Disabilities
National Spinal Cord Injury Association
Not Dead Yet
TASH
The Arc of the United States
United Spinal Association
Our reasons for opposing assisted suicide laws are many. Most of them are illustrated by these documented examples of significant problems which occurred in states that have courted the danger of a law based on Oregon’s “death with dignity” Act. These examples are available at:

When assisted suicide is legal, it’s the cheapest treatment available—an attractive option in our profit-driven healthcare system. Bitter experiences has shown that insurers are denying expensive life-sustaining treatment but offering lethal drugs instead.

Terminal diagnoses and prognoses are too often wrong, leading people to lose good years of their lives. If one doctor says “no,” people can “doctor shop” for a “yes,” regardless of their actual legal eligibility. The highly touted “safeguards” turn out to be truly hollow, with no real enforcement or investigation authority. Assisted suicide is a prescription for abuse: an heir or abusive caregiver can steer someone towards assisted suicide, witness the request, pick up the lethal dose, and in the end, even administer the drug—no disinterested witness is required at the death, so who would know?

Evidence appears to show that assisted suicide laws also lead to suicide contagion, driving up the general suicide rate. For example, a CDC report reveals that from 1999-2010, suicide among those aged 35-64 increased 49% in Oregon, where assisted suicide has been legal the longest, as compared to a 28% increase nationally.

Finally, although assisted suicide proponents will say that it’s not about disability, the top 5 reported reasons for assisted suicide requests in Oregon throughout the years since legalization are all disability issues: “loss of autonomy” (90.6%), “less able to engage in activities” (89.1%), “loss of dignity” (74.4%), “losing control of bodily functions” (44.3%), and “burden on others” (44.8%). (The same reports show that every year except the first, some of those who died by lethal prescription were not terminal within six months.)

These are issues that many people face, not only those of us commonly considered disabled, but also seniors, people with chronic conditions, and people with advanced illnesses, including terminal illnesses. These reasons demonstrate that virtually all who die by lethal prescriptions in Oregon are disabled, in that they need assistance from another person for daily activities.

As people who have fought for the civil rights and equal protection of all people with disabilities, we in the undersigned organizations understand that our society is permeated with negative stereotypes about disability. Award winning movies deliver the message that it’s “better to be dead than disabled.” We understand the shame people are taught to feel if they become disabled, the pressure to hide that we need help, the guilt for “inconveniencing” others.

There are ways to address the reasons people have for requesting assisted suicide, but it starts with a societal commitment to treat all suicides as a tragedy, to respond to anyone’s expression of suicidal feelings with an equal level of support, affirmation of the value of their life and effort to address their concerns. A two-tiered system where most people get suicide prevention but certain people get suicide assistance is a deadly form of discrimination that should not be accepted. Assisted suicide laws exacerbate the disability stigma that prevails in our culture and undermine people’s genuine autonomy by establishing a medically administered program of suicide approval and assistance in a health care environment already riddled with pressures to cut costs of care.

Assisted suicide is bad medicine for Maine. We hope that this information is helpful in your consideration of this life and death public policy issue, and would welcome the opportunity to communicate about this further.

Sincerely,

Diane Coleman, JD, MBA
President/CEO
Not Dead Yet
497 State Street
Rochester, NY 14608
708-420-0539 C
www.notdeadyet.org

ON BEHALF OF:

ADAPT
American Association of People with Disabilities
Association of Programs for Rural Independent Living
Disability Rights Education & Defense Fund
National Council on Independent Living
Not Dead Yet
TASH: Equity, Opportunity, and Inclusion for People with Disabilities Since 1975
United Spinal Association

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