Connecticut disability rights leader opposes assisted suicide bill.

The following is a shortened version of the letter published on March 18 in the CTMirror by Lisa Blumberg, an attorney and freelance writer, is a member of the bipartisan disability advocacy Second Thoughts Connecticut. Lisa wrote:

Let’s not be confused by double speak. The bill (HB 5898) that the Connecticut legislature is poised to consider has nothing to do with “aid in dying.” Aid in dying is palliative care to improve the quality of a person’s remaining life. The World Health Organization views such care as a human right. The bill would not expand desperately needed access to palliative care or expand patient autonomy – patients already have the right to refuse any type of treatment. Instead, the bill concerns the authority of doctors. It sets forth the circumstances under which a doctor could actively prescribe lethal drugs to directly cause the death of a supposedly willing patient without fear of liability.

If the selective writing of lethal prescriptions was a valid medical practice, as proponents assert that is, there would be no reason for laws to immunize medical professionals from suffering any consequences from doing so. What is being proposed in HB 5898 would amount to a radical change in medical culture. Causing death could be viewed as an option in the “care” of some patients.

Legalized assisted suicide could be used for-profit entities for their own purposes. There have been cases in Oregon of insurers denying payments for new treatments but offering to pay for lethal drugs. This is an issue that is totally ignored by HB 5898.

Proponents talk of “safeguards.” Nothing can prevent an erroneous prognosis or keep a vulnerable person from subtly being steered. Moreover, the bill’s focus is on the parameters of permissible medical behavior and not on patient protection. Thus, the minimal criteria written into the bill apply only to the prescribing of the lethal drugs, and not to their use. Any mental health evaluation to determine if a person has impaired decision capacity is made when he requests the drugs.

There is no requirement that a person be evaluated just prior to taking the drugs although mental state can fluctuate widely based on physical factors like oxygen level. It is conceivable that a person could take the drugs during a temporary depression or on impulse. Drugs are to be self-administered but there is no mechanism for insuring that will always be the case. It would be very easy for mistakes or abuse to occur and never be discovered.

It is deceptive to think that the main opposition to HB 5898 is faith based. The strongest opposition — the opposition with the most street cred -– are disability groups who represent people who have also been seen as hopeless in medical settings. We oppose legalizing assisted suicide on public policy grounds. With society and healthcare system as it presently is, it would be inherently dangerous to pass HB 5898.

Second Thoughts is an active disability rights organization in Connecticut.

Letter to Connecticut Committee concerning assisted suicide bill.

Message from Washington State lawyer, Margaret Dore, to members of the Connecticut Public Health Committee.

Vote “No” on Committee Bill 5898
Say “No” to Assisted Suicide and Euthanasia
An Act Concerning Aid in Dying
Hearing on Monday, March 18, 2019

Note: The Connecticut committee accepts email testimony at: phtestimony@cga.ct.gov.

Margaret Dore

1. The Act

The Act legalizes “aid in dying,” a traditional euphemism for active euthanasia and physician-assisted suicide.[1]

2. Who May Be Most at at Risk?

Individuals with money, meaning the middle class and above.

3. Assisting Persons Can Have an Agenda

Persons assisting a suicide or performing a euthanasia can have an agenda to benefit themselves. 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:

[Y]ou counseled and aided your wife to kill herself because you wanted ... the 1.4 million.[3]

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]

4. “Even If the Patient Struggled, Who Would Know?”

The Act has no required oversight over administration of the lethal dose, not even a witness is required to be present at the death. The drugs used are water or alcohol soluble, such that they can be injected into a sleeping or restrained person without consent.[6] Alex Schadenberg, Executive Director for the Euthanasia Prevention Coalition, puts it this way:

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).[7]

5. The Death Certificate Will List a “Terminal Illness” as the Cause of Death, Which Will Create a Perfect Crime

The bill, Section 9(b), lines 273 to 274, states:

The person signing the qualified patient's death certificate shall list the underlying terminal illness as the cause of death. (Emphasis added).

With this language, the patient’s death certificate will report death due to a terminal illness as a matter of law. This will create a legal inability to prosecute criminal behavior, for example, in the case of an outright murder for the money. The Act will create a perfect crime.

6. Dr. Shipman and the Call for Death Certificate Reform

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.”[8] The inquiry also found:

that by issuing death certificates stating natural causes, the serial killer [Shipman] was able to evade investigation by coroners.[9]

According to a subsequent article in 2015, proposed reforms included having a medical examiner review death certificates, so as to improve patient safety.[10] Instead, the instant bill moves in the opposite direction to require legal coverup as a matter of law. Doctors and other perpetrators, such as family members, will be legally empowered to evade investigation.

7. Euthanasia Is Allowed

The Act defines “aid in dying” as a “medical practice” in which a physician prescribes “medication,” which the patient may self-administer. (Bill, Section 1.(2), at lines 4-7)

Generally accepted medical practice allows a doctor, or a person acting under the direction of a doctor, to administer medication. With the lethal dose defined as “medication,” other people are allowed to administer the lethal dose to the patient, which is euthanasia.

8. “Eligible” Persons May Have Decades to Live

The Act applies to persons with a terminal illness, which is expected to produce a patient’s death “within six months.”[11] 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. With treatment (insulin), such persons can have years or decades to live.

Footnotes:

[1] Craig A. Brandt, “Model Aid-in-Dying Act,” Iowa Law Review, 1989 Oct; 75(1): 125-215, (“Subject: Active Euthanasia ....”), at https://repository.library.georgetown.edu/handle/10822/738671. See also 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 https://repository.library.georgetown.edu/handle/10822/744116

[2] KTVZ.com, “Sawyer Arraigned on State Fraud Charges,” at https://choiceisanillusion.files.wordpress.com/2016/10/sawyer-arraigned-a-63.pdf

[3] R v Morant , 11/02/18, p. 11, ¶ 78, at https://archive.sclqld.org.au/qjudgment/2018/QSC18-251.pdf

[4] Charlie Leduff, “Prosecutors Say Doctor Killed to Feel a Thrill,” The New York Times, 09/07/2000, https://www.nytimes.com/2000/09/07/nyregion/prosecutors-say-doctor-killed-to-feel-a-thrill.html See also: CBSNEWS.COM STAFF, “Life in Jail for Poison Doctor, 07/12/00, www.cbsnews.com/news/life-in-jail-for-poison-doctor

[5] David Batty, “Q & A: Harold Shipman,” The Guardian, 08/25/05, at https://www.theguardian.com/society/2005/aug/25/health.shipman. See also Fiona Guy, “Healthcare Serial Killers: Doctors and Nurses Who Kill,” Crime Traveller, (2015, Sept 09), excerpts in the Appendix, pages 20 to 23, available at https://www.crimetraveller.org/2018/06/healthcare-medical-serial-killers

[6] In Oregon, the drugs used include Secobarbital, and Pentobarbital (Nembutal) , which are water and alcohol soluble. See http://www.drugs.com/pr/seconal-sodium.html and http://www.drugs.com/pro/nembutal.html

[7] The Advocate, Idaho State Bar, Letters to the Editor

[8] David Batty, supra,

[9] Id., “What are its findings?”

[10] Press Association, “Death certificate reform delays ‘incomprensible,’” The Guardian, January 21, 2015

[11] See the bill, section 1.(19) , lines 76 to 79.

Margaret Dore, Esq., MBA

Law Offices of Margaret K. Dore, PS

Choice is an Illusion, a nonprofit corporation

www.margaretdore.org

www.choiceillusion.org

1001 4th Avenue, Suite 4400

Seattle, WA  98154

206 697 1217

Fabian Stahle: A letter from Sweden to Maryland Senators concerning assisted suicide.

Dear Senator,
 

Maryland Senate.

I write to you from Sweden regarding HB 399 and SB 311 because these bills are similar to the Oregon law that is proposed here in Sweden. After contact with Oregon Health Authority I found disturbing information that was not available before and is highly relevant for HB 399 and SB 311 (below referred to as the ”Bills”).

In this letter I would like to draw your attention to a dangerous passage in the Bills regarding the eligibility criteria that the patient shall be diagnosed with a ”terminal illness” that will result in death within 6 months.

Regarding how this 6 months criteria must be interpreted, I have crucial information revealed from a correspondence I had with the Oregon Health Authority (OHA) in the end of 2017. I believe this information is very significant as the Bills definition of "terminal illness" is almost identical with the Oregon definition.

In my correspondence the OHA acknowledged – for the first time officially - that they always had interpreted the 6 months criteria as ”without administration of life-sustaining treatment”, A3 and A8 in the correspondence (Link to the correspondence).

See also my comments (Link to the comments).

This interpretation is counter-intuitive because most people would take for granted that the meaning of ”terminal illness” is a disease for which there is no treatment or medication, i.e. that all hope is gone. But the interpretation is logically inevitable also for the Bills - and
the implications are far reaching.

As a patient has the right to refuse to receive treatment, any patient having a disease that potentially may develop into a terminal condition can make themselves eligible for assisted death – 'for any reason whatsoever'. Hence a trap-door for suicidal patients is imbedded in the Bills.

This is unavoidable because the patient's autonomy ensures that it must be the patient himself who has to decide when enough is enough.

For those who believe in the basic idea of these Bills, it is obviously unreasonable to request that, for example, a cancer patient who is exhausted by radiation and several unsuccessful chemotherapy treatments should be forced to undergo additional painful treatments with dubious results to gain access to assisted death.
But where should we draw the line? Isn’t it also obviously unreasonable that a patient who has very good prospects to be cured can get assisted death by refusing treatment? Shouldn’t we require that a cancer patient accept at least one treatment before talking about assisted death – or at least to account for reasonable motives for their wish to die? Or what about a young diabetic who, in the despair of a broken relationship, wants to die and stops insulin so as to be able to obtain legal suicide assistance - shouldn't we regard that as unacceptable and ask for some sort of limitation?

However, all such attempts to conditions intrude on patient autonomy – the very autonomy the Bills are intended to expand, not decrease – and leads to insoluble demarcation problems. The Oregon Health Authority has also come to this conclusion. (Link to the conclusion). (A4 and A5).

So in the face of these two contradictory positions the Bills must surrender to the patient's autonomy - just as all other laws like the one in Oregon already have.

As a result the obvious interpretation of the central concepts of “terminal” does not apply – but is left open to the patient's own decision, and hence the door is also opened to pure absurdities as to which people can be legally killed:

A cancer patient who has very good prospects to be cured, but denies treatment. An important reason is that she does not want to lose her hair. We are now in Oregon a while after their law for physician-assisted suicide came into force and the patient in question is Jeanette Hall. Her physician, Dr. Stevens is opposed to the law but was forced to acknowledge that his patient would be eligible to get the death pills she wanted because her cancer was likely to lead to death within 6 months if she was not treated. He managed however to convince her to take treatment and many years later Ms. Hall said: "It is great to be alive."

But nor all doctors are like Dr. Stevens.
Dr. Charles Blanke, an oncologist with Oregon Health and Science University, told The Bulletin about one of his cases, a young patient with Hodgkin lymphoma with a more than 90 percent chance of survival with treatment. She did not believe in chemotherapy and feared its toxicity, despite Blanke’s efforts to convince her otherwise. After cleared by a psychiatrist Blanke approved her for assisted death, holding firm to his belief that doctors should not force patients to receive treatment. But afterwards Blanke asked himself:

“Why doesn’t that patient want to take relatively non-toxic treatment and live for another seven decades?”

The answer to Dr. Blanke’s question is just as simple as disturbing in the context of medical killing:

It is because a law that encourages sick people to commit suicide - by the obvious reason that for a suicidal person a socially accepted and smooth death administered by society is much more attractive than dying on one's own in loneliness, just as the young suicidal Belgian woman testifies in this video (Link to the video).

For any reason whatsoever.
 
A person could, as Dr. Blanke’s cases, fear the possibility of side effects or future disabilities. But it could also be a parallel life crisis that is indirectly linked to the disease. And what about those patients who cannot pay for a potentially effective treatment? These Bills allow and encourage people that are not necessarily dying to commit suicide.

These Bills allows and encourages people that are not necessarily dying to commit suicide. Please reject these dangerous Bills!

Sincerely
Fabian Stahle, Sweden

Euthanasia Party!

This article was published by National Review online on March 14, 2019.

Wesley Smith

By Wesley J Smith

Party!

A Canadian man with diabetes named Dan Laramie, whose illness had advanced to the point he would need amputations, decided to be lethally injected instead. He was killed by his doctor to cheers and applause from family and friends at his euthanasia party — at which photos were taken to commemorate the event, and perhaps, to send along with the story to the media. From the Daily Mail story:

She said music was played an important part in the end-of-life celebration and he had even written 30 songs while he was in hospital.

Speaking after the party [Laramie’s wife] Stef said: ‘I don’t really feel loss, we don’t need any sorrow at this time and I don’t know if that sounds rude.

‘We had a really amazing relationship, if he had died in a way that we had no notion of it or by surprise then it would be a sorrowful thing. But I don’t think dying should be sorrowful.’

His friends, sister, son, daughter, grandchildren and some of his nurses all came to the party.

So, let me ask you, my dear readers, to ponder: If invited to such a “party,” would you go?

It could be an agonizing decision:

Attend, and it seems to me you become complicit in the suicide/homicide. You validate it. You affirm to the suicidal patient that his or her worst fears about continuing to live are true, such as; my life can never have meaning again; I will die in agony; I won’t be remembered well; I am a burden, etc . . .

But refuse, and you could feel guilty for not being with your loved one at his or her death. Moreover, your family supporting the suicide/killing could ostracize you. “How dare you judge grandma! How dare you not be there to support her ‘choice’!”

Back at the euthanasia party, people were getting restless, and so it was time to get on with the killing:

Once Dan signed the papers and said he was ready, his family gathered at his bedside. Stef explained: ‘You could see sort of an energy in the room where people could feel that it was time.

‘It was a really blessed evening. It happened a little later than we had planned so you could feel people getting a little bit restless. ‘The doctor came down, he was beside us and the nurse, the pair of them brought such light and beauty into this assistance.

‘I can’t even tell you how beautiful the smile in his eyes was, he was so ready and it felt like everything we had talked about , that we planned about all these people made it the perfect exit.’

She said after he received three injections, his eyes closed and she gave him a kiss.

Stef said that Dan wanted a round of applause as he died so everybody cheered for him.

‘The release of all that energy, it was really great. There were a lot of things that were very comforting and Dan just loved every minute of it.’

These death events — this is far from the first such story about euthanasia parties — are being publicized in the service of normalizing euthanasia as the best way to die. It’s the real “death with dignity,” don’t you know?

The goal, I believe, is to push society toward the point that having oneself killed becomes the expectation, not the exception.

Is this kind of thing right or wrong? It depends on one’s values and moral beliefs. Some may see it as empowering, dying “his own way,” as the media continually put it.

Others, as I do, see darkness and nihilism in cheering on death, an (often unintentional) abandonment of people at their darkest hour. Indeed, this story reminds me of Canadian journalist Andrew Coyne’s cogent warning against the culture of death from many years ago:

A society that believes in nothing can offer no argument even against death. A culture that has lost its faith in life cannot comprehend why it should be endured

Yup. Those with eyes to see, let them see.

Oregon's response to the Opioid crisis may increase requests for assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

I have written about the goal of the Oregon Health Plan to reduce Opioid prescriptions for people on medicaid by 2020. There is significant concern that chronic pain patients who require prescriptions for opioids will more likely ask their physician for assisted suicide as a response to insufficient pain control.

Will Oregon's plan to eliminate opioid prescriptions for chronic pain medicaid patients increase requests for assisted suicide?

An article by Markian Hawryluk published in the Bulletin on March 13 examines the response in Oregon to chronic pain patients. He writes:

Oregon’s efforts to prevent opioid overdoses have reached a difficult impasse: what to do with the chronic pain patients who are on high doses of opioids now considered unsafe. 

While some experts are warning about the potential harms of forcing stable pain patients off opioids, others insist reductions will benefit patients whether they want to make the change or not.

According to Hawryluk, Dr. Arian Nachat, a palliative care physician who claims that some chronic pain patients are asking for assisted suicide in response to unresolved chronic pain, Hawryluk writes:

Dr. Arian Nachat, a palliative care physician with Legacy Health, spoke about patients who sought out assisted suicide after being cut off of their opioids cold turkey. 

“I hear this story happening more and more,” she said. “We can’t force people off opioids.” 

Many medical professionals are also questioning the policy of the Oregon Health Plan.

In an article published by Governing.com Sharon Wrona, the immediate past president for Pain Management Nursing writes:

Patients with chronic pain often have limited treatment options because insurers refuse to cover many non-opioid treatments. In some states, laws prevent patients from getting medication for more than seven days at a time. These kinds of restrictions add further stress to people who are already suffering. Some patients say they'd rather die than live with the alternatives they've been given.

Pharmacist Steven Arians states in an article published in the Pharmacist:

Also, Oregon is one of a handful of states that has a “death with dignity” law allowing terminal patients to elect to end their life with assistance from their prescriber. When pain is not treated, bad things can happen. It can delay healing, decrease appetite, increase stress, disrupt sleep and ultimately cause anxiety and depression While these adverse physical health outcomes may make the patient eligible for using Oregon’s “death with dignity law”. Of course, if a Medicaid patient elects to go down this path, the Medicaid system stands to save untold tens of thousands of dollars in expenditures for these patients if they did not exercise for this option.

People who oppose believe in caring and not killing recognize that systems of limiting opioids cannot be based on a one size fits all formula. People who live with chronic pain need to have their pain controlled.

There are some people who will ask their doctors to end their life by assisted suicide if they are not provided adequate pain control. This is an example of how assisted suicide is not about compassion, choice or autonomy but rather assisted suicide threatens the life of people who are living through difficult circumstances.

We believe in caring not killing.

Oregon's teen suicide rate doubled from 2006 to 2015.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The suicide rate in Oregon has been higher than the national average for many years. The fact that the youth suicide rate doubled from 2006 to 2015 should alert Oregon citizens especially when combined with the suicide contagion effect.

An article by Richard Hanners that was published in the Blue Mountain Eagle explains:

According to the Centers for Disease Control, suicide in 2012 was the 10th leading cause of death in the United States for people 16 years and older. About three-quarters of the suicide deaths that year were by males.

The percentage of teen deaths by suicide in Oregon doubled from 2006 to 2015, according to Children First of Oregon. At 38.3 percent, it was the No. 1 cause of death. And while the suicide rate among youths 10 to 24 years stayed roughly the same across the U.S., the rate in Oregon increased by 41 percent.

More than two-thirds of Oregon youths involved in suicide incidents from 2002 to 2012 had cited mental health problems before their attempts. More than a third had been diagnosed with a mental disorder.

...In Oregon, the highest suicide rate is for men over 85 years old: 72.4 per 100,000 individuals. For women, the highest rate was for ages 45 to 54. Men in Oregon were 3.6 times more likely to commit suicide than women, according to the Oregon Health Authority. About 25 percent of suicides in Oregon occurred among veterans.

The Oregon suicide data begs the question, does legalizing assisted suicide lead to higher rates of other suicides?

In her article: In Oregon, Other Suicides Have Increased with the Legalization of Assisted Suicide, elder law attorney, Margaret Dore states:

Since the passage of Oregon’s law allowing physician-assisted suicide, other suicides in Oregon have steadily increased. This is consistent with a suicide contagion in which the legalization of physician-assisted suicide has encouraged other suicides.

Dore makes her case based on the Oregon data. She explains:

• Oregon legalized assisted suicide in 1997. 
• By 2007, Oregon's suicide rate was 35% above the national average. 
• By 2010, Oregon's suicide rate was 41% above the national average. 
• By 2012, Oregon's suicide rate was 42% above the national average. 
• By 2014, Oregon's suicide rate was 43.1% higher than the national average.
  

It is shocking that the youth suicide rate doubled between 2006 and 2015 in Oregon. Legalizing assisted suicide sends the message that suicide is an acceptable response to human difficulties.

Doctors oppose euthanasia in Slovenia.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Euthanasia and assisted suicide are being debated world-wide. In 2017 I was a speaker at a conference in Hungary and in the past few years I have worked with people throughout Europe. STA news in Slovenia published an article today suggesting that doctors are strongly opposing euthanasia in Slovenia. The article stated:

euthanasia has become the subject of an ongoing debate in Slovenia in recent months. Concrete steps still seem remote, with a political push so far only coming from the SocDems, and the medical profession looking united in its opposition to both euthanasia and assisted suicide.

Euthanasia is sold to the public as furthering choice and autonomy. In fact legalizing euthanasia gives doctors the right in law to cause your death.

EPC granted intervention standing in withholding of food and fluids court case

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

The Euthanasia Prevention Coalition was granted intervention in a Ontario court case concerning the withdrawal of fluids and food against the wishes of the substitute decision maker in a case known as the Cement case.

The Cement case concerns a 62 year-old woman (Connie) with Downs Syndrome and dementia who was raised in a family whereby her father was an Orthodox Jewish Rabbi.

In September 2018 Connie entered an ICU in an Ontario hospital. She was having difficulty breathing due to problems with aspiration, she had a tracheotomy and feeding tubes inserted.

Connie now breathes on her own, but due to her dementia she continues to be fed by feeding tube. 

The doctors at the hospital have proposed a "treatment plan" based on providing only comfort measures. The doctors want to withhold fluids and food, and deny ventilator support, if needed, and provide no medical treatment, even if the treatment would be beneficial. 

The doctors have stated that the "treatment plan" is in Connie's "best interests."

Connie's substitute decision makers, family members, have refused to accept the "treatment plan."

The Cement case will soon go before the Consent and Capacity Board.

The Euthanasia Prevention Coalition (EPC) was granted intervention standing based on our position that fluid and food are not medical treatment but rather a basic necessary of life.

We agree with the position of the substitute decision maker that Connie is tolerating and benefiting from tube feeding.

Further to that, tube feeding is beneficial in her condition, it is not contra-indicated and to discontinue tube-feeding will cause her to die and do so in a way that is contrary to her religious beliefs.

The doctors are arguing that because of her life-long disability and since her dementia has been progressing for many years, that the wishes of Connie are unknown.

The EPC agrees with the position of the substitute decision maker that the denial of basic care, such as food and fluid is a form of disability discrimination.

To kill a woman with Down Syndrome and dementia by dehydrating her to death is never in her "best interests" and is the highest form of disability discrimination because her life is seen as having no value.

Child with feeding tube.

We would all agree that to deny a child, who cannot eat on her own, food and fluids by bottle or other means is not denying the child medical treatment but rather denying the child a basic necessary of life.

Fluids and food provided by a feeding tube is not medical treatment but rather normal care. It is simply the way that Connie, in her medical condition, eats and drinks.

The Euthanasia Prevention Coalition will need significant financial support to intervene in the Cement case. (Donation link). More information on this case will follow.

• Texas bill is model legislation to prevent death by dehydration (Link).