Monday, December 29, 2008

Washington State: Seduced by Oregon's big lie

Rita Marker wrote this article about the Washington State I-1000 assisted suicide campaign.

Link to the article from the International Task Force on Euthanasia and Assisted Suicide:

Washington State: Seduced by Oregon's big lie

On November 4, 2008, Washington State voters passed Initiative 1000 (the Washington Death with Dignity Act) legalizing Oregon-style physician-assisted suicide by a margin of 58 to 42 percent. It took over ten years -- after right-to-die proponents failed to get 90 assisted-suicide bills passed in 23 states and were defeated in costly initiative drives in Maine and Michigan -- for another state to embrace assisted suicide after Oregon enacted its Death with Dignity Act in 1997.

Whether or not they realize it, Washington voters have opted to place their state squarely on the crest of an extremely slippery, ice-covered slope. But, they won’t be seeing any noticeable plunges down that slope in the near future -- that is if the assisted-suicide advocacy group Compassion & Choices (C&C) has its way. As the facilitator of the majority of assisted-suicide deaths in Oregon and as the group controlling what information, if any, is made available to the public, C&C’s plan is to get as many states as possible to approve assisted-suicide for only terminally-ill adults before there are any overt moves to expand the practice to the chronically-ill, the mentally-ill, those with a diminished quality of life, and those simply tired of living. Widening the categories of patients eligible for an induced death would make it very difficult for C&C and other groups to sell assisted suicide in states targeted for their "win" column.

But shortly after Washington’s I-1000 passed, another national assisted-suicide organization, Final Exit Network (a C&C splinter group), jumped on the bandwagon and issued a press release calling for the right-to-die movement’s real goal: death on demand for all, terminally ill or not. According to the group's president, Ted Goodwin,
Final Exit Network and its members supported passage of this landmark [Washington] initiative by donating to the advocacy effort…. However, the job is not finished….

Unfortunately, many patients do not meet I-1000's strict criteria. Individuals with neurological illnesses such as Parkinson's disease, Multiple Sclerosis, Muscular Dystrophy, Amyotrophic Lateral Sclerosis (Lou Gehrig's disease) and Alzheimer's disease often lose the reason and will to live long before their disease qualifies as “terminal.” For these individuals, neither I-1000 nor the Oregon law go far enough. That is why Final Exit Network pledges, until laws protect the right of every adult to a peaceful, dignified death, Final Exit Network will be there to support those who need relief from their suffering today! [Final Exit Network Press Release, 11/5/08. Emphasis added.]
The big lie

One might ask, if Final Exit Network (FEN) had released its death-on-demand comments before the Washington election, would it have changed the outcome of the I-1000 vote? Probably not, because C&C and the Death with Dignity National Center, the two groups which orchestrated the “Yes on I-1000" campaign, carefully honed their strategy and talking points to undermine, among other things, any attempt to get voters to see the reality of legalized assisted suicide. There was a reason that these two groups chose Washington as the state most likely to pass an assisted-suicide law. Voters there were seen as easy marks since they closely mirrored Oregon voters in being independent minded, valuing total control, and being largely un-churched.

The majority of voters bought the “Yes” campaign’s mantra that 10 years of legalized assisted suicide in Oregon proves that the practice is transparent, safe, abuse free, and even beneficial to overall health care -- despite proof to the contrary.

They ignored Oregon’s largest newspaper, the Oregonian, when its editorial board exhorted Washington voters to reject I-1000 because, “Oregon’s physician-assisted suicide program has not been sufficiently transparent.” “Essentially,” the board wrote, “a coterie of insiders run the program, with a handful of doctors and others deciding what the public may know.” [Oregonian, 9/20/08]

They ignored a recent Oregon Health & Science University study that found that one in four Oregonians who request assisted suicide may, in fact, be clinically depressed. The authors of the study, published in the British Medical Journal, concluded, “The current practice of the Death with Dignity Act may fail to protect some patients whose choices are influenced by depression from receiving a prescription for a lethal drug.” [Ganzini et al., “Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey,” British Medical Journal, 10/8/08]

When the Washington media reported on the study, the “Yes on I-1000" camp immediately spun the findings to their advantage:
The report proves that most patients who request death with dignity are not depressed, and the safeguards work so that those who are must be referred for counseling. Every single one of the many safeguards in the Death with Dignity Act is working. [Yes on I-1000 Report, 10/7/08. Emphasis added.]
Apparently, voters believed that spin job even though most of it was untrue. Neither the Oregon law nor Washington's I-1000 requires that depressed patients be referred for counseling. In fact, of the 49 assisted-suicide patients who died in Oregon last year, NOT ONE was referred for a psychological evaluation or counseling.

Given the study’s finding that one in four assisted-suicide patients is likely to be clinically depressed, not having even one out of 49 such patients with symptoms of depression is highly questionable. According to psychiatrist Linda Ganzini, lead author of the study, “What it means is that primary care physicians probably need to use more rigorous or well-validated instruments rather than just their gut impression about whether the patient is depressed.” [Oregon Public Radio, 10/7/08]

The campaigns

As previously reported in the Update, assisted-suicide advocacy groups Compassion & Choices and the Death with Dignity National Center spent most of last year preparing for the I-1000 campaign. They raised almost $250,000 as seed money in anticipation of launching their initiative in January 2008; they conducted extensive research, testing the best arguments to use to convince Washingtonians that they needed to legalize assisted suicide; and they did all this before the ink was dry on the final version of the initiative.

The opposition, on the other hand, was slow off the mark, perhaps because they hoped that the initiative wouldn’t get the needed signatures to qualify it for the November ballot. When it did qualify in July, the “No on I-1000" group had to ramp up its efforts quickly.

But the “No” campaign couldn’t compete with the large sums of money that initiative proponents were able to generate from assisted-suicide advocates and groups across the U.S. as well as from Australia and Britain. As of November 1, the “Yes on I-1000" committee reported receipts in the amount of $4,856,732. Over the same period, the “No on I-1000" committee received only $1,510,442.

Despite the lack of funds, the “No” campaign was able to produce two very effective TV ads. The first one featured actor Martin Sheen warning voters about the dangers legalized assisted suicide poses for poor and vulnerable patients. The second ad featured Barbara Wagner, an Oregon cancer patient whose health insurer, the Oregon Health Plan, had denied her payment for a cancer treatment drug prescribed by her doctor, but offered instead to pay for her assisted suicide. Unfortunately, the ads were aired during the latter part of the campaign and, in some cases, after many voters had mailed in their ballots.

Implementing a bad law

Washington’s new assisted-suicide law is scheduled to take effect on March 4, 2009. “We’re going to be gathering information over the next few weeks and expect to start the rulemaking process by the end of the month [November],” explained a spokesperson from the Washington Department of Health, the agency charged with compiling annual statistical reports on assisted-suicide deaths. [The Olympian, 11/7/08] Compassion & Choices of Washington plans to take an aggressive, combative role in that “rulemaking” process. According to the group’s web site,
Now the next battle begins. As the established leaders in end-of-life care in Washington State, Compassion & Choices of Washington (C&C) will be the protector and guardian of Initiative 1000. Our opponents will spare no expense in attacking I-1000, just as they did in Oregon. We need to prepare for a long and potentially costly fight to ensure that the law implemented is the same law that voters endorsed on November 4…. [C & C web site]
Indeed, there may be battles on the horizon. Even the Tacoma News Tribune, one of the many Washington papers that endorsed I-1000, is calling for changes in the new law:
The News Tribune editorial board endorsed I-1000, but we believe it needs stronger public disclosure and mental evaluation requirements. The Legislature should closely monitor implementation of I-1000 and make any needed changes. [News Tribune, 11/7/08]
The “No on I-1000" camp is also considering “every option on the table,” including a legal challenge. [AP, 11/7/08]

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