Page's death puts spotlight on euthanasia

An article from New Zealand that is written by Emma Joliff sadly reminds us of the tragedy that occurred five years ago with the death of Terri Schiavo, who like Margaret Page, died of dehydration.

The difference between Page and Schiavo is that Terri could not have chosen to die by dehydration whereas sadly, Margaret Page willingly dehydrated herself to death.

The article states:

There is fresh debate around euthanasia following the death of Margaret Page, who had refused food for more than two weeks.

The 60-year-old suffered a disabling haemorrhage 19 years ago, and euthanasia supporters say her decision should never have been made public.

Ms Page led an active, outdoor life before suffering her crippling brain haemorrhage.

A euthanasia advocate says starvation is a painful and distressing death, and there should have been a more humane alternative.

It should be noted that Margaret Page did not die of starvation but rather dehydration, nonetheless, the tragedy is not that Page did not have the option of being killed by lethal injection but rather that she felt that dying by dehydration was preferable to living with the care that was available to her.

Lesley Martin leader of pro-euthanasia group Dignity NZ stated:

While starving yourself is ethically challenging, it's not illegal.

Margaret Page was admitted to disability facility St John of God four years ago

St John of God commented by saying:

"Food and water had been offered to Mrs Page by staff members whenever they went into her room and at regular intervals. Mrs Page maintained her resolve to refuse food until the very end of her life."

Sadly, Margaret Page felt that her life was not worth living. The reality is that she refused food and fluids, an situation which is different than Terri Schiavo who was denied food and fluids.

The Page story is not a reason to consider legalizing euthanasia or assisted suicide but rather to provide greater care for people who live with debilitating conditions as well as the need for greater mental health services.

Link to the article: http://www.3news.co.nz/Pages-death-puts-spotlight-on-euthanasia/tabid/423/articleID/148998/Default.aspx

Elder Abuse In and Out of Nursing Homes a Growing Problem

The Australian government has released a new report concerning the increased incidence of Elder Abuse. Greater awareness concerning the crime of elder abuse is necessary in the same way as greater awareness of the crime of child abuse has led to effective prevention strategies.

There is a serious problem within society, care homes, and behind the closed doors of family life concerning the care of the elderly. Whether it be inappropriate care in long-term care facilities or family members abusing elder family members, I believe that the solution to the problem is only beginning.

The euthanasia lobby actually believe that legalizing euthanasia and/or assisted suicide will not lead to the ultimate elder abuse(death by supposed choice) is ridiculous.

At the same time the euthanasia lobby intentionally promotes vaguely worded legislation to legalize euthanasia and assisted suicide based on the ideology that they need to make the legislation appear to have safeguards without the safeguards actually having teeth. In other words, the euthanasia lobby is only interested in making legislation appear to have safeguards because actual safeguards may prevent them from being killed when they don't "qualify" for death but are just tired of living.

Francine Lalonde introduced Bill C-384, to legalize euthanasia and assisted suicide in Canada, with vague and conflicting language. She fears for her future and wishes to have someone kill her by euthanasia and she wouldn't want the wording of her bill to actually create a safeguard or a hurdle that may prevent her from being killed by euthanasia.

I accurately state - being killed, because euthanasia is when another person, usually a physician, is given the legal right to cause your death by lethal injection, or some other means.

Anyway, please read the article. The statistics are startling and the reality should upset us. Elder abuse is inflicted upon those who have built our society and the mothers who raised us.

Australian Department of Health and Ageing has released a new report which shows an alarming rise in physical assaults on the elderly in nursing homes: physical assaults increased by more than 50% and sexual assaults by 36%.

Physical and sexual assaults on our elderly in nursing homes is a problem in the United States as well. Earlier this month the Chicago Tribune reported on the widespread problem within the state of Illinois.

The Centers for Disease Control and Prevention has dated statistics on elderly abuse -- “A study conducted in 1996 found that more than 500,000 persons age 60 years and older were the victims of abuse or neglect during a one-year period.”

As baby boomers age, the sheer number of elder persons makes the risk of elderly abuse a national problem.

Elder abuse is defined as any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult. Laws and definitions of terms vary considerably from one state to another, but broadly defined, abuse may be:

1. Physical Abuse - inflicting physical pain or injury on a senior, e.g. slapping, bruising, or restraining by physical or chemical means.
2. Sexual Abuse - non-consensual sexual contact of any kind.
3. Neglect - the failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.
4. Exploitation - the illegal taking, misuse, or concealment of funds, property, or assets of a senior for someone else's benefit.
5. Emotional Abuse - inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts, e.g. humiliating, intimidating, or threatening.
6. Abandonment - desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.
7. Self-neglect
– characterized as the failure of a person to perform essential, self-care tasks and that such failure threatens his/her own health or safety.

Often the elderly will suffer in silence, especially if the caregiver is the abuser. Some tell-tale signs that there could be a problem are:

1. Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment. Be especially wary if the bruises are around the breast or genital areas, as these may indicate sexual abuse.
2. Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.
3. Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.
4. Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.
5. If you suspect abuse, report it. If the danger is immediate, call 911 or the police.

To report elder abuse, contact the Adult Protective Services (APS) agency in the state where the elder resides. You can find the APS reporting number for each state by:

Visiting the “Hotline” section of the National Center on Elder Abuse website

Sources
theAge.com.au
Administration on Aging (AOA)
Centers for Disease Control and Prevention

Link to the article:
http://www.emaxhealth.com/1024/28/36197/elder-abuse-and-out-nursing-homes-growing-problem.html

To kill or not to kill?

George Webster, a clinical ethicist, Health Care Ethics Service, at St. Boniface General Hospital and CIHR member, wrote an article that was published in the Winnipeg Free Press on March 22, 2010.

Webster begins his article by making reference to the program - The Suicide Tourist that was recently aired on PBS. He then comments on Bill C-384, the bill that would legalize euthanasia and assisted suicide in Canada.

Webster continues by explaining why some people support the legalization of euthanasia and assisted suicide and then he explains why others oppose euthanasia and assisted suicide.

Webster looks at the issue in a fair and balanced manner. He is concerned about what is best for the country, for physicians and for patient care. Webster makes this conclusion:

What to do? I believe we can "care well" for the dying and terminally ill in our society without intentionally bringing about their deaths or assisting in their suicides. Often, those who gravitate toward euthanasia or assisted suicide do so because they fear they will lose control of decisions at the end of their lives. They may have witnessed family members dying with little control over decisions or they may have witnessed loved ones die in great pain.

Via their words and actions, health-care professionals and health-care organizations must assure patients and families they will be involved in a meaningful way with decisions about their care. Patients must be assured they will not be abandoned, left to die in isolation and/or excluded from important choices at the end of life.

In our time, no one need die in this way. Fear of loss of control and fear of a painful, protracted dying process are basic issues for all in this debate. However, all too often in the discussion of assisted suicide the public is presented with two scenarios -- a death characterized by loss of control and unrelieved pain and suffering or a peaceful, calm death. This is, quite simply, a crude and simplistic caricature.

Assisting the suicide of those in our community who are dying and/or others who may be struggling with mental anguish eliminates tragedy and suffering by eliminating the sufferer. Rather than being an expression of mercy or respect, communal endorsement of euthanasia and assisted suicide is the ultimate abandonment of the person.

Palliative care is a viable alternative to euthanasia and assisted suicide. The philosophy of palliative care encourages each patient to live to the fullest as they confront their own unique dying. Palliative care demonstrates death is a communal event and not simply a private matter. Those working in palliative care bring specialized skills to respond to pain, psychological distress and the spiritual needs of patients and their families.

If we are to truly honour and respect those among us who are dying, or those whose hold on life is weakened by disease or suffering, then we must keep company with these people and respond in concrete ways that communicate faithfulness and attentiveness.

Link to the article at: http://www.winnipegfreepress.com/opinion/westview/to-kill-or-not-to-kill-88801087.html

Complications with assisted suicide in Oregon and Washington states

An article that is written by Harris Meyer for crosscut.com examines the complications in the first year assisted suicide report in Washington State and the report from Oregon.

The article states:

Reports show some patients had troubles with end-of-life procedures, but complications were rare. Advocates say they'll work to better publicize proper methods.

There may need to be some tinkering with the machinery of death.

It is important about that people learn that there may be more complications than reported in Oregon and Washington states but due to the control that is exerted by Compassion & Choices and the fact that rarely is the physician, who prescribed the lethal dose, present at the assisted suicide death.

After the death occurs the physician who prescribed the lethal dose is then required to submit the report, but how would the physician know that complications occured when the physician is rarely present at the time of death.

Compassion & Choices suggested that with more information the complication rate will drop. The article stated:

“We’re concerned because we want this to work well and properly,” said Dr. Tom Preston, a retired Seattle cardiologist who serves as Compassion’s medical director in Washington. “The more we can get information out there on doing it correctly, particularly to doctors, the better it works out.”

Eileen Geller, the leader of True Compassionate Advocates, was quoted in the article as stating:

“This is marketed by Compassion and Dr. Preston as a peaceful means of dying,” said Eileen Geller, a Seattle hospice nurse who heads True Compassion Advocates, which tries to steer people away from assisted suicide. “But this type of death is cruel and unusual.”

The article described the complications in this manner:

One terminally ill Washington patient who took the lethal prescription vomited up part of it because he had swilled six cans of Pepsi, his favorite drink, in the hour before taking the drug, Preston said. He got that information from the patient’s physician, who wasn’t there but heard it from people who were present. The patient woke up and fell back asleep several times before finally dying 28 hours later — the longest time to death reported among the 36 Washingtonians who died in 2009 after ingesting the drug.

The other Washington case with complications was a terminally ill woman who swallowed the drug too slowly because she kept stopping to say goodbye to the people around her, Preston said. She fell asleep after drinking less than half the full cocktail, then awakened before later dying. The lethal drug used in assisted dying in Washington and Oregon is either oral secobarbital or pentobarbital, mixed with a sweet-tasting liquid or custard.

Compassion & Choices try to control the implementation of the assisted suicide law by facilitating most of the deaths and ensuring that their volunteers are present at the time of death to ensure that death occurs. The article stated:

Compassion had a volunteer present in 80 percent of the Washington cases where patients ingested the lethal drug last year, and there were no reported complications in those cases, Preston said.

The author of the article let Compassion & Choices promote its services:

“When we have a trained volunteer present, the average time to sleep is five minutes and the average time to dying is 25 minutes,” he said. “Like any medical procedure, there’s a right way to do it. Even when patients and their families have been adequately instructed, it can misfire if there isn’t someone knowledgable there watching.”

In Oregon, there was one reported regurgitation out of the 59 deaths under the law in 2009; there have been 20 out of 460 cases since that state’s pioneering Death with Dignity law took effect in 1998. Over that entire period, just one patient was reported to have awakened after taking the drug, about four years ago.

According to George Eighmey, Compassion’s executive director in Oregon, doctors later concluded that patient woke up because he had taken a laxative to mask the bitter taste of the lethal drug, which prevented his body from absorbing the drug quickly enough. When he awoke after being asleep for 65 hours, there were no signs of pain, and he ended up dying of his underlying disease two weeks later.
In Oregon George Eighmey was willing to talk about two cases. I ask George, what about the other, unreported cases? Eighmey stated:

Oregon reported one Death with Dignity patient last year who took a record 104 hours to die. “The doctors we talked to said it’s likely she just had a very strong heart,” Eighmey said.

There’s no indication that people who have taken longer to die have suffered, Eighmey said; they look relaxed and sleep soundly. In one case last year, however, family members noticed the patient “grimacing or twitching,” he acknowledged. “They were concerned afterward, but the person still died without awakening.”

Compassion & Choices will boast about the way they control the law but the Oregon government should be concerned that the only people who know how the law actually works is Compassion & Choices the article stated:

Eighmey boasts that last year Compassion had volunteers present during 57 of the 59 assisted-dying cases in Oregon, up from around 80 percent over the previous years. “More and more hospices and medical providers are aware of our organization and appreciate our facilitating that process,” he said.

The other fact is that there are no penalties when the mandatory physician reporting forms are not submitted. The fact that there are a few irregularities with the reporting forms means that Compassion & Choices will simply be more careful next year to cover up the lack of reporting. The article states:

In Washington, there is concern that mandatory physician reporting forms on two of the 63 Washington patients who received lethal medication prescriptions from their doctors weren’t filed in time for the 2009 annual report. In addition, there were four missing after-death forms from physicians — making it impossible to know whether four of the 47 patients who received the prescription and subsequently died expired from ingesting the lethal drug or from other causes.

“The law doesn’t provide specific enforcement authority but we are calling doctors to ask them if they forgot to send the forms,” said Donn Moyer, a spokesman for the Washington Department of Health.

Eileen Geller commented on the reporting:

“We don’t know who died from the medication, and there’s no penalty for not reporting,” she said.

She argues that elderly and disabled people are being pressured by relatives to choose assisted suicide for financial reasons, and that providers are being told they can’t report this as elder abuse due to the Death with Dignity law. She said she knows of one case last year where a woman suffering from moderate diabetes wanted to stop taking her insulin to qualify for Death with Dignity; when a hospice nurse told her she didn’t qualify under the requirement that patients be terminally ill with six months to live, a Compassion & Choices volunteer called and berated the nurse.

Preston didn't agree with Geller's assertion:

Preston called Geller’s charge against Compassion a “baseless and unsubstantiated claim,” saying, “we would never consider working with such a patient except to advise her that she didn’t qualify under the law.”

The article then glossed over the similarities and differences between the Washington and Oregon experience with assisted suicide.

Overall, Washington’s experience in the first year of its law was quite comparable to Oregon’s, according to the state reports. The large majority of patients who received the lethal prescriptions had terminal cancer, were white, had some college education, were covered by health insurance, and were concerned about loss of autonomy, loss of dignity, and inability to participate in activities that made life enjoyable.

One difference was that 72 percent of the Washington patients were enrolled in hospice care, compared with 92 percent in Oregon. Both supporters and opponents of the Death with Dignity law urge terminally ill patients to take advantage of hospice to receive palliative care and pain relief, which may dissuade them from seeking assisted suicide. Experts say awareness and use of hospice and palliative care has increased since Oregon’s Death with Dignity law took effect.

Critics have said not enough patients undergo psychological evaluations to determine whether they are competent to use the Death with Dignity law. Last year, according to the state reports, doctors ordered evaluations for three Washington patients who later received lethal prescriptions; in Oregon there were none. Preston and Eighmey noted, however, that other patients — three in Washington and five in Oregon — received evaluations and never got the lethal prescriptions. That wasn’t reported to the states, which only require reporting of cases where patients received the drug.

In one such case, Preston was skeptical about the patient’s competence but the attending doctor initially was reluctant to order a psychological evaluation because it would take too much time. He ended up ordering the test. “The doctor said it turned out to be very helpful,” Preston said. “The patient was too far out of it.”

Link to the article: http://crosscut.com/2010/03/23/health-medicine/19689/

‘Pulling the plug’ isn’t euthanasia

The Ottawa Citizen printed an excellent article by Margaret Somerville on Friday entitled: Pulling the plug isn't euthanasia.

I have been fighting a phantom ever since the Quebec College of Physicians decided that Canada needs to legalize euthanasia and then compared euthanasia to ending life-sustaining medical treatment.

The law clearly allows physicians to withdraw or withhold medical treatment that is futile, burdensome, inappropriate, etc. This is not euthanasia unless it is necessary care that is withheld or withdrawn against the consent of the person.

The important point in this article is that there is a difference between killing and letting die. The other natural difference between killing and letting die is that when you let someone die, sometimes (not often) they don't die and often they don't die immediately. When you give someone a lethal dose by euthanasia, that person will die from the lethal dose and usually within a short period of time.

Somerville wrote:
Recently, I saw an illustration that accompanied an article about euthanasia. It showed the silhouette of a patient lying on a bed. There was an electrical outlet on the wall behind the bed and an unplugged connecting cord hanging down over the side of the bed.

Except in very rare circumstances — for instance, if the treatment were withdrawn without the necessary consent or against the patient’s wishes — withdrawal of life-support treatment is not euthanasia. Yet many people, including the artist who penned this illustration and many health-care professionals, mistakenly believe that it is.

In my experience, they are confused with respect to the ethical and legal differences between withdrawal of treatment that results in death and euthanasia, and why the former can be ethically and legally acceptable, provided certain conditions are fulfilled, and the latter cannot be. This is a central and important distinction in the euthanasia debate, which needs to be understood.

Failure to understand it leads, among other problems, to physicians responding affirmatively to surveys that ask them whether they or their colleagues have carried out euthanasia, when in fact they have not, and members of the public saying they agree with euthanasia, because they agree with people’s rights to refuse medical treatment.

First, the primary intention is different in the two cases: In withdrawing life-support treatment the primary intention is to respect the patient’s right to refuse treatment; in euthanasia it is to kill the patient. The former intention is ethically and legally acceptable; the latter is not.

Patients have a right to refuse treatment, even if that means they will die. They have a right not to be touched, including through medical treatment, without their consent — a right to inviolability. This right protects a person’s physical integrity and can also function to protect physical and mental privacy. The right to inviolability is one aspect of every competent adult’s right to autonomy and self-determination.

Pro-euthanasia advocates use recognition of this right to refuse treatment even when it results in death to argue that, likewise, patients should be allowed to exercise their right to autonomy and self-determination to choose death through lethal injection. They say that there is no morally or ethically significant difference between these situations, and there ought to be no legal difference.

They found their argument by wrongly characterizing the right to refuse treatment as a “right to die,” and then generalize that right to include dying through euthanasia and physician-assisted suicide. But the right to refuse treatment is not a “right to die” and does not establish any such right, although death results from respecting the patient’s right to inviolability. The right to refuse treatment can be validly characterized as a “right to be allowed to die,” but this is quite different from a right to be killed that euthanasia would establish.

Moreover, a “right to be allowed to die by refusing treatment,” is a “negative content” right — a right against one’s integrity being breached without one’s consent. In contrast, a “right to die” through access to euthanasia would be a “positive content” right — that is, a right to something. In general, the law is very much more reluctant to recognize positive content rights, than negative content ones.

This pro-euthanasia line of argument is yet one more example of promoting euthanasia through deliberate confusion between interventions, such as valid refusals of treatment, that are not euthanasia and those that are.

This brings us to the issue of legal causation, which also differentiates refusals-of-treatment-that-result-in-death from euthanasia. In the former, the person dies from their underlying disease — a natural death. The withdrawal of treatment is the occasion on which death occurs, but not its cause. If the person had no fatal illness, they would not die. We can see that when patients who refuse treatment and are expected to die, do not die. In contrast, in euthanasia death is certain and the cause of death is the lethal injection. Without that, the person would not die at that time from that cause.

The fact that the patient dies both in refusing treatment and in euthanasia is one of the sources of the confusion between the two. If we focus just on the fact that in both cases the outcome is death, we miss the real point of distinction between death resulting from refusing treatment and from euthanasia.

The issue in the euthanasia debate is not if we die — we all eventually die. The issue is how we die and whether some means of dying, such as euthanasia and physician-assisted suicide, should remain legally prohibited. In order to maintain that they should, we need to be able to show how currently accepted practices, such as respect for patients’ refusals of treatment, are not euthanasia and differ from it and assisted suicide.

Margaret Somerville is director of the Centre for Medicine, Ethics and Law at McGill University, and author of The Ethical Imagination: Journeys of the Human Spirit.

Link to the article at: http://www.ottawacitizen.com/health/Pulling+plug+euthanasia/2704966/story.html

Minnesota nurse to be prosecuted for his role in counselling suicide deaths.

An article in yesterday's Daily Mail newspaper in the UK confirms that William Melchert-Dinkel, the Minnesota nurse who admitted to being an internet suicide predator, will be charged with encouraging others to commit suicide.

Melchert-Dinkel has admitted to being involved with the suicide death of Nadia Kajouji, the 18 year-old first-year student at Carlton University in Ottawa in March 2008. Kajouji died by drowning after establishing a suicide pact with Melchert-Dinkel who claimed to be a female nurse from Minnesota.

You will notice by the comment from Deborah Chevalier (below the blog entry) that the article had some false comments. Melchert-Dinkel has not been charged yet, even though they expect that he will.

The article stated that:

Melchert-Dinkel, a married father of two, allegedly spent years posing as a young woman who may have contacted more than 100 desperate people across the world.

‘Most important is the placement of the noose on the neck,’ he allegedly wrote in one web chat. He then went on to detail where to place the knot ‘for instant unconsciousness and death.’

He has allegedly admitted to U.S police that he was involved in at least four deaths, including that of an 18-year-old Canadian student Nadia Kajouji.

Melchert-Dinkel also admitted to establishing a suicide pact with Mark Drybrough an IT technician from Coventry in the UK to commit suicide in June 2005. The article stated:

Mr Drybrough’s mother Elaine said that she believed that Melchert-Dinkel appointed himself as her son’s ‘executioner’.

Mark Drybrough killed himself at his home in Coventry in June 2005
‘Mark had had a nervous breakdown and he was depressed and incredibly susceptible,’ she said.

‘This person was there whispering in his ear every time he logged on. In the last email, this person claimed to be a nurse, saying he had medical training, and proposed a suicide pact.’

Mrs Dryborough eventually tracked down Mr Melchert-Dinkel with the help of a Wiltshire youth worker, Celia Blay, who discovered that dozens of people had received similar emails to Mark’s.

Celia Blay worked hard on her own to uncover Melchert-Dinkel's activities:

Mrs Blay had been enraged when a 13-year-old friend of hers had told her that she had made a suicide pact with a female nurse called Li Dao

Mrs Blay contacted members of internet groups used by Li Dao and discovered that she used the pseudonyms Falcon Girl and Cami D.

Li Dao would persuade people to enter pacts in which they would hang themselves in front of internet webcams and watch each other die.

But at the crucial moment there was always a problem with Li Dao’s webcam.

Mrs Blay said: ‘We found out everything about him on Google, including where he lived in Minnesota.’

She added: ‘He befriended them using a female identity, was very loving and sympathetic, but never suggested an alternative to death, even when they were only teenagers.

‘He’d tell them that he intended to kill himself too, and said they should set up a web camera and he would do the same thing so they could watch each other die over the internet.’

‘It took months and months to collect the evidence but when I went to the police [close to her home, which was then at Maidenhead, Berkshire] they just said if it bothers you, look the other way,’ she said.

At this point Melchert-Dinkel has only been disciplined by the Minnesota nurses association who revoked his right to be a nurse. The article stated:

The Minnesota Board of Nursing, which revoked Melchert-Dinkel's licence in June last year, said he encouraged numerous people to commit suicide and told at least one person his job as a nurse made him an expert on the most effective way to do it.

His medical notes record that he told nurses that he was addicted to suicide chat rooms and had ‘posed as a 28 yo female formed suicide pacts with some that he had no attention [sic] of following thru . . . 4 yrs suicide fetish offered medical advice for assisted suicide x2’.

Harold Albrecht MP, (Kitchener-Conestoga) unanimously steered Motion 388 through Canada's parliament to urge the Canadian government to take action in the death of Nadia Kajouji and to protect Canadians from internet suicide predators.

Link to the article at: http://www.dailymail.co.uk/news/article-1259379/The-suicide-voyeur-nurse-encouraged-people-kill-online.html#ixzz0ioCWmlI0

Doctor Death continues to promote veterinarian drugs for suicide

Philip Nitschke, Australia's Dr Death, continues to promote the purchase of veterinarian euthanasia drugs for his supporters to use for suicide.

Philip Nitschke

An article published today in the Australian paper, Perth Now, explains that a source of Nembutal, a drug used in the euthanasia of animals, has been discovered in Thailand.

Nitschke has been irresponsible with his promotion of the use of Nembutal and this has resulted in large numbers of his supporters, as well as young healthy or depressed people also obtaining Nembutal to kill themselves.

A recent report from the Victorian Institute of Forensic Medicine researched 51 people who died from Nembutal in Australia. The report found that young people and depressed people were more likely to die by Nembutal than terminally ill people in Australia.

The report stated that of the 51 people who were known to have died from Nembutal, 6 people were in their 20's, 8 people were in their 30's, 5 people were in their 40's, 14 people were in their 50's, 3 people in their 60's, 10 in their 70's, and 5 people were over the age of 80.

Further to that, the report found that of the 38 known deaths that were investigated by a coroner, only 11 had a significant physical illness or chronic pain with the remaining 27 cases showing no signs of physical problems.

The report suggested that the 27 otherwise healthy people who died from Nembutal use were most likely depressed or mentall ill.

Link to my previous blog comment on this study: http://alexschadenberg.blogspot.com/2010/02/hoarding-death-drugs.html

With the continued promotion of Nembutal, Nitschke is proving that he doesn't care about the colateral damage that is caused by his promotion of Nembutal. People are travelling around the world obtaining Nembutal from veterinary clinics and putting their lives and the lives of others at risk.

Nitschke's irresponsibly promoting Nembutal for his own politcal gain without caring that vulnerable people are dying at the same time.

Link to the article in Perth Now: http://www.perthnow.com.au/news/cheap-flight-to-thailand-for-euthanasia-drugs/story-e6frg12c-1225843186159

Bill C-384 received its first-hour of debate on March 16th (again)

The first-hour of debate (again) on Bill C-384, the bill that is sponsored by Francine Lalonde (La Pointe-de-l'Île, BQ) to legalize euthanasia and assisted suicide in Canada took place, yesterday on March 16, 2010.

Bill C-384 was introduced at first-reading on May 13, 2009. It had its first-hour of debate on October 2, 2009 and it was scheduled for its second-hour of debate for November 16, 2009. Lalonde then traded-backwards in the order of precedence three times to delay the second-hour of debate and vote on Bill C-384. Then Prime-Minister Harper prorogued parliament. Since C-384 had not been voted-on at second reading, therefore prorogation returned C-384 to requiring a first and second-hour of debate before it could be voted-on at Second Reading.

Lalonde’s strategy: Create confusion concerning Bill C-384, euthanasia and assisted suicide and pressure Members of Parliament (MP) to pass the bill at second reading and amendment it in committee.

Lalonde began her speech in parliament by annunciating her strategy to pressure MP’s to support Bill C-384 at second-reading and to amend it in committee. Lalonde stated:

“I think that studying my bill in committee and passing it after consideration and amendments would at last rid us of the criminal nature of physician-assisted dying by euthanasia or assisted suicide.”

Bill C-384 is fatally flawed. There is nothing redeeming or worth amending in the bill.

*Bill C-384 legalizes lethal injection for people who suffer chronic physical and mental pain even when the condition is treatable.

*Bill C-384 is not limited to competent people. It legalizes lethal injection for people who “appear to be lucid”. You are not required to be lucid only to appear to be lucid.

Lalonde then begins her second strategy which is to create confusion about what euthanasia and assisted suicide is and what Bill C-384 does. Lalonde states:

“In a context where any act aimed at shortening life is considered murder punishable by criminal sanctions, it is rather difficult to have an open and frank discussion on all the care that would be appropriate at the end of life.”

“The Canadian legal framework, the Criminal Code, stipulates that any action to end another person’s life constitutes murder and is therefore subject to criminal sanctions.”

Lalonde’s comments are false and misleading.

Euthanasia is when a person (usually a physician) directly and intentionally causes the death of another person, based on suffering. Euthanasia is usually done by lethal injection.

Assisted Suicide is when a person aids, abets or counsels a person to commit suicide. Assisted suicide is usually done by writing a prescription for a lethal dose.

Lalonde's statements relate to the false comments by the Quebec College of Physicians who argue that euthanasia needs to be legalized to protect doctors who use sedation techniques and large doses of morphine, acts that they claim are the same as euthanasia.

The proper use of morphine and other analgesics is not euthanasia. The proper use of analgesics will relieve a person of pain and if the rare and unintended consequence is the death of the person, then it is clearly not euthanasia but rather the reality that death is a natural end for the human person. The abuse of the use of analgesics may be euthanasia and should never be confused with the effective and proper use of morphine.

The proper use of sedation techniques are not euthanasia, but rather a good form of palliative care. When a person is properly sedated to relieve them of pain, this is not euthanasia, but the abuse of the use of sedation techniques may be euthanasia.

I am concerned that false and misleading comments concerning the proper use of sedation and analgesics to effectively control pain may lead some physicians to hesitate from using large doses of analgesics or hesitate from sedating a person who is experiencing painful symptoms. This would be a tragic.

Lalonde also asked the question: “What will the parliament of Canada do?” if the Quebec government commission that is seeking information on euthanasia and assisted suicide, introduces a motion in the Quebec legislature to legalize euthanasia?

Lalonde promotes the myth that her bill is strict and limited. She stated:

“My bill has a specific objective. It deals only with people capable of making decisions for themselves who are living in conditions of suffering that cannot be alleviated.“

“My bill is specific and limited”

Bill C-384 is wide open and uncontrollable.

It allows euthanasia (lethal injection) and assisted suicide (lethal prescription) for people who are experiencing physical or mental pain or terminally ill, who have accepted or rejected effective treatments, and who appear to be lucid.

Bill C-384 is not limited to terminally ill people. It allows euthanasia for someone who is experiencing chronic physical or mental pain, who have rejected effective treatment, even if that effective treatment was for chronic depression, and who appear to be lucid.

Bill C-384 would allow someone who lives with treatable chronic depression to be killed by lethal injection.

This is a bill that specifically targets people with disabilities who live with chronic conditions.

C-384 is a recipe for elder abuse. A person only needs to appear to be lucid and the bill does not require a witness at the time of death to ensure that the person who died, actually consented.

Lalonde is creating confusion about what euthanasia and assisted suicide is and what Bill C-384 does. She is pressuring MP’s to vote for Bill C-384 at second reading, even if they don’t actually support the bill, to allow the bill to be debated and amended in the justice committee.

Lalonde is constantly repeating a lie with the hope that the lie becomes accepted as a fact.

Bill C-384 needs to be defeated at second reading. Tell your MP to vote against Bill C-384.

Vancouver Sun and euthanasia lobby activist dissing disability activists

Stephen Drake from Not Dead Yet is not taking the crap from the euthanasia lobby, who are attempting to discount the opposition by people with disabilities to euthanasia and assisted suicide.

All I have to say is go get-em Stephen:

Read his comments:
Ann Neumann, writing on the Otherspoon blog, has stated in the past that she's inclined to shy away from direct criticism of disability rights groups like NDY in the "right to die" debate, seeing it as "a trap."

Neumann found a way around the "trap" last week by quoting someone else's work. Specifically, she quoted a "hit and miss" attempt at analysis of the impact of the disability rights movement in Canada published in the Vancouver Sun.

Here's the relevant portion of the article in regard to assisted suicide and euthanasia, which Neumann also shares on her blog:

The battle for disabled rights has had other unpredicted twists and turns.

One of them is over the so-called "right to die." As advocates for the disabled have continued battling for recognition, they have clashed with people who want laws in Canada and the U.S. permitting assisted suicide for those with severe disabilities and terminal conditions.

Even though polls show the majority of Canadians support regulated euthanasia, disability rights activists have strongly lobbied politicians to make sure no one, regardless of the severity of their disability, should be able to choose an assisted suicide.

In this increasingly bitter debate, disabled activists claim legalizing assisted suicide would be an ethical "slippery slope" that would lead to all disabled people, no matter the degree of their impairment, being devalued as human beings.

In turn, advocates for assisted suicide maintain the arguments of disabled-rights activists are a misplaced over-reaction to their proposals.

American readers should take careful note of the specific wording. The debate in Canada is not limited to advocacy of assisted suicide or euthanasia for the "terminally ill" alone. As I'll get to in a bit, it's not even limited to those who ask to die.

All the more curious that she'd highlight this, since one of her criticisms in her previous post responding (sort of) to Not Dead Yet, contained this:

As to the provision of rights to one group infringing on the rights of another, that's just bad thinking too. Giving a mentally-sound, terminal patient with less than six the right to a lethal prescription that they may or may not choose to take when death approaches has nothing to do with the disabled community. Again, I sympathize with the fear and vulnerability the disabled community feels toward the medical industry, the state, and society. But conflating two separate issues is just bad advocacy. With a little (understandable) paranoia thrown in.

Paranoia? Certainly not in Canada.

See, the reporter at the Vancouver Sun didn't do his homework. The one single case that galvanized the disability community in Canada in regard to this issue was the murder of a disabled 12-year-old girl by her father, who claimed it was a "mercy killing" after failing to pass her death off as a natural one. Robert Latimer, who gassed his daughter Tracy in the cab of his truck, had many defenders - including members of the "right to die" movement in Canada.

Ruth von Fuchs, current president of the Right to Die Society of Canada, had some pretty unambiguous quotes during the trial of Robert Latimer:

Proponents of euthanasia say that, until proper legal and social supports are in place, many people, like Latimer, have to take the law into their own hands. "This law is being written unofficially in emergency rooms and intensive care wards every night," says Ruth von Fuchs, a member of the Right to Die Society in Toronto. Von Fuchs views Tracy's death as part of a "continuum" that begins with brain-damaged infants, some so severely handicapped that doctors quietly remove life support within hours of birth. It is unfortunate, she adds, that because mercy killing has been "criminalized," Latimer felt he had to act alone, without the help of a social worker or medical expert. Von Fuchs, and other members of the euthanasia movement, is calling for a change in attitude to mercy killing. "In our society, we forbid people to give up," she argues. "We say, 'Never say die,' but sometimes you have to stand back and realize that really is a cliché. We cannot fix everyone every time forever."

You want a clearer statement from a leader in the Canadian "right to die" movement? Here is an excerpt from a 1997 NY Times article quoting the late Marilyn Seguin, then the executive director of of the Canadian group Dying with Dignity:

Marilynne Seguin, executive director of Dying With Dignity, a Toronto-based group promoting freedom of choice for physician-assisted deaths, said that the Latimers had already lived under a sentence during the 12 years that Tracy was alive and that to add the 10-year punishment "is quite unconscionable." (emphasis added.)

Going back to the original article, opposition of disability rights activists - and mistrust of the motives of euthanasia advocates - might seem less like an "overreaction" and more an appropriate reaction with more information.

The Vancouver Sun reporter failed to supply a full context for the nature of the real debate here - through laziness, sloppiness or reasons unknown. Whether Neumann found this appealing due to true ignorance or a simple wish to use misinformation is anyone's guess. But even with the limited information available in the article, she certainly can't accuse disability activists of conflating "terminal illness" with "disability." Disability is openly on the agenda of the euthanasia proponents in Canada.

It is here in the US as well. The larger organizations just favor an incrementalist approach and are a little embarrassed by the recently publicized more radical activities of the Final Exit Network. --Stephen Drake

Link to the comments on the Not Dead Yet blog:
http://notdeadyetnewscommentary.blogspot.com/2010/03/ann-neumann-and-vancouver-sun-dissing.html

When is euthanasia justified?

The Globe and Mail, Canada's national newspaper, published an excellent article by Margaret Somerville yesterday.

The article asks the rhetorical question, When is euthanasia justified?

Somerville answers the question with the reality of the practice of euthanasia in other jurisdictions.

Somerville stated:
Francine Lalonde's private member's bill to legalize euthanasia and assisted suicide will be back in Parliament tomorrow.

For millennia, euthanasia (a word I use to include assisted suicide) has been considered morally and legally unjustifiable. People who oppose euthanasia still believe it's inherently wrong – it can't be morally justified and even compassionate motives don't make it ethically acceptable.

But what are the attitudes of pro-euthanasia advocates regarding whether its use needs to be justified, were it to be legalized? And, if justifications are required, what are they?

People who would accept euthanasia, but only in some circumstances, usually limit its access to people who are terminally ill, in serious unrelievable pain and suffering, and require that euthanasia be used as a last resort. These limitations show these people believe each case of euthanasia needs moral justification to be ethically acceptable.

But although the need for euthanasia to relieve pain and suffering is the justification given, and the one the public accepts in supporting its legalization, research shows that dying people request euthanasia far more frequently because of fear of social isolation and of being a burden on others, than pain. So, should avoiding loneliness or being a burden count as a sufficient justification?

Recently, some pro-euthanasia advocates have gone further, arguing that respect for people's rights to autonomy and self-determination means competent adults have a right to die at a time of their choosing, and the state has no right to prevent them from doing so. In other words, if euthanasia were legalized, the state has no right to require a justification for its use by competent, freely consenting adults.

For example, they believe an elderly couple, where the husband is seriously ill and the wife healthy, should be allowed to carry out their suicide pact. As Ruth von Fuchs, head of the Right to Die Society of Canada, stated, “life is not an obligation.” But although Ms. von Fuchs thought the wife should have an unfettered right to assisted suicide, she argued that it would allow her to avoid the suffering, grief and loneliness associated with losing her husband – that is, she articulated a justification.

We can see this same trend toward not requiring a justification – or, at least, nothing more than that's what a competent person over a certain age wants to do – in the Netherlands. Last month, a group of older Dutch academics and politicians launched a petition in support of assisted suicide for the over-70s who [ OMIT are] “consider their lives complete” and want to die. They quickly attracted more than 100,000 signatures, far more than needed to get the issue debated in parliament under citizens' initiative legislation.

And what about avoiding health-care costs as a justification? Although this question has largely been dodged – one could say “religiously” – by pro-euthanasia advocates, euthanasia could be used as a cost-saving measure, and is likely to be if legalized.

Half of the lifetime health-care costs of the average person are incurred in the last six months of the person's life. Euthanasia would be a way to implement a “reasonably well or dead” approach – sometimes referred to as “squaring the curve” of health decline at the end of life, so the person drops precipitously from being reasonably well to dead – which would avoid those costs.

The medical authority of the U.S. state of Oregon – where physician-assisted suicide is legal – seems to have adopted this approach. Shortly before he died this month, Montreal journalist Hugh Anderson wrote in The Gazette that Oregon “has acknowledged that when it turns down an application to cover the cost of an expensive new drug, it sends out simultaneously a reminder that the state's assisted suicide program is available at an affordable cost.” As Mr. Anderson noted, “What a great way to put a crimp in medical costs. Have the patients kill themselves when the cost of keeping us alive gets too high.”

The Netherlands' 30-year experience with euthanasia shows clearly the rapid expansion, in practice, of what is seen as an acceptable justification for euthanasia.

Initially, euthanasia was limited to terminally ill, competent adults, with unrelievable pain and suffering, who repeatedly asked for euthanasia and gave their informed consent to it. Now, none of those requirements necessarily applies, in some cases not even in theory and, in others, not in practice.

For instance, parents of severely disabled babies can request euthanasia for them, 12- to 16-year-olds can obtain euthanasia with parental consent and those over 16 can give their own consent. More than 500 deaths a year, where the adult was incompetent or consent not obtained, result from euthanasia. And late middle-aged men (a group at increased risk for suicide) may be using it as a substitute for suicide.

Indeed, one of the people responsible for shepherding through the legislation legalizing euthanasia in the Netherlands recently admitted publicly that doing so had been a serious mistake, because, she said, once legalized, euthanasia cannot be controlled. In other words, justifications for it expand greatly, even to the extent that simply a personal preference “to be dead” will suffice.

Legalizing euthanasia causes death and dying to lose the moral context within which they must be viewed. Maintaining that moral context is crucial in light of an aging population and scarce and increasingly expensive health-care resources, which will present us with increasingly difficult ethical decisions.

Link to the article in the Globe and Mail: http://www.theglobeandmail.com/news/opinions/when-is-euthanasia-justified/article1499212/

Dutch petition to permit the killing by euthanasia of healthy people over 70 gets 100,000 signatures

By Alex Schadenberg
Executive Director 
Euthanasia Prevention Coalition

An article that was published in the Daily Telegraph stated that a lobby group has got 100,000 signatures demanding that the Dutch government allow euthanasia and assisted suicide for people who are over the age of 70 for any and all reasons "tired of living".

The Dutch euthanasia lobby has been pushing for euthanasia for those who are "tired of living" as their "final solution" for many years. 

When I attended the World Federation of Right to Die Societies Conference in Toronto in September 2006, the leader of the NVVE - Dutch euthanasia society, stated that he was concerned that activism on the part of the euthanasia lobby should be discouraged because it would prevent their group from achieving the final goal - euthanasia for those who are "tired of living." At the same conference Philip Nitschke, Australia's Dr. Death, asked the question, why should we not have euthanasia available to those who are "tired of living."

My mom turns 70 this year. She is a great dutch woman and she has always put other people ahead of herself in life. Women like her should never be told, even subtly, that they are "better off dead".

Our mothers continue to want the best for us, even after we have grown up. It would be easy to convince some of them that death is preferable than living with special needs. These women will feel that by agreeing to euthanasia they are doing "what is best for their children".

Oh by the way - It would be a free choice for these elderly women? Bull! This is the prime example of how choice is a lie and assisted suicide and euthanasia are a "recipe for elder abuse." In this case, choice is simply a slogan and not a reality.

The 100,000 people who signed the petition urging the government to allow "doctors" to lethally inject or provide lethal doses to our elderly mothers should be ashamed of themselves. They represent the most uncaring, self-centred, group of people that have ever lived.

This whole concept is based on a few academics who philosophically believe that death is the ultimate freedom. They really don't care that their philosophy threatens the lives of the many so the few white wealthy academics can say - "I am free".

It is bad enough that they allow euthanasia in general, but to simply say - "Oh by the way I am tired of living, give me the Kool-Aid" is ridiculous at best.

Link to the article at: http://www.telegraph.co.uk/news/worldnews/europe/france/7414590/Dutch-plan-to-let-healthy-elderly-people-commit-suicide.html

True Compassion Advocates - Press Advisory - Washington State Assisted Suicide Report

Press Advisory
True Compassion Advocates

One Year Anniversary Protest - March 3rd, 2010

Protest of Assisted Suicide law to be held Friday, March 5th at University of Washington Medical Center

The first anniversary of the implementation of Washington's Death With Dignity Act is Friday, March 5th. A supportive care demonstration will gather in front of the UW Medical Center to protest the legalization of assisted suicide. From 12 noon to 1pm, protestors will line the sidewalk near the front of the hospital at 1959 N.E. Pacific Street.

According to Eileen Geller, RN, BSN, President of True Compassion Advocates, protestors will "stand in solidarity with seniors, people with disabilities, and other victims of the 'collateral damage' caused by legalizing assisted suicide in this state."

Over 52 Washingtonians have died under the Death with Dignity Act since the law was implemented. There were a total of 80 requests for assisted suicide, and 72 lethal drug overdoses dispensed, according to the March 2, 2010 statistics from Washington State Department of Health. Of the 80 requests, only four people received psychiatric consults assessing them for untreated clinical depression, a common problem among those with serious and chronic illnesses. Geller stated that: "I can only hope all the reported assisted suicides were not the result of untreated depression or someone else's choice." She added: "Unfortunately, given the flimsy reporting standards and potentially coercive provisions of the DWD Act, there is no way to know for sure."

The TCA president believes the overall number of people adversely affected by the Act is much higher than the official count of assisted suicides gathered by DOH. In the last year, her organization has received increasing reports of 'the collateral damage' from the DWDA, including calls about seniors who feel increased pressure to commit suicide or assisted suicide. They have also heard from health care professionals worried about vulnerable adults being adversely impacted by the "duty to die" climate fostered by the Act.

Geller, a longtime hospice nurse, stated: "These calls are an indicator of abuse. I've spoken to patients for whom this pressure is very real. With the rates of elder abuse and financial exploitation climbing, Washington's legalization of assisted suicide has created increased stress on vulnerable adults. With state budget cuts and a tough economy, the 'choice,' promised by the Death With Dignity Act, quickly becomes illusory."

"The need for creating and maintaining in our communities assisted suicide-free 'safe harbors' has never been greater," Geller emphasized. Hospitals, such as the UW, which 'opted in' to allowing assisted suicide in their facilities, along with nursing homes and adult family homes, are hearing from patients, families, and community members. They are saying that they want safe, competent care, but not assisted suicide," she stressed.

Link to the press advisory: http://www.truecompassionadvocates.org/press9.html

Washington State "Death with Dignity" Statistics are Consistent with Elder Abuse; No Recourse for Elders.

The Washington State Department of Health has released its first annual report for Washington's Death with Dignity Act, which was enacted via a voters' initiative in 2008. The Act, which legalized assisted suicide, went into effect on March 5, 2009. A copy of the report can be viewed here: http://www.doh.wa.gov/dwda/forms/DWDA_2009.pdf

According to the report, lethal prescriptions intended to kill people were dispensed to 63 individuals. The majority were 65 years old or older, and educated. Nearly half had private insurance. These factors are consistent with their being individuals with money. Older people with money are prime targets of abuse. See Met Life Study on Elder abuse at: http://www.metlife.com/assets/cao/mmi/publications/studies/mmi-study-broken-trust-elders-family-finances.pdf

According to the report, 23% took this step due a concern about being a "burden." This is a marker of possible abuse because the person was pressured to feel that way.

Washington's Act is, regardless, coercive: An heir who will benefit from the death, is allowed to help the person sign up for the lethal dose; there is no requirement of consent at the time of death. See: Margaret Dore, "Death with Dignity: What do we Tell our Clients?," Washington State Bar News, July 2009. http://wsba.org/media/publications/barnews/jul-09+deathwithdignity.htm .

After the death, even prosecutors are required to treat the death (voluntary or not) as "Natural." http://www.doh.wa.gov/dwda/forms/MEsAndCoroners.pdf. Elders abused by the Act have no recourse.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition
euthanasiaprevention@on.aibn.com
1-877-439-3348

Margaret Dore
Attorney at law – Seattle Washington
www.margaretdore.com

2009 Annual Oregon Physician Assisted Suicide Report: “More Conspiracy and Control”

Physicians for Compassionate Care

Education Foundation

P.O. Box 6042

Portland Oregon 97228

(503) 533-8154; www.pccef.org

Press Release
March 4, 2010

2009 Annual Physician Assisted Suicide Report: “More Conspiracy and Control”

The annual report from the Oregon Department of Human Services (DHS) regarding Oregon physician-assisted suicide (PAS) for the 2009 year was released March 3, 2010. (1)

It reports that 95 prescriptions were written in 2009 by 55 doctors, resulting in 59 PAS deaths in 2009. In the 12 years from 1998 to 2009, there have been 460 reported PAS deaths in Oregon.

PCCEF is concerned with several areas of the DHS report for the 2009 year.

● The report is very brief, consisting of a two-page summary report and a 2 ½ page Table. This is not consistent with the “surveillance” responsibility of the DHS regarding assisted suicide in Oregon. There are no true investigations of assisted suicides in Oregon by the DHS. 

● None of the 59 patients was referred for psychiatric evaluation. Over the past three years in Oregon, only 1% (2 of 168) of patients committing assisted suicide were referred for psychiatric evaluation. This is in marked contrast to the report by OHSU researchers in 2008 that 25% of patients requesting assisted suicide were considered to be depressed. (2) This year’s report confirms there is no protection for depressed patients in Oregon. 

● Only 6 of the 59 PAS death patients had “inadequate pain control or concern about it” as an end-of-life concern. As has been reported previously, pain is not a major reason for assisted suicide. 

● The prescribing physician was present at the time of lethal overdose ingestion for only 3 of the 59 deaths, and was present at the time of death for only one patient. Medical details of that time and knowledge of complications for the other 58 patients was obtained second or third-hand. How do we really know what happened in the majority of the deaths? Why are the prescribing physicians not present at this critical time? 

● The median duration of patient-physician relationship was only 9 weeks. Some patients had no prior relationship with the prescribing physician. Many patients have prescriptions for lethal drugs written by other than their personal physician.

One organization is responsible for 97% of the assisted suicide deaths this past year. Compassion & Choices, the assisted-suicide-proponent organization, are authors of Oregon’s physician-assisted suicide law and proclaim they are its steward. 78% (359/460) of all Oregon assisted suicide deaths are their cases. In the past two years they have been involved in 92% of Oregon’s assisted suicides. They reported involvement in 53 of 60 deaths in 2008, and in 57 of 59 deaths in 2009. (3) The Oregonian editorial board correctly stated in 2008 that “a coterie of insiders run the [assisted suicide] program, with a handful of doctors and others deciding what the public may know.” ( 4 ) As is particularly evident for the 2009 year, they control the assisted suicide market; 97% (57 of 59) of physician assisted suicide deaths in 2009 were their cases! As was noted in The Oregonian in 2008 ( 5 ), “the initials ‘C &C’ of this organization more properly reflect its repeated public behavior – that is, ‘Conspiracy and Control’ ” .

Very few doctors are involved in most physician assisted suicides. Oregon Department of Human Service officials reported in 2009 that there were 109 physicians who wrote 271 prescriptions resulting in assisted suicide deaths in the years 2001 to 2007 (6). 165 of the prescriptions were written by 20 physicians, and 62 of these 165 prescriptions were written by only 3 physicians. In other words, 61%of the fatal suicide barbiturate overdose prescriptions were from 18% of the prescribing doctors; and 23% of the fatal suicide prescriptions were from less than 3% of prescribing doctors.

In this same article, the DHS authors expressed concern regarding the “worrisome trend” over the years in the decline in requests for formal psychiatric evaluation, they stated: “the decline in formal evaluation raises concerns that depression remains undiagnosed in some patients who request and receive a prescription under the DWDA.”

Physicians for Compassionate Care Educational Foundation promotes the ethic that all human life has inherent value and that physician-assisted suicide:

● Undermines trust in the patient-physician relationship
● Changes the societal role of the physician from healing to medical killing
● Endangers the value that society places on life, specifically for those who are most vulnerable, those who are frail, elderly, and at the end of life.

References:
1. 2009 Summary of Oregon’s Death with Dignity Act, March 3, 2010.
http://oregon.gov/DHS/ph/pas/index.shtml.
2. Ganzini, L, Goy ER, Dobscha SK. “Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey”. British Medical Journal 2008:337:a1682.
3. Personal email from Sue Porter to Kenneth Stevens, February 14, 2010, for the 2009 year data.
4. The Oregonian, “Washington state’s assisted suicide measure: Don’t go there. September 20, 2008, http://oregonlive.com/opinion/index.ssf/2008/09/washington_states_assistedsuic.html.
5. Stevens, KR, and Toffler, WL. “Assisted Suicide: Conspiracy and Control” , Oregonian, 9-24-08, www.oregonlive.com/opinion/index.ssf/2008/09/assisted_suicide_conspiracy_an.html
6. Hedberg, K, Hopkins, D, Leman, R, Kohn, M. “The 10-Year Experience of Oregon’s Death with Dignity Act:1998-2007”, The Journal of Clinical Ethics, Summer 2009; 20:124-132.
© All Rights Reserved
Physicians for Compassionate Care Educational Foundation

The Washington State Department of Health has released the 2009 Death with Dignity Act Report.

The Washington State Death with Dignity statistics stated:
- 63 people received a lethal dose,
- 47 of those people died,
- 36 of them were known to have died from ingesting the lethal dose.
- 7 of them were known to have died a natural death (not ingesting the lethal dose).
- 4 of the people who died, it is unknown whether they died from the lethal dose or not.
- The status of the 16 remaining people who were prescribed a lethal dose is unknown.

The report is consistent with concerns related to elder abuse. Most of the participants were older, educated, many had private insurance. (Report, page 5). All such factors correlate with the decedents having had money. Older people with money are prime targets of abuse. Link to an article concerning elder abuse from
http://www.metlife.com/assets/cao/mmi/publications/studies/mmi-study-broken-trust-elders-family-finances.pdf

There is no proof that the persons consented at the time of death. "Consent" not required by the law. Involuntary killing is allowed by the Death with Dignity Act.
Link to an article in the July 2009 edition of the Washington State Bar Association News: http://wsba.org/media/publications/barnews/jul-09+deathwithdignity.htm

The people who died listed their concerns as follows:
- Losing Autonomy - 100%;
- Less able to engage in activities they enjoy - 91%;
- Loss of Dignity - 82%;
- Losing control of bodily functions - 41%
- Inadequate pain control - 25%
- Burden on family, friends/caregivers - 23%
- Financial implications of treatment - 2%

Inadequate pain control was the prime reason voters supported the I-1000 assisted suicide initiative and yet only 25% identified this as a concern.

End of life concerns such as people feel they are a "burden" is a sign of elder abuse in the form of pressure from others to die.

The Death with Dignity Act specifically devalues people with disabilities. The main concerns people have for requesting assisted suicide are disability related concerns.

It is important to note that:
* The actual reason and the social dimension connected to death by assisted suicide is basically unknown.
* Less than 5% (3 out of 63) people who received a lethal dose were referred for a Psychiatric/ Psychological Assessment. Depressed people often appear to be lucid, when they are not lucid.
* There is no follow up after the lethal dose is dispensed, therefore there is no protection for vulnerable people who are being subtly pressured into assisted suicide.
* There is no witness required at the time of death, therefore there is no way to know that the person chose to die by assisted suicide.
* The reports are filed by the physician who prescribed assisted suicide, it is unlikely that a decision to prescribe a lethal dose to a person who did not qualify, under the act, would be divulged. There are no third party investigations or reports.

The Euthanasia Prevention Coalition recognizes that voters in Washington State opened a pandora’s box when legalized assisted suicide. We question whether they fully understood the implications of assisted suicide and we have outline how the Act does not protect people from undue pressure from death by assisted suicide.

Link to the report: http://www.doh.wa.gov/dwda/forms/DWDA_2009.pdf