Monday, September 27, 2021

EPC - USA letter opposing Massachusetts assisted suicide bills.

Joanne M. Comerford, Chair and Members Joint Committee on Public Health

RE: H2381/S1384, O'Day and Mahoney/Comerford, an Act relative to end of life options; legalizing Assisted Suicide

Dear Chairperson and Members:

The Euthanasia Prevention Coalition USA opposes euthanasia and assisted suicide, instead supporting positive measures to improve peoples’ quality of life which also helps their families. We are aging and disability advocates, lawyers, doctors, nurses and politicians.

We are asking you to let H2381/S1384 die in your committee. You will hear several of the more obvious concerns about Assisted Suicide from other opponents. I will focus on these issues about Assisted Suicide that you may not otherwise hear.

  • Assisted Suicide is not about pain or a peaceful death; both are myths.
  • Assisted Suicide caters to the privileged.
  • Insurance companies use Assisted Suicide to deny coverage for curative life-saving treatments, offering to pay for Assisted Suicide instead.
  • People of color opposed Assisted Suicide by 2-1 margins on your 2012 ballot measure.

It’s Not about Pain or a Peaceful Death; Both are Myths.

Dr. Lonny Shavelson who exclusively practices in providing California’s Medical Aid in Dying (a name used for Assisted Suicide) says promoting it as avoiding pain is a political sales pitch. See webinar minutes 25:24 - 27:53. In his experience, people choose Assisted Suicide because they are low energy or afraid of losing control. He says Oregon’s data is consistent with his experience. The Oregon data show most people choose Assisted Suicide because of a decreasing ability to participate in enjoyable activities (94%), loss of autonomy (93%) and loss of dignity (72%), not fear of pain and suffering.

Dr. Shavelson says another myth is that Assisted Suicide creates a peaceful beautiful death. Actually, it does not change what happens during dying. It simply makes it faster. People gasp for air, change colors, sweat, twitch, have seizures and sometimes vomit which is why he puts them into a coma first. See webinar minutes 37:35 - 41:00. Most people who die under these laws do not have a medical person present, (two-thirds in Oregon). Either way, the family will experience this.

For many years, fatal quantities of barbiturates were prescribed to carry out Assisted Suicide. These drugs cause the lungs to fill with fluids like drowning. When these drugs became expensive, Assisted Suicide doctors experimented on people with other drug cocktails, some of which burned people’s throats causing them to scream in pain and extended the dying process by more than 3 hours and as much as 31 hours.

Assisted Suicide Caters to the Privileged

Assisted Suicide laws like the End of Life Options Act are used primarily by privileged white people. Oregon’s last report says 96.5% of those using the Oregon law in the past twenty-three years were white. Massachusetts is already in the top ten states with increasing youth suicides, positioning your state for more if you enact the End of Life Options Act. Your Office of the Child Advocate found concerning suicide trends among younger Black children, LGBTQ, Native American and Hispanic youth in Massachusetts.

More youth will commit or attempt suicide, especially youth of color, if you pass the End of Life Options Act. In so doing, you send the message that suicide is an acceptable solution to problems. Publicity about suicide leads to more suicides; this is called suicide contagion. Legalizing Assisted Suicide is linked to suicide contagion. Suicide contagion especially impacts youth of color. All of this is more fully explained below.

Publicity about the details of how to commit suicide or that normalizes suicide makes suicide contagious. In 2017 when Netflix released 13 Reasons Why, the story of a 17 year old girl’s suicide and its aftermath, teen female suicides went up by 21.7% (95% CI, 7.3%-36.2). For every person who dies by suicide, another 30 attempt suicide. This particularly impacts teens and adolescents. Because youth are far more likely to attempt than commit suicide, the medical costs for this group can be significant, especially for those who become disabled. Those less financially well off are impacted: 28.4% of medical costs for suicide and attempts are paid by Medicaid; another 24.8% are incurred by the uninsured.

Legalization of Assisted Suicide contributes to suicide contagion, again especially impacting youths. A 2019 report found teen suicides in California increased by 34% since that state legalized Assisted Suicide in 2016. Oregon’s youth suicides increased 79.3% from 2000 to 2018. Research about completed suicides in four states that legalized Assisted Suicide (Oregon, Washington, Vermont and Montana) found it was associated with at least a 6.3% increase in the rate of all suicide deaths. The study reported:

“PAS [Physician Assisted Suicide] is associated with an 8.9% increase in total suicide rates (including assisted suicides), an effect that is strongly statistically significant (95% confidence interval [CI] 6.6%-1.2%). Once we control for a range of demographic and socioeconomic factors, PAS is estimated to increase rates by 11.79% (95% CI 9.3%-14.1%). When we include state-specific time trends, the estimated increase is 6.3% (95% CI 2.7%-9.9%).”

Black and Hispanic youth are particularly impacted. The Congressional Black Caucus calls suicides by Black youth a crisis. Nationally, Black youth under age 13 are twice as likely to die by suicide than their white peers. From 1991-2017, attempted suicides by Black adolescents (boys and girls) rose 73%, while injuries from those attempts rose 122% for the boys. From 2000 to 2015, the suicide rate among Hispanic females rose by 50% overall while increasing nearly 100% among young Hispanic women. Adolescent Hispanic girls attempt suicide at much higher rates than Black or non-Hispanic white girls.

Insurance Companies Use Assisted Suicide to Deny Curative Life-Saving Treatment Insurers stop covering certain treatments due to the availability of Assisted Suicide. Dr. Brian Callister of Nevada says he was stunned when insurance would not cover life saving treatment for his patients who were transferring to California and Oregon, but offered to pay for Assisted Suicide instead. These were people who could be cured with the denied treatment rather than being rendered terminal. In effect, Assisted Suicide is being used to shunt people off the curative, restorative medicine track, especially if they cannot afford to pay for treatments out of pocket.

People of color get this. Even with insurance, people of color get poorer hospital care and pain relief according to a New York Times article. They are disproportionately dying of COVID-19. So, it is unsurprising that Black and Latinx people oppose Assisted Suicide by 2-1 margins‒ “… the voting results from [Massachusetts] Ballot Question 2 in 2012 show Assisted Suicide pits wealthier, whiter districts against those with poorer people and people of color according to Second Thoughts – Massachusetts. 

In closing, I urge you to consider the heartache for families who lose their youth to suicide and the loss of insurance coverage for curable treatments that would follow enactment of these bills, both of which contribute to inequity for people of color. If you weigh that against the so-called benefits of Assisted Suicide which Dr. Shavelson says are myths, you will let the End of Life Options Act die in your committee. 


Sara Buscher, Chair
Euthanasia Prevention Coalition USA

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