Monday, February 28, 2022

Woman considering euthanasia changed her mind after being diagnosed with a treatable condition

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A Canadian woman, and mother of 3, who lived for 17-years with an undiagnosed chronic pain condition was considering MAiD but changed her mind after being diagnosed with a treatable medical condition.

This is a case of medical misdiagnoses in the sense that she had a treatable but undiagnosed medical condition.

A February 26 news story by Meredith Bond for CityTV News reported:
After 17 years suffering from chronic pain, Jennifer Monaghan (picture) began researching medical assistance in dying (MAiD), but a miracle diagnosis saved her life.

The 43-year-old has suffered from narcolepsy since she was 13 years old, but it wasn’t until years later that the pain started.

Narcolepsy is a neurological condition where a chemical is missing in the brain that controls if you’re awake or asleep. “Dealing with narcolepsy really didn’t bug me. I just worked around it. I managed it,” said Monaghan.

However, when she started feeling a shooting pain down her leg, that’s when everything changed. “It was really overwhelming because all of a sudden, life had to stop. And I was going to the doctors and trying to figure out what was wrong. And I didn’t know what was wrong.”

Bond explains that Monaghan began researching MAiD after 17 years of living with chronic pain:

Doctor’s visits weren’t a form of relief as they couldn’t tell Monaghan what was causing her pain. “Even many times throughout my journey of 17 years, I really did believe it was in my head. And that’s a really scary thing because I’m like, why am I creating all this pain and anger?”

Finally 17 years into her pain journey, she started researching medical assistance in dying. “By that point, I was stuck in bed and I’d really had quite a low point where I just felt like I had tried everything, tested every product on the market, went to all the extra things like a chiropractor, a naturopath,” describes Monaghan. “I just tried everything I could and I just couldn’t get there and so that’s when I decided to consider medically assisted [death]”

“So I just focused most of my energy studying things, but then also studying the MAiD programme and medically assisted death and seeing what my options were,” said Monaghan.
Monaghan may be alive today because she had hope that she would recover.
Monaghan said despite her research into MAiD, she did always want to get better and held out hope. “No matter how dark it got, it was still there. And I thank God for it every day that I was still able to have that hope in a real place of darkness.”

She said throughout her pain journey, she visited several neurologists as Monaghan was convinced her pain had something to do with her nervous system.

“At the very end of that 17 years, I asked for one more neurologist appointment. I really wasn’t expecting much when I went there because everything else was always a dud.”
Monaghan received a diagnosis after 17 years of chronic pain:
Once she described all her symptoms to the neurologist, she said he knew exactly what it was.

“Small fiber sensory neuropathy,” said Monaghan. “Basically, my brain is sending signals to different areas of my body, like shocking pain or cold water. It’s my brain reading the signals wrong, [the] pain signals wrong. So my brain thinks there’s all this pain going on, but my brain technically is creating it.”

“I was elated that I hadn’t lost my mind. I was so happy that this thing had a name and I didn’t give up. And I asked for that one more appointment.”

With a diagnosis and treatment in hand, Monaghan said her pain started getting less and less, until “the pain sensations started disappearing.”

Monaghan is happy to be alive. Her pain began to disappear and she became a grandma at about the same time. She said:

“I think the biggest thing is as soon as I got better, our children became parents and so I became a grandma. And it’s the best thing that’s ever happened to me. It is so nice to be able to spend time with them. Now, their children, I just feel so blessed, I feel super blessed that I got this opportunity and to this day, I won’t waste a minute of it.”

She is now helping others who are living with chronic pain:

“When someone says, ‘How are you feeling?’ I can say I feel great and mean it. And I love my life now and I appreciate it in a completely different way.”
Monaghan said she will continue to help others dealing with chronic conditions, regardless of what choices they decide to make.
“My mission now is just to support people, regardless of whatever choices they’re making. For me, it doesn’t matter. They just need like acceptance in someone that listens. Listening is a really important tool to help anyone with a disease while they’re dying or in chronic pain.”

The article is missing the fact that had she been diagnosed many years earlier, that she would not have lived with chronic pain for 17 years and she would not have sought MAiD (euthanasia).

The question is - how many people are being killed by euthanasia who have been misdiagnosed or not diagnosed?

According to Brian Mastroianni who published an article in on February 22, 2020 medical misdiagnosis is more common than you think. According to the data: 

More life and death stories related to medical misdiagnosis.

In October 2016 Mya DeRyan (picture) survived a suicide attempt. While recovering DeRyan learned that the terminal diagnosis that she was trying to escape from was in fact a wrong diagnosis.

In April 2013, Pietro D’Amico, a 62-year-old magistrate from Calabria Italy, died by assisted suicide at a Swiss assisted suicide clinic. His autopsy found that he was misdiagnosed.

Considering the data, it is dangerous and irresponsible to legalize euthanasia and assisted suicide. Many people, such as Jennifer Monaghan, live with undiagnosed chronic pain for many years. We need to change the healthcare system not kill the misdiagnosed patient.

Friday, February 25, 2022

Assisted suicide: It's not that simple

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Hartford Current published an excellent article written by disability rights lawyer, Lisa Blumberg, titled: Medically assisted suicide: It's not that simple. In the article Blumberg explains why she opposes Connecticut assisted suicide Senate Bill 88.

Blumberg first explains how the assisted suicide drugs work.
First, there is no magic pill for a gentle death. No assisted suicide law gives doctor guidance on what a drug prescription to end life should contain. In Oregon, it has sometimes taken people up to 72 hours to die. With doctors free to devise a cocktail involving multiple drugs and desiring to keep cost down, side effects like burned mouths or seizures can occur. Terry Law, a frequently active assisted suicide doctor, said, “There’s lots of data on stuff that helps people live longer, but there’s very little data on how to kill people.” The focus of the FDA is, of course, to minimize drug toxicity, not maximize it.
Blumberg then writes about the reality of attitudes and bias.
Implicit bias involves making often unconscious assumptions about a person based on factors such as the person’s race/ethnicity, gender, socioeconomic status, age or disability. Doctors and nurses seem to exhibit the same level of implicit biases as the general population, with growing evidence that a clinician’s bias can impact the quality of a patient’s health care.

In a recent study of doctors’ perceptions of disabled people, 82.4% of the doctors surveyed felt that people with disability have a worse quality of life than others, and fewer than 57% said they strongly welcomed disabled patients. Lisa Iezzoni, the lead author and a health care policy researcher at Massachusetts General Hospital, said, “The magnitude of physicians’ stigmatizing views was very disturbing.”
Blumberg continues by writing about how estimates of life-expectancy will often be wrong.
Assisted suicide bills follow the Oregon model, leaving it up to doctors — any two doctors — to decide if a patient is terminally ill with a six-month life expectancy or less and thus eligible for a lethal prescription. However, such medical judgments are often wrong: 12%-15% of hospice patients outlive their six-month prognosis.

Implicit bias can influence the way a clinician sees likely patient outcomes. A doctor might assume a person’s functional limitations indicate frailty, undermining their chance to withstand standard treatment. Doctors don’t always get the distinction between disability — especially when it is progressive as it often is when combined with aging — and terminal illness.
Blumberg then tackles the issue of why people ask for assisted suicide.
Assisted suicide laws also direct that a doctor be satisfied that a person’s decision to die is not being unduly influenced by another. It is not clear how office visits can yield this information. If doctors start with the presumption that a person’s illness or accompanying disability inevitably diminishes his life, clues can be overlooked. The pandemic has caused depression rates to soar, and this is especially so among doctors. It is not fair to anyone to ask a health care worker who might be struggling or overwhelmed to evaluate the merits of an assisted suicide request.

Proponents of legalized assisted suicide tend to portray uncontrollable pain as the prime reason a person would want to die. Oregon data, though, indicates that people far more often request lethal prescriptions due to perceived lessening of autonomy, or feelings of being a burden. Indeed, a recent study has shown that a fear of going into a nursing home is much more likely to fuel a desire to hasten death than pain is. Such a fear is certainly rational, especially in this time of COVID-19. People with significant disabilities often live with it daily. However, this is a societal issue that must be solved by a commitment to broad access to quality in-home support.
Blumberg finishes the article by explaining how assisted suicide is not truly about choice.
The message behind assisted suicide laws is that it is reasonable for a certain subclass of people to want death hastened based on their health and disability. But a just community cannot make death the default option. Assisted suicide would not give patients more choice or control. Instead, it would be a reflection of the lack of choice or control that many people feel in our inequitable and beleaguered health system. This is unacceptable.
Lisa Blumberg is a Connecticut writer, lawyer and disability rights activist.

Washington State assisted suicide proposed study includes the expansion of assisted suicide law to include euthanasia/homicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Just as we began celebrating the news that the Washington state assisted suicide expansion bill (HB 1141) died, the main sponsor of that bill, Representative Rude, introduced PSHB 1816 which seeks $200,000 from the Washington state budget for a study on the state assisted suicide law.

PSHB 1816 seeks $200,000 to study the possible expansion of assisted suicide to include, among other things, death by lethal injection (euthanasia/homicide), elimination of waiting periods, forcing non-participating health institutions to permit assisted suicide and for the government to pay for it.

PSHB 1816 states - The study shall review the extent to which there are barriers to achieving full access to the Washington death with dignity act, including:

  1. A lack of awareness of the Washington death with dignity act and its provisions; 
  2. Burdens for qualified patients to meet the fifteen-day waiting period; 
  3. The effectiveness of pain control medication used during the fifteen-day waiting period;
  4. Concerns that inhibit the participation of health care providers in the provisions of this chapter;
  5. Hospital, medical, hospice, and long-term care providers' policies that restrict the participation in and the distribution of information about the provisions of this chapter; 
  6. Limited geographic access to compounding pharmacies or other pharmacies that dispense medications under this chapter; 
  7. Restrictions based on the requirement that the medications under this chapter be self-administered; 
  8. Lack of insurance coverage for the services and medications necessary to participate in the provisions of this chapter; 
  9. The need for improvements to the data collection system; and 
  10. Any other barriers identified in the course of performing the study.
Section 2 questions the 15-day waiting period and Section 5 questions the policies medical institutions have restricting assisted suicide.
Section 7 questions the requirement to self-administer the lethal drugs. If lethal drug cocktails are not self-administered then someone else must administer. In other words, section 7 would study changing the law to permit death by lethal injection euthanasia / homicide.
The current Washington state assisted suicide law gives doctors the right to approve and prescribe lethal drugs that the patient self-administers. If the law were amended to include euthanasia, then doctors would have the right to lethally inject their patients with lethal drugs. Euthanasia is murder.

Great News: Washington State assisted suicide expansion bill died a natural death.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have great news. Washington State's assisted suicide expansion bill (HB 1141) has died a natural death. 

I congratulate everyone who spoke out against the bill and lobbied to defeat the bill.

HB 1141 was introduced in January 2021 and passed in the state House on February 25, 2021. It was referred to the Senate where it was stopped. 

HB 1141 was re-introduced in January 2022 and passed in the state House on January 12, 2022 and referred to the Senate. On February 18 it had a Public hearing in the Senate Committee on Health & Long Term Care. HB 1141 is now dead.

HB 1141 would have:

  • Expanding the list of who can prescribe lethal drug cocktails by changing it from physicians to "qualified medical provider." A "qualified medical provider" is defined as a physician, or a licensed physician assistant, or a osteopathic physician, or an advanced registered nurse practitioner.
  • Expanding the list of who is legally able to counsel a person, when the qualified medical provider questions the ability of the person to consent. Those who would be permitted to offer counseling include: a state licensed psychiatrist or, psychologist, independent clinical social worker, advanced social worker, mental health counselor, or psychiatric advanced registered nurse practitioner.
  • Eliminating the 15 day waiting period and replacing it with a 72 hour waiting period and then allowing the waiting period to be rescinded if the qualified medical provider believes that the person may be imminently dying. This permits a "same day death."

Here is a link to my video on HB 1141 from January 2021.

Please note that the current version of HB 1141 did not permit the lethal drug cocktail to be delivered by mail or courier.

This is great news, but we expect that the assisted suicide lobby will try again to expand the Washington State assisted suicide law in 2023.

Once again, I congratulate everyone who successfully worked to defeat HB 1141. Similar assisted suicide expansion bills are still being debated in Vermont and Hawaii.

As I have always stated, once we legalize prescribing suicide by lethal drugs, the prohibition on killing has now been crossed. The only remaining question is the rules that are established to kill.

Thursday, February 24, 2022

Netherlands man arrested for selling suicide powder resulting in at least 4 deaths.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Ximena Knol
A Netherlands man was arrested on Febuary 21 in the deaths of four people who died after ingesting a suicide powder. The man may have sold the suicide powder online to at least 500 people.

Ximena, who was 19 years-old, (picture) died in February 2018 after ingesting the suicide powder.

Gerda Frankenhuis reported for De Telegraaf news that Tom de M. from Castricum was arrested on Wednesday evening on suspicion of involvement in four suicides and may have sold the suicide powder to five hundred people via the internet. According to Frankenhuis (google translated):
The police found the man after a report of criminal assistance with a suicide in Zeeland and a suspicious death in Breda. A major investigation was immediately started. It became clear that the persons involved had all taken the suicide powder that they had ordered via the internet. A postal package found led the police to De M. in Castricum.
Frankenhuis also interviewed Lawyer Sébas Diekstra who represents various relatives of people who have died after taking the suicide powder. Diekstra told Frankenhuis that in at least one case, the suicide drug appears to have been ordered from the suspect, he says. Frankenhuis stated:
“It is good to see that the Public Prosecution Service has also taken the matter seriously in this case and is investigating further. Hopefully it will also become clear how many people here have become victims of the provision of this poisonous and inhumane drug with which many young people have taken their own lives," said the lawyer. “It remains horrifying to see that there are people who earn their living with a means of killing others.”
The Netherland Coöperatie Laatste Wil (CLW) assisted suicide lobby group has promoted the suicide powder. The Public Prosecution Service arrested the CLW chairman, Jos van Wijk, last September for his alleged involvement in promoting and distributing the suicide powder.

Recently I published an article by Randy Knol, the father of Ximena, who died in February 2018 after taking the suicide powder. Since then Randy has been working to ban the lethal suicide powder. Randy is the founder and chairman of the Ximena’s Butterfly Foundation.

Wednesday, February 23, 2022

Cathy Ludlum opposes Connecticut assisted suicide bill. She is literally fighting for her life.

Co-chairs and members of the Public Health Committee:

My name is Cathy Ludlum, and I am one of the leaders of Second Thoughts Connecticut, a group of disabled people and allies who are working to prevent the legalization of medical assisted suicide. I am opposed to SB 88.

The question at hand is not whether people can take their own lives. Suicide is not illegal. The question is how many other struggling people will follow their lead, pressured by society and assisted by the healthcare system to die?

Every year when this bill comes up, I testify against it. I stand before you as a competent, creative, and successful professional who has a good life while experiencing a high level of disability.

Not this year.

The shortage of direct care workers (whether you call them personal assistants, PCAs, or home health aides) has reached a point where lives hang in the balance, including mine.

Yes, I am talking about the fact that people are not consistently getting out of bed in the morning, or must go to bed at 5 in the afternoon. Sometimes meals are skipped or other bodily needs go unmet because there is no one to assist with these critical activities.

These workers are significantly undercompensated and are leaving the field by the hundreds because they cannot make ends meet. They do not feel respected or appreciated, and the value of the support they provide has been largely unrecognized.

But in the context of today’s legislation, I am talking about the psychological impact of being severely disabled and not having enough support …for years.

Every so often, someone asks what medical assisted suicide has to do with disability. For two decades, the disability community has been pointing to the End-of-Life Concerns listed in the Oregon and Washington State data summaries. The top four concerns never change:

From the Oregon Death with Dignity Act 2020 Data Summary 1
  • Less able to engage in activities making life enjoyable (94.3%)
  • Losing autonomy (93.1%)
  • Loss of dignity (71.8%)
  • Burden on family, friends/caregivers (53.1%)
From the Washington State 2020 Death with Dignity Act Report 2
  • Less able to engage in activities making life enjoyable (90.6%)
  • Losing autonomy (89.6%)
  • Loss of dignity (74.8%)
  • Burden on family, friends/caregivers (58.6%)
Let me show how this is relevant to me and my colleagues.

Less able to engage in activities making life enjoyable — With the dedicated support of my personal assistants, I have lived in my own home for 30 years, worked, traveled, done things with friends, and basically had a great life. That seems to be over as I struggle to get enough supports. Advertising no longer produces new hires. Without enough workers, my focus every day has to be on shifting people around so I can get my most basic needs met.

Losing autonomy – My independence depends on interdependence. Technology allows me to do a few things for myself, mainly on the computer. But without human assistance, I cannot clean my house, take a shower, or get to a doctor’s appointment; much less work toward my personal and business goals.

Loss of dignity – I believe that dignity is inherent in everyone, but not everyone is treated that way. I have had to hire a number of people who were literally repulsed by normal bodily functions. Some hurt me with their words. I have adjusted so many things in my life, my home, my relationships, and my personal care that I don’t even know where I can trim anymore.

Burden on family, friends/caregivers – Everyone is going to burn out eventually. Not having enough workers, I overrely on the ones I have left. In times past, I had backup assistants, but you can’t find those now. When I cannot find anyone else, I have to rely on friends, some in their 70s, to provide care. I know like I’ve never known before what it means to feel like a burden.

I am telling my story because I want you to understand that death has begun to look preferable to living like this.

You can keep saying that medical assisted suicide is not intended for the likes of me, but it takes a lot of effort every single day to keep my body working and my lungs breathing… and increasingly I think about giving up.

Don’t believe I would qualify under SB 88? Look at the bill. It clearly points to people like me as appropriate users of medical assisted suicide.
Sec. 1 (21) “Terminal illness” means the final stage of an incurable and irreversible medical condition that an attending physician anticipates, within reasonable medical judgment, will produce a patient’s death within six months if the progression of such condition follows its typical course.
The progression of spinal muscular atrophy is death if it follows its typical course. I am almost 60 years old because I have been vigorously interfering with the typical course of SMA. When I was 35 I became unable to eat enough to sustain my life and started using a feeding tube. At 38 I was choking in my sleep so I started using respiratory support.

SB 88 says nothing about the impact of treatment on life expectancy. The public likely assumes that the lethal prescription is only available to people who have exhausted all treatment options. But this is not so. An individual may stop life-sustaining medications or technologies at any point, rendering them terminal within six months. In my case, we are talking days, not months.

In their discussion on whether people with anorexia qualify for assisted suicide, the American Clinician’s Academy on Medical Aid in Dying’s (ACAMAID) Ethics Consultation Service notes:
Mandating that the patient exhaust all possible treatments before requesting aid in dying is not in keeping with other “terminal” illnesses. For example, we allow patients with end stage cancer to forgo chemotherapy or other potentially life – extending treatments and request medical aid in dying. 3
As an Oregon official has clarified in writing, any person who becomes terminal because they do not receive treatment, for any reason (including not only refusal of treatment, but inability to pay for treatment), would qualify for assisted suicide under an Oregon-type law. 4 5
The law is best seen as a permissive law, and states only that patients must have a terminal illness with six months or less to live. It does not compel patients to have exhausted all treatment options first, or to continue current treatment. It is up to the patient and doctor to discuss disease and treatment options. But if the patient decides they don’t want treatment, that is their choice.
I am not suggesting that people be forced to accept treatment they do not want. But we must understand that populations other than those traditionally considered to be terminal (end stages of cancer, COPD, kidney failure, for example) will be affected by this legislation.

Refusal of treatments that have previously allowed people not only to live, but to thrive, should point in the direction of suicide prevention. Instead, there is too often an assumption that death is imminent and even preferable. Connecticut’s State Suicide Prevention Plan 2025 describes the challenges faced by disabled people in getting equal access to suicide prevention services. It also acknowledges that physician assisted suicide puts people with disabilities at particular risk. Please see pp. 56-58. 6

Suicide is contagious, and this is suicide, no matter how often and fervently you deny it.

I am not alone. Many people are hanging on by a thread. Maybe because of unmet disability needs. Maybe because of economic distress. Maybe from isolation and sadness.

Do we as a society want to strengthen that thread so it does not break? Do we want to make sure people who need supports (whether home care or other supports) get them?

Or do we want to create a policy that says, in effect, “ending your life is reasonable if your problems are big enough”? Given that wink of approval, some (I suggest many) will cut that thread. Perhaps not right away, but more and more as the years go by.

I am aware that there is intense pressure to get this bill passed in this legislative session. If it does, there will be plenty of time to go back later and gut the hollow safeguards it contains. This is already happening in other states.

Again, I say, the question at hand is not whether people can take their own lives. The question is how many other struggling people, pressured by society and assisted by the healthcare system, will follow their lead?

SB 88 is bad medicine, bad for people, and bad public policy. Please vote NO. Thank you.

1 Oregon Death with Dignity Act 2020 Data Summary dignityact/Pages/index.aspx
2 Washington State 2020 Death with Dignity Act Report dignityact/Pages/index.aspx
3 Summary of Consultation concerning a Patient with Anorexia Nervosa, American Clinicians Academy on Medical Aid in Dying (ACAMAID), Aid in Dying Ethics Consultation Service Nervosa-9-3-21.pdf

4 Fabian Stahle, “Oregon Health Authority Reveals Hidden Problems with the Oregon Assisted Suicide Model”

5 “Diabetics Eligible for Physician Assisted Suicide Oregon,” The Washington Times suicide-oreg/;

6 Connecticut’s State Suicide Prevention Plan 2025, pp. 56-58
revention-Plan- 2020-2025.pdf

Disability leader testifies against Connecticut assisted suicide bill.

Testimony in strong opposition to SB 88 An Act Concerning Aid in Dying for Terminally Ill Patients

February 23, 2022 (Link to the testimony by Stephen Mendelsohn).

By Stephen Mendelsohn

Co-chairs and members of the Public Health Committee:

Stephen Mendolsohn
I am an autistic adult and one of the leaders of Second Thoughts Connecticut, a coalition of disabled people opposed to the legalization of assisted suicide. Second Thoughts Connecticut is a member of the Connecticut Suicide Advisory Board. Personally, I serve on the board of directors of Euthanasia Prevention Coalition-USA and previously served on the Connecticut MOLST Task Force.

We in the disability community have read this year’s bill as we have in previous years. We notice the changes from previous assisted suicide bills in an attempt to win over the opposition and get it passed. I am here to say that essentially nothing has changed. SB 88 is fatally flawed and should be rejected.

No amount of change in bill language can change the fact that some people will suffer prolonged and agonizing deaths from the experimental lethal drug cocktails, with some even regaining consciousness only to die of their terminal illness. Nothing can change the fact that the currently most widely used lethal compound, DDMA / DDMA-Ph, contains amitriptyline, which burns the throat. Medical science cannot guarantee the peaceful death proponents claim. If lethal injections administered for capital punishment have resulted in inhumane deaths, oral ingestion of lethal drug compounds is far more likely to do so. We may put our pets down without their consent and for bad reasons—because they are unwanted or have behavior problems—but at least we do not make them ingest these experimental lethal compounds and make them suffer even more in the process.

No change in language can change the deadly mix between assisted suicide and a broken health care and home care system. As the cheapest “treatment,” assisted suicide diminishes choice, and especially so for people of color, disabled people, and others who have been historically marginalized in our health care system.

No change in language can change the problem of misdiagnosis or the unreliability of terminal prognosis. Jeanette Hall, John Norton, and Rahamim Melamed-Cohen have outlived ostensibly terminal prognoses by decades. All three became staunch opponents of assisted suicide.

No change in language alters the fact that offering suicide prevention to most people while offering suicide assistance (redefined as “aid in dying”) to an ever-widening subset of disabled people is lethal disability discrimination.

The changes that have been made in the bill from previous years are ineffective and do nothing to protect against mistakes, coercion, and abuse. I will outline some of them and why this is so.

The definition of “terminal illness” in Section 1 (21) adds the words “... if the progression of such condition follows its typical course.” As Cathy Ludlum demonstrates in her powerful testimony, she still qualifies for lethal drugs under this definition. As Fabian Stahle notes, so do people with chronic conditions like insulin-dependent diabetes who reject treatment. So do people who have treatment denied by their insurance company or are otherwise unable to afford it.

Shockingly, even people with treatable anorexia who refuse nutrition have been deemed to be both “terminally ill” and “mentally competent” and thus eligible for assisted suicide. Without nutrition, the “typical course” for anorexia is death in under six months. The American Clinicians’ Academy on Medical Aid in Dying (ACAMAID) has a case report in which their “Ethics Consultation Service” stated,

If the patient’s eating disorder treating physician and evaluating psychiatrist agreed that she had a “terminal disease” and retained decision-making capacity, she would meet those requirements of the aid in dying statute in her jurisdiction.
At least one of ACAMAID’s physicians found it “ethically reasonable” to support assisted suicide in this particular case.

In testimony opposing an assisted suicide bill in Maryland, psychiatrist Dr. Angela Guarda, director of the Johns Hopkins Eating Disorders Program, shows just how destructive it can be to cut lives short by 60 years or more by offering assisted suicide for those deemed “terminal” for refusing nutrition (video starting at 3:37:00; unofficial transcript):

I treat people with anorexia nervosa, the most lethal psychiatric condition. Nearly every case can improve with expert care and many extremely ill patients make full recovery. Anorexia is challenging to treat because persons with this disorder are ambivalent towards and often avoid the treatment they most need: nutrition.

I had two recent cases “change their mind” and contact me from hospice where they were certified as terminally ill by their physician. Both improved dramatically with appropriate treatment and left hospital hopeful for their future. Under this bill they could be dead. Recovery feels out of reach to many with anorexia, to their exhausted family and to their doctor. And — these patients are often treated by general practitioners and avoid psychiatrists. Most doctors, — psychiatrists included, can recognize anorexia but have no training to treat it. Faced with a patient in intensive care who weighs 50 pounds is in kidney failure with unstable vital signs, all resulting from their anorexia, the attending physician may judge the patient terminal because they are unaware of, and don’t know, how to get her the treatment she needs — especially when she refuses it. And the starved patient could be influenced to view “aid in dying” as the best way out of an intolerable situation, or believe her family would be better off without her emotionally and financially.

The definition of “attending physician” in Section 1 (3) has been modified to exclude someone whose practice is “primarily comprised of evaluating, qualifying and prescribing or dispensing” the lethal drugs. This is apparently an attempt at discouraging doctor shopping. It will not work because anyone can just set up a 50-50 practice with half devoted to curative or palliative care and half to assisted suicide. Moreover, the limitation does not appear to be enforceable and there are no sanctions for setting up a practice primarily devoted to assisted suicide. 

The definition of “competent” allows evaluations by social workers for capacity evaluations, and still allows someone else to speak for a patient with a communication disability.

Section 3 reverts to the 2015-2020 bills in requiring two written requests and disallowing heirs and other interested parties from being witnesses to the dispensing of the lethal prescription. Nonetheless, an heir can still bring two close friends to be witnesses to a pair of faxed-in requests and allows the examination to occur via telehealth. The attending and consulting physicians may have no idea that the patient is being pressured into dying faster by an abusive heir. Moreover, there is no required independent witness at the time the lethal drugs are ingested. Many people change their minds, yet all “safeguards” end once the prescription is dispensed.

Section 9 (6) (b) from previous bills, stating “The person signing the qualified patient's death certificate shall list the underlying terminal illness as the cause of death,” has been removed from SB 88. In no way does this mean that death certificates will not continue to be falsified. Previous bills demonstrate clear intent to do so. In Oregon this language is not in statute but is in regulations, and that is certain to be the case in Connecticut. The only way to correct this is to specifically include language similar to Oklahoma’s Death Certificate Accuracy Act, §63-1-316b. It states in part:

A certifier completing cause of death on a certificate of death who knows that a lethal drug, overdose or other means of assisting suicide within the meaning of Sections 3141.2 through 3141.4 of this title caused or contributed to the death, shall list that means among the chain of events under cause of death or list it in the box that describes how the injury occurred. If such means is in the chain of events under or in the box that describes how the injury occurred, the certifier shall indicate "suicide" as the manner of death.

A certifier who knowingly omits to list a lethal agent or improperly states manner of death in violation of subsection E of Section 1-317 of this title shall be deemed to have engaged in unprofessional conduct as described in paragraph 8 of Section 509 of Title 59 of the Oklahoma Statutes.

Moreover, the “accordance” language in Section 14 (c) and (d) of SB 88 also mandates falsification of death certificates. According to the Office of the Chief Medical Examiner, death certificates in Connecticut are required to list the manner of death as either “homicide,” “suicide,” “accidental,” “natural,” “therapeutic complication,” or “undetermined.” The “accordance” language rules out homicide and suicide as a matter of law, and “accidental,” “therapeutic complication,” and “undetermined” are clearly ruled out as the manner of death is both intentional and of known cause. Thus as in other states, the death will be deemed “natural,” even if it was unnaturally caused by an intentional overdose of lethal drugs. This would interfere with a potential murder prosecution no less than the removed Section 9 (6) (b) from previous bills.

This “accordance” language would also interfere with our state’s suicide prevention plan, which calls this act suicide and notes the intersection between assisted suicide and suicide prevention, particularly with regard to suicide prevention for disabled people (pp. 57-59).

Beyond the failure of any changes to the bill language to protect against mistakes, coercion, and abuse, there is the issue of expansion. We only need to look at what Compassion & Choices and other proponents are saying, and the bills and lawsuits they have been pushing in other states. We can all remember when Compassion & Choices’ president emerita Barbara Coombs Lee came to Hartford in October 2014 declaring support for assisted suicide for people with dementia and cognitive disabilities unable to consent; in her words, “It is an issue for another day but is no less compelling.”

We can also look at recent expansion legislation and court cases being pushed by Compassion & Choices in other states, particularly those in states that already have legalized assisted suicide, including Oregon, Washington, California, Vermont, Hawai‘i, and New Mexico. Bills have provisions that would dramatically shorten and/or waive the mandatory waiting period, allow APRNs and PAs to prescribe lethal drugs, waive the requirement for a second doctor to confirm the ostensibly terminal diagnosis, allow almost anyone who does counseling for a fee to qualify in the rare case that the patient is referred for a mental health evaluation, allow mail-order delivery of lethal overdoses, and compel objecting providers to refer patients to other providers who will dispense lethal prescriptions.

This last provision, enacted last year as California SB 380, is a threat to patient safety, as noted by the example of Jeanette Hall, who sought to die under Oregon’s law but was persuaded by her doctor to accept cancer treatment and is still alive more than 20 years later. Under a “do or refer” regime supported by Compassion & Choices, people like Jeanette Hall would have their lives cut short by years or even decades as ethical doctors will be forbidden to use their professional judgment to encourage their suicide-minded patients to seek lifesaving treatment.

Compassion & Choices and other assisted suicide proponents are already active in attempting to strike down the residency requirement in Oregon and the self-administration requirement in California.

So when Compassion & Choices’ president Kim Callinan testifies about all of the “safeguards” in SB 88, please remember she is working diligently to gut these same provisions in the aforementioned states that have already enacted this legislation.

Moreover, once the concept of certain people having a right to assistance with their suicides to end their suffering is codified into law, there is no limiting principle to prevent it from being extended to other disabled people who also may claim to be suffering. If SB 88 were enacted, further expansion will move into the hands of judges. While we in the disability-rights community view legalizing assisted suicide as a violation of the Americans with Disabilities Act and the disability equal protection clause (Article XXI, amending Article V) of the Connecticut Constitution—people with certain disabilities are thus denied the benefit of suicide prevention services—judges could easily use both of these provisions to require extending the “benefit” of this “end of life option” to other disabled people. The limitations of “six months,” “terminally ill,” “mentally competent,” and “self-administer” in SB 88 all discriminate on the basis of disability. Indeed, back in 1999, former Deputy Attorney General of Oregon David Schuman wrote this response to state senator Neil Bryant regarding the issue of self-administration:

“The Death with Dignity Act does not, on its face and in so many words, discriminate against persons who are unable to self-administer medication. Nonetheless, it would have that effect....It therefore seems logical to conclude that persons who are unable to self-medicate will be denied access to a ‘death with dignity’ in disproportionate numbers. Thus, the Act would be treated by courts as though it explicitly denied the ‘benefit’ of a ‘death with dignity’ to disabled people....”

Indeed, the Connecticut Supreme Court’s ruling in State v. Santiago, striking down a prospective repeal of the death penalty in favor of full repeal, shows how our courts can expand laws beyond the intent of this legislature using equal protection grounds. The same principle is at work with SB 88, which gives suicide assistance to some while others get suicide prevention, and the arbitrary difference is what disability they have.

So what about the person with ALS who has a six month prognosis, but has lost the ability to self-administer? What about the person with Parkinson’s disease, who will have tremors for years before dying? What about people with communication disabilities who may not be able to make the request on their own? What about Grandma with dementia, or the person with a severe psychiatric disability? Once the door to assisted suicide is pried open, Compassion & Choices will seek to open it further through the courts, going from six months terminal to one year, to perhaps five years; from assisted suicide to euthanasia; and from euthanasia for terminal illness, to chronic illness, to mental suffering. This is how we go down the same road as Canada, which has enacted Bill C-7 to allow euthanasia even for non-physical conditions, and where hospitals routinely deny treatment to disabled people while offering euthanasia instead. For Compassion & Choices, these are merely issues for another day, and for them, no less compelling.

Legislators and the public should not be fooled by a privileged lobby that seeks to sell suicide as a solution to their own disability-phobia. We should follow the recommendations of the National Council on Disability’s report, “The Danger of Assisted Suicide Laws,” and reject codifying lethal and systemic disability discrimination into law.

Reject Connecticut Bill No. 88, an Act Concerning Aid in Dying for Terminally Ill Patients.

Link to the original document from Margaret Dore (Link).


I am an attorney and president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. I have personally appeared and testified against these practices in 20 US states and also internationally.’

The proposed Act, Raised Bill No. 88, seeks to legalize physician—assisted suicide and euthanasia as those terms are traditionally defined. This will be on both a voluntary and involuntary basis.

The Act is based on similar acts in Oregon and Washington State. I urge you to protect yourselves and the people you care about. Vote “‘No” to reject Raised Bill No. 88.


A. Physician-Assisted Suicide, Assisted Suicide and Euthanasia

The Act does not define physician-assisted suicide, assisted suicide or euthanasia. Per the American Medical Association, “‘physician—assisted suicide” occurs when a physician “facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act.” For example:

[T]he physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide.
“Assisted suicide” is a general term in which the assisting person is not necessarily a physician. “Euthanasia” is the administration of a lethal agent by another person.

B. Aid in Dying

“Aid in dying” has been a euphemism for assisted suicide and euthanasia since at least l992. The proposed act defines aid in dying as follows:

“Aid in dying” means the medical practice of a physician prescribing medication to a qualified patient who is terminally ill, which medication a qualified patient may self-administer to bring about his or her death. (Emphasis added)
Note that per this definition, self—administration is allowed, but not mandated.

C. Withholding or Withdrawing Treatment

Withholding or withdrawing treatment (“pulling the plug”) is not euthanasia if the purpose is to remove burdensome treatment, as opposed to an intent to kill the patient. More importantly, the individual will not necessarily die. Consider this quote from Washington State regarding a man removed from a ventilator:

[I]nstead of dying as expected, [he] slowly began to get better.


A. Overview

The Act has an application process to obtain the lethal dose. Once the lethal dose is issued by the pharmacy, there is no oversight. No doctor, not even a witness, is required to be present at the death.

Resulting death will be reported as natural on the patient’s death certificate. Reports issued by the Department of Public Health will not contain identifying information of any patient or health care provider. Any data collected by the Department will not be subject to disclosure under the Freedom of Information Act.

B. “Eligible” Persons May Have Years or Decades to Live

The Act applies to persons with a “terminal illness,” meaning those predicted to have less than six months to live.’ Such persons may in fact have years or decades to live. This is true based on the Oregon and Washington experience with their similar Acts, and common knowledge that predictions of life expectancy can be wrong, sometimes way wrong.’

Patients may also have years or decades to live because treatment can lead to recovery. A well known example is Jeanette Hall. In 2000, she made a settled decision to use Oregon’s Act. Her doctor convinced her to be treated for cancer instead, such that she is alive today. In a recent declaration, she states:

It has now been 21 years since my diagnosis. If [my doctor] had believed in assisted suicide, I would be dead.’
C. Assisting Persons Can Have an Agenda

Persons assisting a suicide or euthanasia can have an agenda. Consider Tarnmy Sawyer, trustee for Thomas Middleton in Oregon. Two days after his death by legal assisted suicide, she sold his home and deposited the proceeds into bank accounts for her own benefit.’ Consider also Graham Morant, convicted of counseling his wife to kill herself in Australia, to get the life insurance. The Court found:

[Y]ou counselled and aided your wife to kill herself because you wanted ... the 1.4 million.
Medical professionals too can have an agenda. New York physician, Michael Swango, got a thrill from killing his patients.’ 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.’

D. Even if the Patient Struggled, Who Would Know?

The Act has a formal application process to obtain the lethal dose.’ Once the lethal dose is issued by the pharmacy, there is no oversight. No witness, not even a doctor, is required to be present at the death.

In addition, the drugs used are water or alcohol soluble, such that they can be injected into a sleeping or restrained person without consent. 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 Connecticut 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 the patient struggled, “who would know?” (Emphasis added
E. The Act Allows Euthanasia as Traditionally Defined

1. Self-administration is not required

The Act repeatedly describes the lethal dose as being self— administered. There is no language, however, that self-administration is required.

2. The lethal dose is “medication”

The proposed Act repeatedly refers to the lethal dose as “medication” to end a patient’s life. The lethal dose is also a prescription drug (or drugs) . Generally accepted medical practice allows doctors and family members to administer prescription drugs to a patient. If the medication/prescription drug administered is a lethal dose, this is euthanasia as traditionally defined.

3. The Americans With Disability Act would override any prohibition of euthanasia

The Americans with Disability Act (ADA) is a US federal civil rights law “that prohibits discrimination against individuals with disabilities in every day activities, including medical services.” Here, the proposed Act refers to the lethal dose as a medication to be prescribed, thereby rendering it a medical service.

Per the ADA, medical care providers are required “to make their services available in an accessible manner.” This includes:

reasonable modifications to policies, practices, and procedures when necessary to make health care services fully available to individuals with disabilities, unless the modifications would fundamentally alter the nature of the services ...

Per the proposed Act, the fundamental nature of the services is the provision of a lethal dose of medication to end a patient’s life. If, for the purpose of argument, the proposed Act can be read as requiring self—administration, the ADA would nonetheless require providers to make a reasonable modification for individuals unable to self-administer. For example, by providing the assistance of another person to administer the lethal dose. This would be euthanasia as traditionally defined.


The Act states:

(c) Any actions taken in accordance with sections 1 to 13, inclusive, of this act or sections 15 to 19, inclusive, of this act, do not, for any purposes, constitute suicide [or] homicide (Emphasis added)

The Act does not define accordance. Dictionary definitions include “in the spirit of,” meaning “in thought or intention."

In other words, a mere thought or intention to comply with the Act is sufficient to prevent a death from being treated as suicide or homicide. If enacted, actions taken in accordance with the Act will not constitute suicide or homicide as a matter of law.


Connecticut requires the manner of a person’s death to be reported as one of six categories, five of which are substantive: (1) homicide; (2) suicide; (3) accidental; (4) natural; and (5) therapeutic complication. The sixth category is “undetermined."

As noted in the preceding section, a death occurring in accordance with the Act will not constitute suicide or homicide as a matter of law. The death will also not be due to a therapeutic complication or accident due its having been an intended event. This leaves “natural” as the only remaining substantive cause of death. The official legal manner of death will be natural as a matter of law.


Per 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.” The inquiry also found:

that by issuing death certificates stating natural causes, the serial killer [Shipman] was able to evade investigation by coroners. (Emphasis added)
Per a subsequent article in 2015, proposed reforms included having a medical examiner review death certificates, so as to improve patient safety. Instead, the proposed Act moves in the opposite direction to require that deaths be reported as natural. If enacted, family members and other persons will be able to kill under mandatory legal cover.


Connecticut Code Section 45a—447 does not allow a person guilty of killing another person (the victim) to inherit from that person. Deaths occurring in accordance with the Act, however, are natural as a matter of law. More to the point, straight up perpetrators will be allowed to inherit from a victim so long as the killing is done pursuant to the Act.


If passed into law, the proposed Act will apply to people predicted to have less than six months to live, some of whom will in fact have years or decades to live.

Assisting persons can have an agenda, with more obvious reasons being inheritance and life insurance, but also, as in the case of Dr. Swango, the thrill of seeing someone die. The lack of required oversight at the death, coupled with the mandatory falsification of the death certificate and an otherwise near complete lack of transparency, will create a perfect crime in which perpetrators will be legally allowed to inherit.

The Act’s passage will render people with money, meaning the middle class and above, sitting ducks to their heirs and other financial predators. Protect yourselves and the people you care about. Say “No” to Raised Bill 88.

Respectfully Submitted,

Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion, a nonprofit corporation
www.margaretdore . org
www.choiceillusion. org
3 Sunset Plaza, Unit B
Kalispell MT 59901
206 697 1217

Link to the original document from Margaret Dore (Link).

Tuesday, February 22, 2022

EPC - USA Testimony opposing Connecticut Assisted Suicide Bill.

February 21, 2022

Mary Daugherty Abrams and Jonathan Steinberg, Co-Chairs and Members Connecticut Public Health Committee

Link to the letter (Link).

RE: Testimony Opposing S.B. 88, An Act Concerning Aid in Dying for Terminally Ill Patients

Dear Co-Chairs 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 SB 88 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.

  • The Bill allows Assisted Suicide with elastic and meaningless “safeguards.”
  • Assisted Suicide is not about pain or receiving a peaceful death; both are myths.
  • Assisted Suicide spawns more suicides and attempted suicides.
  • Insurance companies use Assisted Suicide to deny coverage for curative life-saving treatments, offering to pay for Assisted Suicide instead. This raises equity concerns.
The Bill allows Assisted Suicide with elastic and meaningless “safeguards.”

Connecticut criminalizes aiding a person to commit suicide, which is classified as 2nd degree manslaughter. CGS § 53a-56. S.B.88 at Sec. 12(d) removes criminal prosecution under CGS § 53a-56 for anyone self administering a lethal prescription under the “aid in dying” law. Thus, it is clear the bill is allowing assisting a person to commit suicide whatever pretty euphemism is created by marketing consultants to make it sound better.

Dr. Diane E. Meier, best known as the founder of Mt. Sinai’s Center to Advance Palliative Care, and a one-time proponent of Assisted Suicide years ago, recently said safeguards go up in smoke once the law allows it:
All the heartfelt adherence to restrictions that are announced when you first get the public [or Legislature] to vote in favor of this go up in smoke once the practice is validated. …It’s a dangerous path to go down with the claim that it is all about respect for autonomy, when the real drivers are getting rid of a painful and expensive burden on society.
S.B. 88 allows the prescription of a lethal dose to people who are terminally ill, with a 6 month prognosis, and who can self-administer by ingesting. No safeguards or witnesses are required at the time of ingestion regardless of the person’s mental state or ability to self-administer. I will briefly touch on this.

People qualify as terminally ill despite being able to live for years with treatment. Some of the diagnoses that qualify are infectious disease, gastrointestinal disease, diabetes, arthritis, sclerosis, stenosis, and musculoskeletal system disorders. The latest effort to stretch “terminally ill” treats anorexia as a qualifying terminal disease.

Here’s how one doctor describes self-administration in his practice:
He would load the medication into a plastic syringe and then hand the plunger to the patient, who would press down on it to “self-administer” and “ingest” the drugs. Sometimes, if a patient was weak, Shavelson would hold the plunger himself and place the patient’s hand on top of his. “If I feel you pushing on my hand,” he would say, “we will push together.”
It’s Not about Pain or a Peaceful Death; Both are Myths

Dr. Lonny Shavelson’s practice is limited to providing only Assisted Suicide. He now consults and educates other physicians who are willing to kill. He says:
promoting “aid in dying” 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. See webinar minutes 37:35-41:00.

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 Spawns More Suicides and Attempted Suicides.

If you enact S.B. 88, more people will die by suicide and more will attempt suicide. This is the collateral damage caused by suicide contagion when Assisted Suicide is legalized. If you do so, you send a 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.

Legalization of Assisted Suicide especially impacts 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. For every person who dies by suicide, another 30 attempt suicide.

So let’s apply this to Connecticut which now has a low suicide rate compared to other states. In 2020, 359 people died by suicide in Connecticut. A 6.3% increase will add 22 suicides if S.B. 88 is enacted. For each one of these 22 suicides, another 30 or 660 people will attempt suicide; some of them will become permanently disabled.

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, just like Dr. Diane Meier said.

There also equity concerns. 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 Latin0 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. The same is likely true in Connecticut.

In closing, I urge you to consider the heartache for families whose members are impacted by suicide contagion and the loss of insurance coverage for curable treatments that would follow enactment of S.B. 88 which also contributes to inequity for people of color. If you weigh that against the so-called benefits of Assisted Suicide which are myths, you will let S.B. 88 die in your committee.


Sara Buscher, Chair
Euthanasia Prevention Coalition USA