Hawaii murder investigation into "assisted suicide" death.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

A murder investigation has been opened in an Hawaii woman's death who had been approved for "assisted suicide." Allegedly the doctor "completed the death" after the woman began choking on the assisted suicide poison cocktail. The Honolulu Star reported that:

Honolulu police said they have opened a second-degree murder investigation after a doctor allegedly administer a lethal prescription dose to an 88-year-old woman in violation of Hawaii’s assisted death law. 

(KHON2 News report)

The Hawaii assisted suicide law requires the person to "self-administer" or complete the act themselves. The Honolulu star reported:

A Honolulu Police Department summary of the case said that on Oct. 15, it was reported to HPD’s Homicide Detail that a woman who died less than a week earlier did not self-administer the lethal prescription.

Police said the investigation found that the woman died at home on Oct. 9 at 5 :34 p.m and that before her death, the doctor “assisted in administering the lethal prescription which caused the female to choke.”

“At one point she motioned for the doctor to stop, but he continued to administer the prescription, ” the police report alleges.

The Hawaii news reports indicate that this is the first homicide related to an assisted suicide death. 

There may have been many homicide deaths related to assisted suicide since the law does not require independent oversight of the law. The Hawaii law requires the doctor who approved the death to self-report by being the same person who reports the death.

In this case, there must have been someone else at the death (family member or friend) who reported concerns related to how the lethal poison was "administered" and how the woman had motioned to the doctor to stop.

Nearly Every US State That Has Legalized Assisted Suicide, Has Expanded Its Law

Alex Schadenberg

Executive Director
Euthanasia Prevention Coalition

Colorado Governor Gary Polis signed  Senate Bill 24-068 on June 5 to expand their State assisted suicide law. 

Nearly every state that has legalized assisted suicide has expanded their law.

Senate Bill 24-068 expanded the Colorado assisted suicide law by:

• allowing advanced practice registered nurses to approve and prescribe lethal poison,
• reducing the waiting period from 15 days to 7 days,
• allowing the doctor or advanced practise registered nurse to waive the waiting period if the person is near to death,
• Adding language specifying that if any end-of-life options conflict with requirements to receive federal money, the conflicting part is inoperative and the remainder of the law will continue to operate.

The bill also added language concerning insurance companies:

• Denying or altering health-care or life insurance benefits otherwise available to a covered individual with a terminal illness based on the availability of medical aid-in-dying; or
• Attempting to coerce an individual with a terminal illness to make a request for medical aid-in-dying medication.

The original version of SB 24-068 would have reduced the waiting period to 48 hours and removed the residency requirement for assisted suicide in Colorado.

Most of the states are expanding their assisted suicide laws to allow advanced practise registered nurses to participate because very few doctors participate in assisted suicide.

Nearly every state that has legalized assisted suicide has expanded their laws. 

In 2019 Oregon expanded their assisted suicide law by giving doctors the ability to waive the 15 day waiting period when a person was deemed near to death. In 2023 Oregon removed the residency requirement extending assisted suicide nationally to anyone.

In 2021 California expanded their assisted suicide law by reducing the waiting period from 15 days to 48 hours, it forced doctors who oppose assisted suicide to be complicit in the process (later struck down by the court) and it forced all medical institutions to post their policy on assisted suicide.

In 2022 Vermont expanded their assisted suicide law by removing the 48 hour waiting period, (allowing a same day death), removing the requirement that an examination be done in person, (allowing approvals by telehealth), and it extended legal immunity to anyone who participates in the act.

In 2023 Vermont expanded their assisted suicide law by removing the residency requirement expanding assisted suicide nationally by allowing anyone to die by assisted suicide in Vermont.

In 2023 Washington State expanded their assisted suicide law by allowing advanced practice registered nurses to approve and prescribe lethal poison, by reducing the waiting period to 7 days and to force healthcare institutions and hospices to post their assisted suicide policies.

In 2023 Hawaii expanded their assisted suicide law by reducing the waiting period from 20 days to 5 days, by allowing the waiting period to be waived if the person is near to death and by allowing advanced practice registered nurses to approve and prescribe lethal poison.

There is currently a lawsuit by the assisted suicide lobby challenging the New Jersey state residency requirement for assisted suicide.

The goal of the assisted suicide lobby is to legalize assisted suicide in more states and to expand the scope of the assisted suicide laws in the states that have legalized assisted suicide.

It must be noted that the American Clinicians Academy on Medical Aid in Dying have determined that when a person, who does not otherwise qualify for assisted suicide, decides to stop eating and drinking, that they will immediately qualify for assisted suicide based on becoming terminally ill.

Assisted suicide: Safeguards debated as bioethicist warns of unintended consequences

The following article was written by bio-ethicist, Philip Reed, in response to Arthur Caplan's article supporting assisted suicide and was published by Kevinmd.com on March 19, 2024.

Reed begins his article by referring to Caplan's article and then writes:

In Canada, deaths by a physician have increased by more than 25 percent every year since legalization in 2016 and now make up over 4 percent of all deaths. Media reports have profiled physician-assisted death for non-terminally ill Canadians who were having trouble accessing medical care, housing, and social support. Caplan understandably wants to avoid this scenario.

The question, however, is how well the safeguards are really working even in the United States. Are they set up to protect the U.S. sufficiently against the Canadian scenario?

One safeguard originally built into these laws was that access to lethal drugs would be limited to state residents. States understandably did not want to become destinations for suicide tourism. But Oregon has stopped enforcing this requirement and Vermont passed a law last year overturning their residency requirement. Other states are expected to follow suit.

Another alleged safeguard is that people who are mentally ill or depressed cannot have access to lethal drugs. However, only Hawaii requires that terminally ill patients be evaluated by a mental health professional. The other states only require referral when they suspect depression or another mental disorder might interfere with decision-making.

In the 25 years of assisted suicide in Oregon, only 3 percent of patients have been referred for a psychiatric evaluation. On the one hand, this is surprising, given that by some estimates 1 in 5 Americans have some kind of mental illness. On the other hand, given that only specialized doctors are willing to prescribe lethal drugs, patients have to shop for the right doctor. In Oregon, the median length of the relationship between the patient who receives a lethal prescription and the doctor who prescribes is down to only five weeks. One can understand how psychiatric referrals get in the way of this transaction. But one also wonders whether this sufficiently protects depressed patients.

Even when a referral is made, the objective is only to determine eligibility for assisted suicide. Only one jurisdiction (the District of Columbia) requires that patients be informed about the option of mental health counselling.

Another safeguard of assisted suicide laws is to have significant waiting periods between the patient’s initial request and obtaining the prescription. This helps ensure the request’s authenticity and that the patient is not choosing rashly. The standard waiting period, endorsed by Caplan, has been 15 days but things are changing. In 2019 the Governor of Oregon signed a law allowing physicians to bypass the waiting period in certain cases. In 2021, California shortened its waiting period from 15 days to 48 hours and subsequently witnessed a 47 percent increase in lethal prescriptions. Hawaii and Washington shortened their waiting periods in 2023 and Colorado has pending legislation to shorten it. New Mexico, seeing the trend, said, “Why wait?” and started with a 48-hour waiting period.

Are people being pushed to choose an assisted death prematurely? I suggest that the ways in which some of these choices are made are subtle and stem from complex psychological and social forces that are not easily captured by evidence. For example, are we expressing to terminally ill patients that experiencing the burdens of their disease does not jeopardize their dignity when we label the alternative “death with dignity?”

About half of Oregon patients who use assisted suicide say that they don’t want to be burdens on their families. Is a choice for death authentic if it is motivated by the idea of sacrificing a potential life worth living in order to unburden one’s caregivers?

Also, in my view, it is unfortunate that some states have incorporated assisted suicide into hospice and palliative care. Hospice says to terminally ill patients, “We can give you an acceptable quality of life at the end of life.” The offer of assisted suicide contradicts this and undermines the mission of hospice.

Medicine in the 21st century is so impressive that we are genuinely surprised when the doctor tells us that nothing can be done. But medicine is not a panacea and it cannot treat mortality. The trouble with assisted suicide laws is that they present death as a neat and tidy way to solve one’s problems. The alleged safeguards are inadequate, and as they have gradually eroded, more and more people come to believe that death can solve their problems too.

Thank you Philip Reed for responding to Caplan.

Hawai'i expanded their assisted suicide law in 2023. Hawai'i assisted suicide deaths are increasing.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Hawai'i assisted suicide deaths have continually increased since legalization. The Euthanasia Prevention Coalition expects greater increases in 2023 based on the fact that Hawai'i expanded their assisted suicide law in 2023 by passing House Bill 650.

According to the Hawai'i assisted suicide data, there were 55 assisted suicide deaths in 2022, which was up from 49 in 2021. We don't have the 2023 Hawai'i assisted suicide data yet.

For instance, California's assisted suicide deaths increased by 63% in 2022, after they expanded their assisted suicide law (Article).

As stated in an article that I published last year, (HB 650) expanded the Hawai'i assisted suicide law by reducing the waiting period, allowing non-physicians to approve and prescribe assisted suicide and expanding who can counsel someone for assisted suicide. HB 650 was signed into law on June 2, 2023.

HB 650 reduced the assisted suicide waiting period from 20 days to 5 days and it allowed the waiting period to be reduced to 48 hours when a person was deemed to be "near to death."

HB 650 also allowed non-physicians to approve and prescribe assisted suicide drugs and it expanded who was able to counsel a person who is considering assisted suicide. The expansion of assisted suicide providers was deemed necessary because very few physicians were willing to participate in assisted suicide.

Hawai'i, like most states that have legalized assisted suicide, passed their original assisted suicide law with "safeguards" that were designed to persuade legislators to vote for the bill.

Hawai'i debated and defeated assisted suicide bills almost every year until 2018, when the sponsor of the assisted suicide bill, included more "safeguards" than the Oregon law resulting in the bill passing.

The very first Hawai'i assisted suicide report (2019) included a push to remove "safeguards" in the law. I stated in my commentary that:

Even though assisted suicide was legal for less than one year, the assisted suicide lobby is promoting two options for expanding the assisted suicide law.

Hawai'i is the best example of how the assisted suicide lobby will support a "tight" bill to legalize assisted suicide and soon after introduce a bill to eliminate "restrictions."

More information on this topic:

• The assisted suicide lobby wants to legalize assisted suicide in your state and expand it later (Link).
  

Connecticut assisted suicide bill 1076 must be defeated.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Cathy Ludlum, Second Thoughts Connecticut

Last year I celebrated the defeat of the Connecticut assisted suicide bill by one vote in the judiciary committee. That bill was the 10th consecutive assisted suicide bill in Connecticut to fail. But I also told my supporters that the battle in Connecticut may return for an eleventh straight year in 2023.

This year's Connecticut Assembly Bill 1076 has been amended to appear specifically tighter in its wording, than previous bills because the assisted suicide lobby has failed to legalize assisted suicide for 10 consequtive years. The New York assisted suicide bill is also written in a tighter manner, based on the fact that the assisted suicide lobby has failed to legalize assisted suicide in New York.

The assisted suicide lobby has no intention of leaving the bill restrictions in place. The assisted suicide lobby has two strategies, the first is to do what is necessary to legalize assisted suicide and the second is to expand those bills once legal.

A few years ago, Hawaii was a state that had rejected assisted suicide bills over consequtive years. The Hawaii legislature legalized assisted suicide in 2018. The very next year the assisted suicide lobby was pressuring the Hawaii legislature to expand their law. Hawaii is currently debating House Bill 650 to expand their assisted suicide law.

Members of the Connecticut legislature must reject the current bill, because assisted suicide is always wrong and they assisted suicide lobby are trying to legalize assisted suicide and, if passed, they will amend it in the coming years.

The bills to legalize assisted suicide in Minnesota, a state that has not debated assisted suicide every year, is a wider bill than Connecticut.

The Minnesota bill:

• Allows non physicians to assess, approve and prescribe lethal assisted suicide drugs. Minnesota defines a "Provider" as: a doctor of medicine or osteopathy, and an advanced practice registered nurse. 
• Allows lesser trained mental health professionals to assess competency. "Licensed mental health provider" is defined as a psychiatrist, psychologist, clinical social worker, psychiatric nurse practitioner, or clinical professional counselor. 
• There is no waiting period for being approved for assisted suicide. It is possible that a person request assisted suicide and die the same day.
  
• Allows the lethal drug cocktail to be delivered by mail or messenger service. 
• Allows a healthcare facility to prohibit assisted suicide but the facility cannot prohibit information about assisted suicide or referrals for assisted suicide.
• Does not require the person requesting death by lethal drugs to be a resident of Minnesota. Oregon withdrew their residency requirement in 2022. There is now an assisted suicide clinic and suicide tourists in Oregon. 
• Creates a "standard of care" for assisted suicide, Medical care that complies with the requirements of this section meets the medical standard of care. Assisted suicide is not medical care.
  

By reading the articles by the assisted suicide lobby and assisted suicide bills that are being promoted by the assisted suicide lobby, they are clearly moving to allowing an easier approval process and to enable more people to qualify for assisted suicide.

Recently Oregon withdrew their residency requirement for assisted suicide and Vermont has a bill to also remove their residency requirement. Oregon, Vermont and California lessened their waiting periods for assisted suicide and Hawaii and Washington state currently have bills that will lessen their waiting periods.

So lets call a spade a spade. Connecticut has rejected assisted suicide for 10 consecutive years and in response the assisted suicide lobby has presented a tighter bill. If Connecticut passes Assembly Bill 1076, within a year or two, the assisted suicide lobby will be expanding it.

The only way to protect vulnerable people is to reject assisted suicide completely.

Hawaii House Bill 650 to expand assisted suicide law.

Hawaii is the best example of how the assisted suicide lobby will support a "tight" bill to legalize assisted suicide and the next year introduce a bill to eliminate "restrictions."

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Hawaii legislature

Hawaii House Bill 650 (HB 650) would expand Hawaii's assisted suicide law by reducing the waiting period, allowing non-physicians to approve assisted suicide and expanding who can counsel someone for assisted suicide.

HB 650 is not a surprise since a similar bill was debated but not passed in Hawaii last year.

Hawaii debated and defeated assisted suicide bills almost every year. In 2018, the sponsor of the Hawaii assisted suicide bill included more restrictions than the Oregon law and sadly, the bill passed.

The very first Hawaii's assisted suicide report (2019) included a push to remove certain restrictions in the law. I stated in my commentary that:

Even though assisted suicide was legal for less than one year, the assisted suicide lobby is promoting two options for expanding the assisted suicide law.

Hawaii is the best example of how the assisted suicide lobby will support a "tight" bill to legalize assisted suicide and next year introduce a bill to eliminate "restrictions."

Today I read Rhode Island assisted suicide bill (H 5210) which is similar to the New York State assisted suicide bill. The assisted suicide lobby has introduced a tradition style assisted suicide bill, with the hope of it passing, and then they will push to widen the bill in the following years.

Last week I wrote about New York State's assisted suicide Assembly Bill 995 (A00995) and Senate Bill S2445 that are based on the original Oregon assisted suicide law. The New York assisted suicide lobby failed to legalize assisted suicide in the past so they are attempting to legalize assisted suicide with tighter restrictions and in the near future they will push for expansions of the law.

There is only one line in the sand. It is either legal to kill by assisted suicide or not. Once assisted suicide is legal we are only debating the reasons to kill and who can do the killing.

2022 Assisted Suicide US Predictions.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I predict that 2022 will be a very active year for US assisted suicide bills, especially in the eastern US. The US assisted suicide lobby are sponsoring bills in many states, but they are focusing on New York and Massachusetts. I predict that they will also focus on bills in Connecticut and Maryland.

The assisted suicide lobby have invested significant money into 2022 campaigns as they fear that they may lose supportive seats in the November 2022 mid-term elections.

I also predict that in many states, the bill that will be debated will be similar to the New Mexico bill (HB 47) that passed in 2021. New Mexico has the most extreme assisted suicide law in America.

Among other things, New Mexico Bill HB 47 approved:

• Expanded who can approve and prescribe assisted suicide by creating the term health care provider which includes advanced nurses, and other non-physicians.
• Required a 48 hour waiting period (rather than a 15 day waiting period) that could be waived if the person is nearing death (same day death).
• Waives approval by a second health care provider if the person is enrolled in a hospice program.
• Trampled on conscience rights for medical professionals.

Assisted suicide expansion laws.

When examining the assisted suicide expansion bills and the court cases to expand assisted suicide, clearly these laws are expanding over time. Legislatures pass assisted suicide laws with "safeguards" that are designed to sell legalization.

In 2022, the assisted suicide lobby will continue to support bills to expand current assisted suicide laws. In 2021, California, Hawaii, Vermont and Washington State had bills to expand their current assisted suicide regimes, only the California bill passed. Assisted suicide expansion bills in Hawaii, Vermont, Oregon and Washington state will be strongly pushed in 2022.

Most of these bills concern lessening or waiving waiting periods, expanding who can approve assisted suicide and trampling on conscience rights.

There are several court cases to legalize or expand US assisted suicide laws.

The assisted suicide lobby has launched court cases to expand assisted suicide and euthanasia in the United States, because other jurisdictions, such as Canada, have legalized and expanded euthanasia through the courts.

The California (Shavelson) case states that people with disabilities, due to their physical abilities, are experience discrimination with the California assisted suicide law. Shavelson et al argues that the law must be permit death by lethal injection (euthanasia) to enable equality under the law. 

The Shavelson case is not asking the court to expand the assisted suicide law, but rather it is asking the court to legalize euthanasia, which is a form of homicide. (Link to article on the case). If an activist judge agrees with Shavelson, the door to euthanasia in every state that permits assisted suicide will be opened.

The Oregon (Gideonse) case is challenging the residency requirement in the Oregon assisted suicide law. The Gideonse case is arguing that a patient, who lives in Washington state, should be permitted to die by assisted suicide in Oregon. If an activist judge agrees with Gideonse et al, then every American will be able to die by assisted suicide in Oregon. (Link to an article on the case).

The Massachusetts (Kligler) case claims that prosecuting doctors for prescribing lethal assisted suicide drugs violates the Massachusetts State Constitution. (Link to an article on the case). 

I believe that even though the Kligler case focuses on the Massachusetts State Constitution, that it may be used to challenge the Supreme Court 1997 Glucksberg decision that found that there was no right to assisted suicide.

The Minnesota Final Exit Network case is a continuation of previous cases are challenging the Minnesota law prohibiting assisted suicide based on free speech statutes. I personally think that the Final Exit Network case will fail again. (Link to an article on the case).

The assisted suicide lobby will continue to lobby is hoping to win in New York. They have put a lot of money into this campaign.

Assisted suicide laws give medical professionals the right in law to cause your death. These laws are not about choice or autonomy but abandonment and physician control.

We need a society that cares not kills its citizens.

Link to: Preventing the spread of assisted suicide in America (Link)

Hawaii 2020 assisted suicide report - more death - and the report demands even more death.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Hawaii assisted suicide law came into effect on January 1, 2019. The 2019 Hawaii assisted suicide ("Our care, our choice act") report indicated that in the first year of the assisted suicide law: 

• 30 people were prescribed a lethal drug cocktail, 
• 15 people died by assisted suicide, 
• 8 people who received a lethal prescription died a natural death and 
• 7 people who received a lethal prescription were alive at the end of 2019.

The Hawaii 2020 assisted suicide report that was recently released indicated that:

• 37 people where prescribed a lethal drug cocktail, 
• 25 people died by assisted suicide, 
• 7 people who received a lethal prescription died a natural death,
• the status of four people who received a lethal presciption is unknown.

When the status is unknown, the person may have died by assisted suicide but no reports were received.

Similar to the 2019 report, the 2020 report concludes with the Hawaii Department of Health lobbying for an expansion of the assisted suicide law. The report states:

The DOH recommends the following changes to the OCOCA.

1. Waiver of any waiting periods if the attending provider and consulting provider agree that patient death is likely prior to the end of the waiting periods. 
2.  Given access to health care providers is limited, the DOH recommends authorizing advance practice registered nurses to serve as attending providers for patients seeking medical aid in dying. 

As stated by Wesley Smith's commentary on the Hawaii assisted suicide report:

Please understand, dear readers, that when assisted-suicide advocates promise strict guidelines to protect against abuse, they don’t really mean it. The promise’s purpose is to get the law passed, not to be kept.

Hawaii is not the only jurisdiction pushing for more death. A court case was just launched by the assisted death movement in California to expand its assisted suicide law to euthanasia (homicide).

Suicide, assisted suicide, disability rights and FEN.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Allison Wallis, wrote an indepth essay that was published by Aljazeera on August 8 titled: Death doulas and end-of-life rights: The debate on assisted dying.

I don't agree with much of Wallis's essay but she uncovers significant information related to the Final Exit Network (FEN). Wallis is from Hawaii where assisted suicide has been legal for several years.

Wallis begins by explaining her story that led to her interest in the issue she writes:

A few years ago, I spent a lot of time in bed. I had developed holes in my dura – the thick covering that surrounds the spine and brain – that were leaking cerebrospinal fluid. Every time I would sit up, I would get hit by a wave of dizziness and nausea, and the pain in my head from low brain pressure would become unbearable. Many times, I would faint, passing out on the floor or in bed.
...
Every single day, I felt like a burden. The pain never relented. Many of those days, I wanted to die.

My life is exponentially better now. I am no longer suicidal and have no remaining ideation. But I do still think a lot about the ethics of suicide – and especially of medical aid in dying (MAID), a practice legal in a small but growing number of states which allows a doctor to write a fatal prescription for a sick person who feels sure they want to die.

Wallis writes that she lives with chronic pain and supports the concept that someone should be able to end their life when they are dying or life becomes difficult. She states:

I decided I wanted to know what it would mean to choose to die with the help of my doctor under Hawaii’s MAID law: the Our Care, Our Choices Act. I spoke to death doulas, lobbyists and doctors, and one man who operates in the margins of the law by helping people learn how to end their lives.

Wallis examines opposition to assisted dying from the disability perspective.

This opposition means they also oppose limited laws like the Our Care, Our Choice Act in Hawaii, which allows terminal, mentally competent residents with less than six months to live the right to request medication that will end their life. It is the beginning of a slippery slope, activists say. Many disabled people have been told that they were terminal, but are still alive decades later. In January in Canada, a 35-year-old father named Chris Gladders died with medical assistance in a filthy room in a nursing home that investigators found to be poorly managed and neglectful. Disability rights advocates held the case up as an example of exactly what they were worried about. If he had been able to live at home, with his family and skilled care, would he still be alive today?...

The National Council on Disability (NCID) strongly opposes MAID and has produced a 70-page document (PDF) that outlines its concerns. These include insurance companies that have refused to pay for possibly life-saving care, but that did offer to pay for much less expensive lethal drugs. The Council also argues that medical science is not perfect and that disabled people are sometimes called terminal when they are not. People considering MAID may be living with demoralisation, caused by the internalised feelings that they are an expense or a burden to loved ones. Most physicians are not trained in recognising or addressing demoralisation in their disabled patients. Instead, these physicians may reinforce those feelings by conflating disability with a terminal illness or poor quality of life.

Wallis explains how disability advocates want better care not death.

In recent years, in response to the opioid epidemic, the Centers for Disease Control and Prevention (CDC) has been cracking down on the prescription of pain medication – even though the treatment of pain is considered a civil right. As a result, it is easier for some people who live with severe pain to obtain deadly MAID drugs than to obtain opioids – the only type of medication that may help with their pain. What disabled people need instead of aid-in-dying laws, the Council suggests, is adequate long-term care. Palliative care and pain medication that is fully funded and easily accessible. Home health aides that are affordable or paid by insurance. Instead of being encouraged to die, we need the ability, through support, to live the best life possible.

Wallis then interviewes Brian Rudder from the Final Exit Network (FEN):

Brian Ruder believes that a person should have a civil right to end their life on their own terms. He is with the Final Exit Network, a nationwide organisation that provides training for people who want to end their life. Clients do not need to be terminal. To request FEN’s services, you must write a letter and send in your medical records to be reviewed by a board of doctors. ...

When I called Brian to talk about it, he insisted that FEN does not assist or encourage suicide, but only provides information about various possible methods. I found it hard, however, to understand how a volunteer flying out to Hawaii to give a lesson about dying to someone who may be suicidal is not encouraging the act. He also said that FEN does not accept people with mental illness. Not yet, anyway. And he stressed that the group turns away applicants whose families are not on board, as well as people with severe medical issues who do not think they are within a year of wanting to die. These people are given a reference to a suicide how-to book. They are not given a referral for mental health care.

One of the reasons I like Wallis's article is that she uncovers some of the FEN practises. FEN is an assisted suicide group that assists in the deaths of people who don't qualify for death under the state assisted suicide laws or assists suicides in states where it is illegal. FEN promotes a "suicide how-to book" for people when they will not assist the death. In other words they will advocate for suicide in cases when they won't approve the suicide.

Wallis asks Brian whether FEN would have helped her to die when she was at her low time. He told her:

“Maybe,” Brian said. The medical board would have had to review my letter and medical records. While FEN does not approve people with solely mental health issues, they do not see depression as a barrier to approving people who also have serious health problems. He seemed to dance around my question a bit, but I got the impression that, if I had asked for FEN’s help to die, I probably would have been accepted.

Brian also told Wallis how FEN supports assisting a suicide for people who think their life is complete (completed life). Wallis responds by writing:

Brian seemed like a nice guy. Like he would be a good grandfather. My disabled friends would call him a serial killer. I left the interview feeling very uneasy. That feeling has not gone away.

Wallis then writes about death doulas, an "ideal" assisted suicide death and her memories of her grandmother's natural death. She ends her essay by stating that she supports disability organizations opposition to assisted suicide but she also supports the option of assisted suicide. Wallis is clearly inconsistent and divided.

I appreciate how Wallis shows how FEN is an extremist group. They say that they don't assist suicides but they assist in every way possible in suicide. Wallis shows how FEN will not approve everyone for assistance in suicide but when they do not approve they assist by providing "how to" suicide information. Finally she shows how FEN leaders support the concept of "completed" life and how they are willing to assist the suicides of people who have suicidal ideation.

I hope that Wallis will notice the inconsistency in the assisted suicide ideology, an ideology that enables other people to approve and be involved with causing death. These are dangerous concepts for people living in a difficult time of their life.

It is far more consistent to believe that nobody in society has the legal right to be involved with killing another person. True equality recognaized the value of every human life.

North Dakota debates assisted suicide bill HB 1415

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The assisted suicide lobby intends to legalize assisted suicide throughout the US. North Dakota is not a state that has debated assisted suicide in the past, but seven legislators have sponsored HB 1415, a bill to legalize assisted suicide in North Dakota.

HB 1415 is similar to the Oregon assisted suicide law.

Several states that have legalized assisted suicide, such as Oregon, Washington State and Hawaii, are now debating the expansion of their assisted suicide laws. If HB 1415 passes the assisted suicide lobby will move to expand it in future years.

The Hawaii assisted suicide law came into effect on January 1, 2019. Only one year after legalizing assisted suicide, the Hawaii legislature debated two assisted suicide law expansion bills and this year Hawaii is debating bill SB 323 to expand their assisted suicide law.

Legalizing assisted suicide gives medical professionals, the right in law, to prescribe lethal drug cocktails knowing that the person intends to use it to cause their death.

State laws should never give anyone the right in law to be involved with causing the death of another person. This is a dangerous public policy.

Links to important articles:

• Assisted suicide bills are not what they appear to be (Link).
  
• 12 myths about assisted suicide and Medical Aid in Dying (Link).
• Oregon 2019 assisted suicide report (Link).
• Washington State debates expansion of assisted suicide law (Link). 
• Hawaii debates bill to expand assisted suicide law (Link).
  

Hawaii debates bill to expand assisted suicide law.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Hawaii assisted suicide law came into effect on January 1, 2019. Only two years after legalizing assisted suicide, the Hawaii legislature is now debating the expansion of assisted suicide with Bill SB 323.

SB 323 proposes to expand assisted suicide by:  

• Reducing the reflection period to 15 days and then allowing the reflection period to be waived if the requester is deemed to be nearing death, 
• Allowing registered nurses to also approve and prescribe lethal assisted suicide drugs,
• Allowing clinical social workers to counsel people with questionable consent.

The 2019 Hawaii assisted suicide ("Our care, our choice act") report indicated that in the first year of assisted suicide:

• 30 people were prescribed lethal drugs,
• 15 people died by assisted suicide,
• 8 people received a lethal prescription died but did not die by assisted suicide, and 
• 7 people remained alive at the end of 2019. 

The 2019 Hawaii assisted suicide report was released on July 1, 2020. The report also included preliminary data for 2020 indicating that from January 1 to June 26, 2020, 24 people were prescribed lethal drugs and 13 people died by assisted suicide.

Even though assisted suicide had only been legal for one year, in 2020 the Hawaii legislature debated bill SB 3047 that would have expanded the assisted suicide law by:

• Allowing assisted suicide for incompetent people through advanced directives,
• Waiving the counseling requirement, 
• Approving assisted suicide by "telehealth" and 
• Requiring insurance companies to pay for assisted suicide.

When Hawaii legislators debated assisted suicide, in 2018, the safeguards in the bill were proposed to get legislators to vote YES to assisted suicide. It appears that the assisted suicide lobby got the assisted suicide bill passed with the intention of quickly expanding it.

• Assisted suicide bills are not what they appear to be (Link).

Assisted suicide in America. Predictions for 2021.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

As 2021 begins, it is important to prepare for what may happen.

We predict that assisted suicide bills will be introduced in at least 20 states and some states that legalized assisted suicide will debate bills to expand their assisted suicide laws, in 2021.

In 2020, many states debated assisted suicide bills but most of those bills died on the order paper. Some of the assisted suicide bills died on the order paper because the COVID-19 pandemic temporarily shut down state legislatures.

We are very concerned about possible assisted suicide bills in Maryland, Massachusetts, New Hampshire, New Mexico and New York, among others.

Links to key articles for fighting assisted suicide:

• A patient's journey. If we jumped on the death train, that man would have died (Link).
• Assisted suicide bills are not what they appear to be (Link).
  
• 12 myths about assisted suicide and Medical Aid in Dying (Link).
• Oregon 2019 assisted suicide report (Link).
• The Netherlands to extend euthanasia to children (Link).
• Be careful what you wish for when you legalize killing (Link).
• Assisted suicide deaths may not be quick or peaceful (Link).
• Assisted suicide doctor conducts human experiments in killing people (Link).
• Prolonged painful deaths and assisted suicide lethal drug experiments (Link).
• Hawaii assisted suicide report urges removal of safeguards (Link).
• Dr Anne Hanson's testimony opposing assisted suicide (Link).
• Pressured to die by assisted death (Link).
• Assisted suicide by telehealth and medical misdiagnosis (Link).
• There is no effective oversight of assisted suicide laws (Link).
• The assisted suicide lobby plans to eliminate safeguards (Link).
• Psychiatrists must prevent suicide not provide it (Link).
• Federal study finds assisted suicide laws are rife with dangers to people with disabilities (Link).

States that have legalized assisted suicide will likely debate bills to expand those laws.

In January 2019 I commented on an article by the CEO of Compassion & Choices, (formerly known as the Hemlock society) who stated that assisted suicide laws need fewer regulations.

In Oregon, the number of assisted suicide deaths increased to 188 reported deaths in 2019. In 2019 Oregon passed Bill SB 0579 which came into effect on January 1, 2020, which essentially eliminated the 15 day waiting period. There were other Oregon assisted suicide expansion bills debated in 2019, that may return in 2021.

In Washington state the legislature debated Bill 2419 states a study bill to examine the elimination of "safeguards" in assisted suicide laws. Section f of the bill questioned the need to self-administer lethal drugs. If lethal drugs are not self-administered then someone else must administer, thus legalizing euthanasia.

The Hawaii 2019 assisted suicide report indicated that 15 people reportedly died by assisted suicide in 2019. The report also included preliminary 2020 data indicating that in the first few months of 2020, 13 people reportedly died by assisted suicide.

In the final paragraph of the assisted suicide report the Hawaii Department of Health recommends the following changes to the assisted suicide law:

Waiver of any waiting periods if the attending provider and consulting provider agree that patient death is likely prior to the end of the waiting periods.

Given access to health care providers is limited, the DOH recommends authorizing advance practice registered nurses to serve as attending providers for patients seeking medical aid in dying.

The Hawaii Department of Health recommendations follow the direction of the assisted suicide lobby.

For those who are organizing to stop assisted suicide in their State EPC suggests the following: 

• Refer to assisted suicide, and stay away from politically motivated language. 
• focus on how assisted suicide is done. The assisted suicide lobby is experimenting with new drug combinations as they attempt to find cheaper lethal drug cocktails.
• Assisted suicide bills are not what they appear to be. Focus on what the bill actually says, rather than focusing on the theory of assisted suicide. 
• In 2020, several of the assisted suicide bills permitted euthanasia or used undefined language enabling the legislation to be interpreted in a wider manner, while other bills ignored conscience rights for medical professionals.

Defeating assisted suicide bills requires a complete analysis of the bill, outlining the problems with the bill. All of these bills are designed to expand over time.

Emphasize what assisted suicide is and how it is done and discuss how the assisted suicide lobby is conducting unethical lethal drug experiments. They speak about compassion and choices and yet they have caused some horrific deaths.

Work together. All perspectives are important, but stay focused on your goal, that being, protecting people from assisted suicide.

New Jersey reports 12 assisted suicide deaths in its first 5 months.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

The New Jersey assisted suicide act came into effect on August 1, 2019 after being signed into law by Governor Phil Murphy on April 12.

An injunction was granted on August 14 in a case challenging the assisted suicide act, and then the injunction was rescinded on August 27. The New Jersey assisted suicide report indicates that 12 people died by assisted suicide in the first five months of the law.

The report only provides basic data about the people who died. The report states that six men and six women died, that seven the people had cancer, ten of the twelve died at home, one died in a nursing home and one died in someone else’s home.

The report does not provide information about how many people were prescribed lethal drugs. There is no information, in the report, concerning why people asked for assisted suicide and no concerns about possible abuse of the law.

Similar to other assisted suicide laws, the data comes from the reports that are filed by the physicians who prescribed the lethal drugs. There is no independent or third-party involvement to ensure that the reports are accurate.

There is also no requirement that an independent witness be present at the death to ensure that the law was followed. No one will know if the lethal drugs were administered (euthanasia) rather than self-administered (assisted suicide). Euthanasia is a form of homicide since someone else administers the lethal drugs.

The New Jersey law requires doctors to declare assisted suicide deaths as a natural death. The law specifically states that the death: shall not constitute patient abuse or neglect, suicide, assisted suicide, mercy killing, euthanasia, or homicide under any law of this State.

The law clearly protects doctors who are willing to cause death, rather than protecting the person who is living with vulnerable conditions.

Even though assisted suicide has been legal in New Jersey for more than a year, the New Jersey Medical Association, disability rights groups, and others, oppose the law. People who oppose assisted suicide are hoping that the upcoming election results in a change.

Hawaii 2019 assisted suicide report urges removal of safeguards.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition
 

The Hawaii assisted suicide law came into effect on January 1, 2019. The 2019 Hawaii assisted suicide ("Our care, our choice act") report indicates that in the first year of assisted suicide:

• 30 people were prescribed lethal drugs, 
• 15 people died by assisted suicide,
•  8 people received a lethal prescription died but did not die by assisted suicide, and
• 7 people remained alive at the end of 2019.

Since the 2019 Hawaii assisted suicide report was released on July 1 the report also includes preliminary data for 2020 indicating that from January 1 to June 26, 2020, 24 people were prescribed lethal drugs and 13 people died by assisted suicide.

The Hawaii Department of Health urges the government to remove safeguards.

In the final paragraph of the 2019 report the Hawaii Department of Health recommends the following changes to the assisted suicide law:

1. Waiver of any waiting periods if the attending provider and consulting provider agree that patient death is likely prior to the end of the waiting periods.
2. Given access to health care providers is limited, the DOH recommends authorizing advance practice registered nurses to serve as attending providers for patients seeking medical aid in dying.

The Department of Health recommendations follow the direction of the assisted suicide lobby who are lobbying for the removal of safeguards. On January 1, 2019, the assisted suicide lobby stated that assisted suicide laws contain too many safeguards. In 2019, the Oregon legislature expanded their assisted suicide law by waiving the 15 day waiting period.

Even though assisted suicide was legal for less than one year, the assisted suicide lobby promoted two options to expand the assisted suicide law. The Hawaii legislature debated bills SB 2582 and HB 2451 to expand the assisted suicide law by:

• permitting nurses to prescribe lethal drugs,
• shortening the waiting period in general, and 
• waiving the waiting period when someone is "nearing death."

The Hawaii legislature also debated bill SB 3047 that would have expanded the assisted suicide law by:

• allowing assisted suicide for incompetent people through advanced directives,
• waiving the counseling requirement, 
• approving assisted suicide by "telehealth" and 
• requiring insurance companies to pay for assisted suicide.

When Hawaii legislators debated assisted suicide, in 2018, the safeguards in the bill were proposed to get legislators to vote YES to assisted suicide. It appears that the assisted suicide lobby got the assisted suicide bill passed with the intention of quickly expanding it.

• Assisted suicide bills are not what they appear to be (Link).