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.

EPC April 8 Zoom event with Alex Schadenberg: Examining the growth of assisted suicide in the Western US.

This Zoom event will focus on Oregon, California, Washington state and Hawaii.

Alex Schadenberg

Alex Schadenberg, the Executive Director of the Euthanasia Prevention Coalition will be providing a Western US assisted suicide Zoom event update on April 8 at 7:15 pm (Pacific Time) / 8:15 pm (Mountain Time).

Register in advance for this Zoom event (Registration Link). 

After registering, you will receive a confirmation email containing information about joining the meeting. 

This event will uncover the incremental growth of assisted suicide, a reality that the assisted suicide lobby denies in states when they are trying to legalize assisted suicide.

Alex Schadenberg will examine the increasing number of assisted suicide deaths and the expansions to the assisted suicide laws in Oregon, California, Washington state and Hawaii and provide an analysis of the data and the assisted suicide expansion bills.

There will be a specific focus on recent legislation such as Oregon removing it's assisted suicide law residency requirement to permit suicide tourism and California Bill HB 1196, a bill that would blur the distinction between assisted suicide and euthanasia (homicide) in California.

Register in advance for this Zoom event (Registration Link).

Links to recent articles on these topics:

• Oregon assisted suicide poison prescriptions increase by 29% in 2023. (Link).
  
• The nationalization of assisted suicide in America (Link). 
• California assisted suicide deaths surge by 63% in 2022 (Link).
• Does California Senate Bill HB 1196 legalize euthanasia/homicide? (Link).
• Hawai'i expanded their assisted suicide law in 2023. Hawai'i assisted suicide deaths are increasing (Link).
• Washington State failed assisted suicide law (Link).
  

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).
  

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.

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.

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).

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).

EPC August 5 free webinar update.

Stop euthanasia and assisted suicide

Watch the webinar (Link).

Join the EPC free webinar with Alex Schadenberg

Wednesday, August 5th at: 2 pm (EST)

Email: info@epcc.ca for the webinar information.

Topics will include:

• Analysis of the Canadian (MAiD) euthanasia and assisted suicide data,
• Analysis of the California, Hawaii, and New Jersey assisted suicide data,
• Canada's Bill C-7, 
• Delta Hospice Society update, 
• The Netherlands "Completed Life" debate, 
• Some recent stories.

Assisted Suicide lobby is using Covid 19 virus to promote assisting suicides via telehealth.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The death lobby is promoting the approval of assisted suicide and prescribing of lethal drugs via telehealth. This means that a person could be approved for death by lethal drugs, without being examined or even meeting the death prescribing doctor.

Today's fundraising email from Kim Callinan, the President of an assisted suicide lobby group, states that the current Covid-19 crisis provides new opportunity for assisted suicide. She writes:

As always, we are responding quickly to the needs and opportunities of the times. As the workforce grapples with the pandemic, telehealth is gaining prominence as a critical mode of delivering medical care. This provides a unique opportunity to make sure health systems and doctors are using telehealth, where appropriate, for patients trying to access end-of-life care options. These efforts should improve access to medical aid in dying in the short and long-term.

This is not a new plan. The 2019 New Mexico assisted suicide bill included a telehealth provision and the recent bills to expand assisted suicide in Hawaii include a telehealth provision.

Let's think this through. A person with difficult health issues who feels like a burden on others, or experiencing depression or existential distress, could be assessed, via telehealth, and prescribed lethal drugs for suicide.


The death lobby focuses on facilitating death and protecting doctors who are willing to be involved with killing their patients. They are not concerned with protecting people.


For more information read the articles:  

• Assisted suicide bills are not what they appear to be. 
• Oregon assisted suicide deaths increase again in 2019.

 

Assisted suicide bills are not what they appear to be.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The assisted suicide lobby has introduced assisted suicide bills in at least 18 States in 2020. All of these bills include "safeguards" that appear to provide oversight of the law.

Recently I published an article explaining how the "safeguards" are written with loosely defined language to permit the laws to be redefined over time. I also explained that the "safeguards" are designed to convince legislators to legalize assisted suicide, while the assisted suicide lobby intends to remove them overtime. 

For instance, the Hawaii legislature passed an assisted suicide bill in 2018 that came into effect on Jan 1, 2019. There were 27 assisted suicide deaths in 2019.

The assisted suicide lobby is proposing to expand the assisted suicide law after only one year. The Hawaii legislature is debating bills SB 2582 and HB 2451 to expand the assisted suicide law by:

• permitting nurses to prescribe the 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 allowed:

• assisted suicide for incompetent people who requested death in an advanced directive,
• physicians to waive the counseling requirement, 
• assisted suicide to be approved by "telehealth" and 
• require insurance companies to pay for assisted suicide.

Its hard to believe that the assisted suicide lobby wants death by "Telehealth."

The Washington State legislature is debating Bill 2419, a bill to study the "safeguards" in their assisted suicide law. One of the issues to be studied is allowing euthanasia (lethal injection) rather than limiting it to assisted suicide.

Last year the Oregon legislature expanded their assisted suicide law by waiving the 15 day waiting period.

Assisted suicide may not be a peaceful death.

The assisted suicide lobby has been using experimental lethal drug cocktails as they attempt to find a cheaper way to kill. The current assisted suicide drug cocktails have caused painful deaths that may take many hours to die. A recent article stated:

The (first drug mix) turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients — and up to 31 hours in one case.

The assisted suicide lobby is working on their third experimental lethal cocktail. Assisted suicide is not guaranteed to cause a "peaceful or painless death."

Our greatest concern is the New York assisted suicide bill. Governor Cuomo stated that he will sign an assisted suicide bill into law.

New York Assembly Bill A2694 and Senate Bill S3947 where introduced as the Medical Aid in Dying Act.

As Margaret Dore, the President of Choice is an Illusion stated in her article: New York: Reject Medical Aid in Dying Act:

“Aid in Dying” is a euphemism for euthanasia.[3] The Act, however, purports to prohibit euthanasia. On close examination, this prohibition will be unenforceable.

If enacted, the Act will apply to people with years or decades to live. It will also facilitate financial exploitation, especially in the inheritance context. Don’t render yourself or someone you care about a sitting duck to heirs and other predators. I urge you to reject the proposed Act.

Assisted suicide is an act whereby one person (usually a physician) provides a prescription for a lethal drug cocktail knowing that the other person intends to use it for suicide.

Euthanasia is an act whereby one person (usually a physician) lethally injects another person, usually after a request.

Several of the assisted suicide bills have language that can be interpreted to permit euthanasia.

Assisted suicide bills are usually designed as an application process for obtaining a lethal dose.

For instance the Maryland assisted suicide bill HB 0643 may permit euthanasia (homicide) because it doesn't require the person to self-administer. The Maryland bill doesn't protect the conscience rights of medical professionals either.

The Massachusetts assisted suicide bill can also be interpreted to permit euthanasia.

The New Hampshire assisted suicide bill gives physicians the right to write a lethal prescription but the term self ingest is not found in the main text of the bill. Only within the life insurance section is there a statement that may be construed as limiting the act to assisted suicide where it states:

Neither shall a qualified patient’s act of ingesting medication to end such patient’s life in a humane and dignified manner have an effect upon a life, health, or accident insurance or annuity policy.

Even this statement does not refer to self-ingestion.

The New Hampshire bill permits euthanasia by giving a physician the right in law to write a lethal drug prescription, but it does not limit how the lethal drugs can be used.

New Hampshire assisted suicide bill will create a perfect crime (Link).

Assisted suicide bills are intentionally written in a deceptive manner, so that if legalized, the legislation can be interpreted in a wider manner. Further to that, the assisted suicide lobby has no intention of maintaining the "safeguards" in the bills. These "safeguards" are simply mean't to sell assisted suicide to the legislators.

Hawaii is debating the expansion of its assisted suicide law only one year after it came into effect, and Washington State is examining all of the safeguards, while Oregon expanded its assisted suicide law last year.

Clearly assisted suicide bills are not what they appear to be.

Hawaii: 27 people died by assisted suicide in 2019.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Brittany Lyle that was published in the Honolulu Civil Beat on January 9, 2020 stated that in 2019 Hawaii had 27 assisted suicide deaths.

The article focuses on the assisted suicide lobby wanting to remove restrictions in the assisted suicide law. For instance the article suggests that Hawaii needs to amend the assisted suicide law to allow doctors to waive the waiting period. In 2019, Oregon expanded its assisted suicide law by allowing the waiting period to be waived.

The article also suggests that Hawaii needs to remove the mandatory mental health competency exam in the law.

It is significant that no doctors in Maui are willing to prescribe the assisted suicide drug cocktail. Most doctors oppose assisted suicide.

This media article was overwhelmingly pro-assisted suicide. The assisted suicide lobby is pushing to expand the Hawaii assisted suicide law, even though the law only came into effect one year ago.

Last January the leader of one of the assisted suicide lobby groups stated that it was there goal to eliminate the regulations in the assisted suicide laws in America.

Hawaii assisted suicide law came into effect.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Hawaii's assisted suicide law came into effect on January 1. According to the Associated Press very few doctors and pharmacies are willing to prescribe or dispense lethal drugs.

• Hawaii assisted suicide bill passes (March 1, 2018)

Melinda Ashton, the chief quality officer for Hawaii Pacific Health, one of the state's largest healthcare providers, told the Associated Press:

“There are a number of health care providers, nurses and others who are really uncomfortable about this, so asking anybody to participate as a patient ends their life is a really tough thing,” 

“The most recent barrier does seem to be we haven’t yet located a pharmacy willing to provide the medication.”

The Euthanasia Prevention Coalition promotes a model of caring for people, never killing.

Hawaii assisted suicide bill passes in two house committees,

Committee member complains that he never saw the amended text.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I have very bad news.  On February 28, the Judiciary Committee voted (7 - 1) and the Health and Human Services Committee voted (4 - 1) in support of Hawaii assisted suicide bill HB 2739.

• Not Dead Yet Testomony against Hawaii assisted suicide bill.

Nathan Eagle reporting for the Honolulu Civil Beat stated that Representative Bob McDermott, who voted No to the bill, was upset that he was expected to vote on the bill even though he was not given a copy of the amended bill. Eagle reported:

“I don’t know what we’re voting on,” he said as Nishimoto called for the vote.

Nishimoto said that given the time constraints, working on changes to the bill up until 15 minutes before the hearing started, he did not have an opportunity to give McDermott a copy.

“Pass it then read it,” a member of the public shouted out sarcastically.

They claim that the bill has greater "safeguards." Eagle reported:

Hawaii would be the first state to require counseling, Mizuno said. He added that the tele-health provision would help make it easier for residents in Hawaii to comply with the counseling requirement, recognizing that some live in rural areas far from doctors. 

The committees also lengthened the time the patient must wait between making two verbal requests for medically assisted death. Instead of 14 days, the amended version now calls for 20 days. One signed written request, witnessed by two people (one unrelated to the patient), is also required.

In 2017, the Hawaii Health Committee defeated assisted suicide bill SB 1129 (7 - 0), after the Committee members read the bill. Margaret Dore, from Choice is an Illusion, explained how the bill was a big fat fib.

Not Dead Yet Testimony Opposing Hawaii Assisted Suicide Bill

This article was published by Not Dead Yet on February 27, 2018

Testimony Of Diane Coleman, JD, President/CEO of NOT DEAD YET

Opposing Hawaii Assisted Suicide Bill HB 2739

Judiciary and Health and Human Services Committees

Submitted February 26, 2018

Diane Coleman

I am a severely disabled woman, and head up the national disability group, Not Dead Yet, which has members in Hawaii. I’ve spent a lifetime advocating for the rights of disabled people, young and old, to control our own lives and not have our choices dictated by doctors and other professionals. So you might wonder why I oppose a bill that is widely portrayed as giving people choice and control over their own death.

But who actually has choice and control under assisted suicide laws? Anyone could ask their doctor for assisted suicide, but the law gives the authority to doctors to determine who is eligible. More importantly, the purported “safeguards” to prevent mistake, coercion and abuse are empty window dressing, with little substance or effect.

One of the most frequently repeated claims by proponents of assisted suicide laws is that there is “no evidence or data” to support any claim that these laws are subject to abuse, and that there has not been “a single documented case of abuse or misuse” in Oregon during the 18 reported years. These claims are demonstrably false.

Regarding documented cases, please refer to a compilation of individual cases and source materials pulled together by the Disability Rights Education and Defense Fund entitled Oregon and Washington State Abuses and Complications.[1] For an in-depth analysis of several cases by Dr. Herbert Hendin and Dr. Kathleen Foley, please read Physician-Assisted Suicide in Oregon: A Medical Perspective.[2]

Moreover, revisions to last year’s bill in the 2018 bill do nothing to address the fundamental deficiencies identified below.

The focus of the discussion below is the Oregon Health Division data.[3] These reports are based on forms filed with the state by the physicians who prescribe lethal doses and the pharmacies that dispense the drugs. As the early state reports admitted:

“As best we could determine, all participating physicians complied with the provisions of the Act. . . . Under reporting and noncompliance is thus difficult to assess because of possible repercussions for noncompliant physicians reporting to the division.”

Further emphasizing the serious limits on state oversight under the assisted suicide law, Oregon authorities also issued a release in 2005 clarifying that they have No authority to investigate Death with Dignity case.[4]

Nevertheless, contrary to popular belief and despite these extreme limitations, the Oregon state reports substantiate some of the problems and concerns raised by opponents of assisted suicide bills.

Non-Terminal Disabled Individuals Are Receiving Lethal Prescriptions In Oregon

The Oregon Health Division assisted suicide reports show that non-terminal people receive lethal prescriptions every year except the first.

The prescribing physicians’ reports to the state include the time between the request for assisted suicide and death for each person. However, the online state reports do not reveal how many people outlived the 180-day prediction. Instead, the reports give that year’s median and range of the number of days between the request for a lethal prescription and death. This is on page 11 of the 2017 annual report.[5] In 2017, at least one person lived 603 days; across all years, the longest reported duration between the request for assisted suicide and death was 1009 days. In every year except the first year, the reported upper range is significantly longer than 180 days.

The definition of “terminal” in the statute only requires that the doctor predict that the person will die within six months. There is no requirement that the doctor consider the likely impact of medical treatment in terms of survival, since people have the right to refuse treatment. Unfortunately, while terminal predictions of some conditions, such as some cancers, are fairly well established, this is far less true six months out, as the bill provides, rather than one or two months before death, and is even less true for other diseases. Add the fact that many conditions will or may become terminal if certain medications or routine treatments are discontinued – e.g. insulin, blood thinners, pacemaker, CPAP – and “terminal” becomes a very murky concept. Recent published emails from the Oregon Public Health Department have confirmed that a person who becomes terminal because they do not receive treatment for any reason, including lack of insurance coverage, would qualify for assisted suicide under the Oregon law.[6]

The state reports that non-cancer conditions found eligible for assisted suicide has grown over the years, to include: neurological disease, respiratory disease, heart/circulatory disease, infectious disease, gastrointestinal disease, endocrine/metabolic disease and, in the category labeled “other”, arthritis, arteritis, sclerosis, stenosis, kidney failure, and musculoskeletal systems disorders (pages 10-11).

In addition, it should be noted that the attending physician who determines terminal status and prescribes lethal drugs is not required to be an expert in the disease condition involved, nor is there any information about physician specialties in the state reports.

The Only Certifiers of Non-Coercion And Capability Need Not Know the Person

Four people are required to certify that the person is not being coerced to sign the assisted suicide request form, and appears capable: the prescribing doctor, second-opinion doctor, and two witnesses.

In most cases over the years, the prescribing doctor is a doctor referred by assisted suicide proponent organizations. (See, M. Golden, Why Assisted Suicide Must Not Be Legalized,[7] section on “Doctor Shopping” and related citations). The Oregon state reports say that the median duration of the physician patient relationship was 10 weeks in 2017, and 13 weeks over all years (page 11). Thus, lack of coercion is not usually determined by a physician with a longstanding relationship with the patient. This is significant in light of well-documented elder abuse-identification and reporting problems among professionals in a society where an estimated one in ten elders is abused, mostly by family and caregivers. (Lachs, et al., New England Journal of Medicine, Elder Abuse.[8])

The witnesses on the request form[9] need not know the person either. One of them may be an heir (which would not be acceptable for witnessing a property will), but neither of them need actually know the person (the form says that if the person is not known to the witness, then the witness can confirm identity by checking the person’s ID).

So neither doctors nor witnesses need know the person well enough to certify that they are not being coerced.

No Evidence of Consent or Self-Administration At Time of Death

In about half the reported cases, the Oregon Health Division reports also state that no health care provider was present at the time of ingestion of the lethal drugs or at the time of death. Footnote six clarifies:

“A procedure revision was made mid‐year in 2010 to standardize reporting on the follow‐up questionnaire. The new procedure accepts information about time of death and circumstances surrounding death only when the physician or another health care provider is present at the time of death. This resulted in a larger number of unknowns beginning in 2010.”

While the only specific example mentioned is the “time of death,” other “circumstances surrounding death” include whether the lethal dose was self-administered and consensual at the time of death. Therefore, although “self administration” is touted as one of the key “safeguards”, in about half the cases, there is no evidence of consent or self-administration at the time of ingestion of the lethal drugs. If the drugs were, in some cases, administered by others without consent, no one would know. The request form constitutes a virtual blanket of legal immunity covering all participants in the process.

Moreover, the addition of a form that is supposed to be signed by the patient, with no witness, within 48 hours of the administration of the lethal drugs does not add meaningful protection from involuntary administration by another person in the absence of an independent witness to the act. This form is just another bit of window dressing.

Pain Is Not the Issue, Unaddressed Disability Concerns Are

The top five reasons doctors give for their patients’ assisted suicide requests are not pain or fear of future pain, but psychological issues that are all-too-familiar to the disability community: “loss of autonomy” (91%), “less able to engage in activities” (90%), “loss of dignity” (76%), “losing control of bodily functions” (46%), and “burden on others” (44%) (page 10).

These reasons for requesting assisted suicide pertain to disability and indicate that over 90% of the reported individuals, possibly as many as 100%, are disabled.

Three of these reasons (loss of autonomy, loss of dignity, feelings of being a burden) could be addressed by consumer-directed in-home long-term care services, but no disclosures about or provision of such services is required. Some of the reported reasons are clearly psycho-social and could be addressed by disability-competent professional and peer counselors, but this is not required either. Moreover, only 4.9% of patients who request assisted suicide were referred for a psychiatric or psychological evaluation, despite studies showing the prevalence of depression in such patients.

Basically, the law operates as though the reasons don’t matter, and nothing need be done to address them.

Conclusion

The Oregon assisted suicide data demonstrates that people who were not actually terminal received lethal prescriptions in all 20 reported years except the first, and that there is little or no substantive protection against coercion and abuse. Moreover, reasons for requesting assisted suicide that sound like a “cry for help” with disability-related concerns are apparently ignored. Thus, the data substantiates problems with the implementation of assisted suicide laws and validates the concern that the risks of mistake, coercion and abuse are too great. Well-informed legislators on both sides of the aisle should vote against assisted suicide bill.

Please vote NO on HB 2739.

[1] https://dredf.org/wp-content/uploads/2015/04/Revised-OR-WA-Abuses.pdf

[2] https://dredf.org/wp-content/uploads/2012/08/Hendin-Foley-Michigan-Law-Review.pdf

[3]http://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year20.pdf

[4] https://dredf.org/wp-content/uploads/2012/08/Oregon-DHS.pdf

[5]http://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year20.pdf

[6] https://www.washingtontimes.com/news/2018/jan/11/diabetics-eligible-physician-assisted-suicide-oreg/

[7] https://dredf.org/public-policy/assisted-suicide/why-assisted-suicide-must-not-be-legalized/

[8] http://www.nejm.org/doi/full/10.1056/NEJMra1404688

[9]http://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/pt-req.pdf