New Hampshire Death With Dignity Act Will Create a Perfect Crime

Media Release: Concord, New Hampshire, USA

Dore: “Persons assisting a suicide or euthanasia can have an agenda to benefit themselves. More obvious reasons include inheritance money and life insurance.”

“The Act will apply to people with years or decades to live.”

Contact: Margaret Dore, Esq.
margaretdore@margaretdore.com
(206) 697-1217

Margaret Dore

Attorney Margaret Dore, president of Choice is an Illusion, which has fought against assisted suicide and euthanasia legalization efforts in many states, made the following statement in connection with a bill seeking to legalize these practices in New Hampshire. (HB 1659). 

Wednesday, 02/12/20, 1:00 P.M., SH Rm Reps Hall, House Judiciary.

“The proposed Death With Dignity Act seeks to legalize assisted suicide and euthanasia as those terms are traditionally defined,” said Dore. “If passed into law, the Act will apply to people with years or decades to live.”

Dore explained, 

“The Act is based on a similar law in Oregon, applying to people with a terminal disease expected to cause death within six months. In practice, such predictions are often wrong. This is due to actual mistakes and the fact that predicting life expectancy is not an exact science."

“Perhaps more importantly," said Dore, "the six months to live is determined without treatment. Consider Jeanette Hall, who was diagnosed with cancer in 2000. She made a settled decision to use Oregon’s law, but her doctor convinced her to be treated for cancer instead. Today, nineteen years later, she is thrilled to be alive.”

Dore said, 

“Persons assisting a suicide or euthanasia can have an agenda to benefit themselves. More obvious reasons include inheritance money and life insurance.”

“Medical professionals too can have an agenda,” said Dore. “Michael Swango, MD, now incarcerated, got a thrill from killing his patients. Consider also Harold Shipman, a doctor in the UK, who not only killed his patients, but stole from them and in one case made himself a beneficiary of the patient’s will.”

Dore said, 

“People who sign up for the lethal dose do not necessarily intend to take it. Sometimes they make the request at the suggestion of a doctor or family member, ‘just in case' they want to use it.’”

“Once the lethal dose is in the home, there is a complete lack of oversight,” said Dore. “No witness, not even a doctor, is required to be present at the death. If the patient objected or even struggled against administration, who would know?”

Dore said, 

“The death certificate will report a natural death, which will create a legal cover up and also allow a perpetrator to inherit. More to the point, the Act will create a perfect crime.”

“Consider also a 2005 article in the UK’s Guardian newspaper regarding a public inquiry of Dr. Shipman’s conduct,” said Dore. “The inquiry determined that he ‘killed at least 250 of his patients over 23 years.’ The inquiry also found ‘that by issuing death certificates stating natural causes, the serial killer [Shipman] was able to evade investigation by coroners.’”

Dore continued, 

“According to a subsequent article in 2015, proposed reforms included having a medical examiner review death certificates to improve patient safety. Instead, the proposed Act moves in the opposite direction to require a legal cover up as a matter of law.”

Dore concluded, 

“If the New Hampshire Act becomes law, there will be new paths of lethal abuse and exploitation, especially for older people with money, meaning the middle class and above. They will be sitting ducks to their heirs and other predators. Even if you like the concept of assisted suicide and euthanasia, the proposed Act is a recipe for abuse, exploitation and legal murder.”

-00-

"Do or Refer" Doctors Are Not Allowed to Use Their Best Judgment for Individual Patients (No More Jeanette Halls)

This article was published by Choice is an Illusion on July 16, 2019

Margaret Dore

Margaret Dore Esq., MBA*

Yesterday, a doctor asked me about "do or refer" provisions in some of the newer bills seeking to legalize assisted suicide in the United States. For this reason, I now address the subject in the context of a 2018 Wisconsin bill, which did not pass.

The bill, AB 216, required the patient's attending physician to "fulfill the request for medication or refer," i.e. to write a lethal prescription for the purpose of killing the patient, or to make an effective referral to another physician, who would do it.

The bill also said that the attending physician's failure to comply would be "unprofessional conduct" such that the physician would be subject to discipline. The bill states:

[F]ailure of an attending physician to fulfill a request for medication [the lethal dose] constitutes unprofessional conduct if the attending physician refuses or fails to make a good faith attempt to transfer the requester's care and treatment to another physician who will act as attending physician under this chapter and fulfill the request for medication. (Emphasis added).[1]

The significance of do or refer is that it's anti-patient, by not allowing doctors to use their best judgment in individual cases.

Jeanette Hall with her son.

Consider Oregonian Jeanette Hall. In 2000, she made a settled decision to use Oregon's assisted suicide law in lieu of being treated for cancer. Her doctor, Kenneth Stevens, who opposed assisted suicide, thought that her chances with treatment were good. Over several weeks, he stalled her request for assisted suicide and finally convinced her to be treated for cancer.

Yes, Dr Stevens was against assisted suicide generally, but he also thought that Jeanette was a good candidate for treatment and indeed she was. She has been cancer free for 19 years. In a recent article, Jeanette states:

I wanted to do our law and I wanted Dr. Stevens to help me. Instead, he encouraged me to not give up and ultimately I decided to fight the cancer. I had both chemotherapy and radiation. I am so happy to be alive!

If "do or refer," as proposed in the Wisconsin bill, had been in effect in Oregon, Dr. Stevens would have been risking a finding of unprofessional conduct, and therefore his license, to help Jeanette understand what her true options were.

Is this what we want for our doctors, to have them be afraid of giving us their best judgment, for fear of sanction or having their licenses restricted or even revoked?

With proposed mandatory "do or refer," assisted suicide proponents show us their true nature. They don't want to enhance our choices, they want to limit our access to information to railroad us to death.
______

[1] AB 216 states:

156.21 Duties and immunities. (1) No health care facility or health care provider may be charged with a crime, held civilly liable, or charged with unprofessional conduct for any of the following: 

(a) Failing to fulfill a request for medication, except that failure of an attending physician to fulfill a request for medication constitutes unprofessional conduct if the attending physician refuses or fails to make a good faith attempt to transfer the requester's care and treatment to another physician who will act as attending physician under this chapter and fulfill the request for medication. (Emphasis added).

* Margaret Dore is an attorney in Washington State where assisted suicide is legal. She is also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia worldwide.

Fabian Stahle: A letter from Sweden to Maryland Senators concerning assisted suicide.

Dear Senator,
 

Maryland Senate.

I write to you from Sweden regarding HB 399 and SB 311 because these bills are similar to the Oregon law that is proposed here in Sweden. After contact with Oregon Health Authority I found disturbing information that was not available before and is highly relevant for HB 399 and SB 311 (below referred to as the ”Bills”).

In this letter I would like to draw your attention to a dangerous passage in the Bills regarding the eligibility criteria that the patient shall be diagnosed with a ”terminal illness” that will result in death within 6 months.

Regarding how this 6 months criteria must be interpreted, I have crucial information revealed from a correspondence I had with the Oregon Health Authority (OHA) in the end of 2017. I believe this information is very significant as the Bills definition of "terminal illness" is almost identical with the Oregon definition.

In my correspondence the OHA acknowledged – for the first time officially - that they always had interpreted the 6 months criteria as ”without administration of life-sustaining treatment”, A3 and A8 in the correspondence (Link to the correspondence).

See also my comments (Link to the comments).

This interpretation is counter-intuitive because most people would take for granted that the meaning of ”terminal illness” is a disease for which there is no treatment or medication, i.e. that all hope is gone. But the interpretation is logically inevitable also for the Bills - and
the implications are far reaching.

As a patient has the right to refuse to receive treatment, any patient having a disease that potentially may develop into a terminal condition can make themselves eligible for assisted death – 'for any reason whatsoever'. Hence a trap-door for suicidal patients is imbedded in the Bills.

This is unavoidable because the patient's autonomy ensures that it must be the patient himself who has to decide when enough is enough.

For those who believe in the basic idea of these Bills, it is obviously unreasonable to request that, for example, a cancer patient who is exhausted by radiation and several unsuccessful chemotherapy treatments should be forced to undergo additional painful treatments with dubious results to gain access to assisted death.
But where should we draw the line? Isn’t it also obviously unreasonable that a patient who has very good prospects to be cured can get assisted death by refusing treatment? Shouldn’t we require that a cancer patient accept at least one treatment before talking about assisted death – or at least to account for reasonable motives for their wish to die? Or what about a young diabetic who, in the despair of a broken relationship, wants to die and stops insulin so as to be able to obtain legal suicide assistance - shouldn't we regard that as unacceptable and ask for some sort of limitation?

However, all such attempts to conditions intrude on patient autonomy – the very autonomy the Bills are intended to expand, not decrease – and leads to insoluble demarcation problems. The Oregon Health Authority has also come to this conclusion. (Link to the conclusion). (A4 and A5).

So in the face of these two contradictory positions the Bills must surrender to the patient's autonomy - just as all other laws like the one in Oregon already have.

As a result the obvious interpretation of the central concepts of “terminal” does not apply – but is left open to the patient's own decision, and hence the door is also opened to pure absurdities as to which people can be legally killed:

A cancer patient who has very good prospects to be cured, but denies treatment. An important reason is that she does not want to lose her hair. We are now in Oregon a while after their law for physician-assisted suicide came into force and the patient in question is Jeanette Hall. Her physician, Dr. Stevens is opposed to the law but was forced to acknowledge that his patient would be eligible to get the death pills she wanted because her cancer was likely to lead to death within 6 months if she was not treated. He managed however to convince her to take treatment and many years later Ms. Hall said: "It is great to be alive."

But nor all doctors are like Dr. Stevens.
Dr. Charles Blanke, an oncologist with Oregon Health and Science University, told The Bulletin about one of his cases, a young patient with Hodgkin lymphoma with a more than 90 percent chance of survival with treatment. She did not believe in chemotherapy and feared its toxicity, despite Blanke’s efforts to convince her otherwise. After cleared by a psychiatrist Blanke approved her for assisted death, holding firm to his belief that doctors should not force patients to receive treatment. But afterwards Blanke asked himself:

“Why doesn’t that patient want to take relatively non-toxic treatment and live for another seven decades?”

The answer to Dr. Blanke’s question is just as simple as disturbing in the context of medical killing:

It is because a law that encourages sick people to commit suicide - by the obvious reason that for a suicidal person a socially accepted and smooth death administered by society is much more attractive than dying on one's own in loneliness, just as the young suicidal Belgian woman testifies in this video (Link to the video).

For any reason whatsoever.
 
A person could, as Dr. Blanke’s cases, fear the possibility of side effects or future disabilities. But it could also be a parallel life crisis that is indirectly linked to the disease. And what about those patients who cannot pay for a potentially effective treatment? These Bills allow and encourage people that are not necessarily dying to commit suicide.

These Bills allows and encourages people that are not necessarily dying to commit suicide. Please reject these dangerous Bills!

Sincerely
Fabian Stahle, Sweden

Oregon woman changed her mind on assisted suicide after her doctor helped her find a reason to live.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Dr Ken Stevens

Dr Kenneth Stevens is a physician in Oregon who helped his patient find a reason to live. 

The patient that I specifically recall is a patient by the name of Jeanette Hall. She was referred to me by her surgeon. She had a low rectal cancer.

So when I saw her I told her what she had, I told her we could treat it with radiation and chemotherapy and said that this is potentially treatable.

She said I don't want to go through all that. I had an Aunt who lost her hair and I don't want to lose my hair.

She went back and saw the surgeon. The surgeon told her that if she wasn't treated that she would be dead within 6 months or a year.

The Oregon law says that if life expectancy is 6 months you qualify for the law so I could have written her a prescription for the lethal medication at that time.

She came back and I talked with her again and she said: why aren't you giving me the pills? I want the pills.

I learned more about her. I learned that she had a son who was going to the police academy. I said:  

Wouldn't you like to see him graduate? That really made her think that I really have something to live for.

Jeanette Hall with her son.

She really struggled in her mind as to whether she was going to be treated or not treated. She finally accepted the treatment, it took a few weeks to give, it was not easy, she actually did lose her hair and her hair grew back and she was able to attend her son's graduation from the police academy.

Five years later, my wife and I were at a restaurant and she was there with a friend and she came over and she said:

Doctor Stevens, you saved my life. If I had gone to a doctor that believed in assisted suicide I would not be here. I'd be dead.

The film clip is from the Fatal Flaws film. 
The Fatal Flaws film can be purchased or rented at: (Link).

• The assisted suicide bill was aimed at people like my husband.

• Fatal Flaws film will change the way you view assisted death.

Quick Facts About New York State Euthanasia Bills

This article was originally published by Choice is an Illusion on June 6, 2018

By Margaret Dore, Esq., MBA
For a pdf version, click here.

1. Euthanasia & Assisted Suicide

The bills, A. 2383-A & S. 3151-A, are titled “Medical Aid in Dying.” This is a traditional euphemism for active euthanasia and physician assisted suicide. The bills seek to legalize these practices.

2. Definitions (Traditional)

“Assisted suicide” occurs when a person provides the means or information for another person to commit suicide, for example, by providing a rope or lethal drug. If the assisting person is a physician, a more precise term is “physician-assisted suicide.” 

“Euthanasia” is the direct administration of a lethal agent to cause another person’s death. Euthanasia is also known as mercy killing.

3. Oregon and Washington State

The bills are based on similar laws in Oregon and Washington State.

4. Assisting Persons Can Have an Agenda

Persons assisting a euthanasia or suicide can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton, in Oregon. Two days after his death by assisted suicide, she signed documents to sell his home. The property sold for $200,000, which she deposited into accounts for her own benefit.

In other states, reported motives for assisting suicide include: the “thrill” of getting other people to kill themselves; and “wanting to see someone die.”

Doctors too can have an agenda, for example, to hide malpractice or to obtain an inheritance or other financial gain. An example is Harold Shipman, a doctor in the UK, who directly killed his patients (euthanasia) and also stole from them. One patient, he put himself in her will.

5. Other States Push Back

Last month, a judge overturned California’s law allowing assisted suicide and euthanasia as unconstitutional. This year, Utah passed a bill clarifying that assisted suicide is a crime. Last year, Alabama passed a bill banning assisted suicide. Two years ago, the New Mexico Supreme Court overturned assisted suicide: Physician-assisted suicide is no longer legal in New Mexico.

6. The Bills Will Apply to People With Years or Decades to Live

The bills apply to an adult with a terminal illness or condition predicted to have less than six months to live. In Oregon and Washington State, nearly identical criteria are interpreted to mean “without treatment,” so that people with chronic conditions, such as diabetes, are terminal and eligible for assisted suicide and euthanasia. More to the point, a healthy 20 year old with insulin dependent diabetes is “terminal” for the purpose of Oregon’s law.

This is significant because statutes adopted from other jurisdictions are presumed to carry the construction given by the other jurisdictions. Here, the proposed bills will be presumed to carry the same construction as Oregon and Washington State. The bills will apply to people with chronic conditions who have years or decades to live.

“Eligible” persons will also have years or decades to live because treatment can lead to recovery. Consider Jeanette Hall of Oregon, who, in 2000, had terminal cancer and made a settled decision to use Oregon’s law. Her doctor convinced her to be treated instead. Today, eighteen years later, she is cancer free and thrilled to be alive.

7. The Bills Will Create a Perfect Crime

The bills allow a patient's heir, who will financially benefit from the patient’s death, to actively participate in signing the patient up for the lethal dose. After that, no doctor, not even a witness, is required to be present at the death. If the patient objected or even struggled, who would know?

The bills say that actions taken in accordance with the bills shall not be construed for any purpose to constitute assisted suicide or euthanasia, and that in the case of self-administration, the cause of death on the death certificate will be the underlying terminal illness or condition.

In Washington State, death certificate instructions interpreting similar language require the death certificate to list a natural death as long as Washington’s statute was “used” (not complied with). This is significant given that the proposed bills will be presumed to carry the Washington State construction. A further significance is that the death will be “natural” (not homicide) as a matter of law so that the bills will allow legal murder. The bills will create a perfect crime.

For back up documentation, see Margaret Dore’s memo and appendix dated June 1, 2018,
available at: (Link) and (Link).

Mary Kills People is a dangerous and irresponsible show that should be terminated.

Nancy Elliott

By Nancy Elliott

Chair – Euthanasia Prevention Coalition - USA

A recent article written by Lindsay Kornick, entitled “Euthanasia Drama Claims Death Can ‘Be a party’” gets it right. It seems that the series “Mary Kills People” is at it again. As she and her accomplice go around killing people, they try to candy coat it for their victims. The latest one is a sick man that instead of encouraging him to fight his disease, she tells him death is a party. First everyone knows that you do not encourage a suicidal person. Second as a doctor she should know that a person fighting a disease needs encouragement and not a kick to the pavement. Additionally, Mary acknowledges that the treatment is working. This is one of the main reasons that legalizing assisted suicide and euthanasia is so detrimental to the health care of us all. Once doctors start killing their patients as a treatment for disease they no longer will work to cure people. This time is valuable to the individual. Yet Mary and those who subscribe to her thinking are OK with pushing people under the bus.

• Mary Kills People promotes euthanasia.

Let’s go back to the flippant comment used to push her death agenda, Death can be a Party. This is not an original thought. The pro death groups have been having death parties for some time. I heard of one in Oregon, where the friends and family of the soon to be departed, gathered to urge him on. The alcohol flowed making it hard for the victim to back down. There was another one where a woman allegedly danced all night at her death party and then encouraged by those around her took the poison, and let’s not forget the California woman who had the full weekend death party ending with someone helping her drink the poison. These are stories that are used to glamorize death by suicide. But is it really glamorous to commit suicide. No it is not. 

Jeanette Hall

The targets for assisted suicide and euthanasia are the sick, elderly and people with disabilities. It is a discriminatory policy that has a special carve out to kill certain people that society thinks are less important. And just like the man that was winning with his chemotherapy, they are not necessarily dying. In Oregon, a young otherwise healthy diabetic qualifies for legal assisted suicide if he refuses insulin. How many others people who are on meds become terminal if they cease their medication and what about all the treatable cancers and other diseases. People could be throwing away years and even decades. Jeanette Hall in Oregon, where assisted suicide is legal was diagnosed with cancer and given 6 months to a year to live. She wanted to use the act to have her life ended. Her doctor talked her into treatment instead and she was cured. Now 17 years later she is happy to be alive.

Doctors who kill their patients instead of treating them, encouraging them and showing them true compassion when they are in need, are lazy, incompetent, murderers, lacking in human empathy or compassion and deserve jail time. I would not want to go to a doctor who ends their patients life as I would not think my life is safe in their hands. And what about Hollywood and more of their usual garbage glamorizing doctors that kill their patients, they are no better than the Nazi’s in Germany who produced films to soften the public to accept euthanasia, and we all know how well that turned out. 

Mary Kills People is a dangerous and irresponsible show that should be terminated.

Nancy Elliott
Chair – Euthanasia Prevention Coalition - USA

Wisconsin Prescribe or refer: Proponents of assisted suicide show their true nature.

This article was published by Choice is an Illusion on February 7, 2018

Margaret Dore

By Margaret Dore Esq., MBA

The Wisconsin bill seeking to legalize assisted suicide and euthanasia includes a provision requiring doctors to "prescribe or refer," i.e., to perform a requested assisted suicide or euthanasia, or to make an effective referral to another doctor, who will do it. 

The bill, AB 216, also says that the attending physician's failure to comply is "unprofessional conduct" such that the physician would be subject to discipline. The bill states:

[F]ailure of an attending physician to fulfill a request for medication [the lethal dose] constitutes unprofessional conduct if the attending physician refuses or fails to make a good faith attempt to transfer the requester's care and treatment to another physician who will act as attending physician under this chapter and fulfill the request for medication. (Emphasis added).*

A significance of prescribe or refer is that it's anti-patient, by not allowing doctors to use their best judgment for individual patients.

Think of Oregonian Jeanette Hall. In 2000, she made a settled decision to use Oregon's assisted suicide law in lieu of being treated for cancer. Her doctor, Kenneth Stevens, who personally opposed assisted suicide, thought that her chances with treatment were good. He stalled her request for assisted suicide and finally convinced her to be treated for cancer.

Dr Stevens with Jeanette Hall

Yes, Dr Stevens was against assisted suicide, but he also thought that Jeanette was a great candidate for treatment, and indeed she was. She has been cancer free for 17 years. In a article from last year, Jeanette states: 

I wanted to do our law and I wanted Dr. Stevens to help me. Instead, he encouraged me to not give up and ultimately I decided to fight the cancer. I had both chemotherapy and radiation. I am so happy to be alive!

With "prescribe or refer," Dr Stevens would have been risking his license or even his livelihood to help Jeanette understand what her true options were.

Is this what we want for doctors, to have them be afraid of giving us their best judgment, for fear of losing their jobs?

This is a particularly sensitive issue for me because it happened to me, but in another context.

When I was in law school, I went to an optometrist who knew what was wrong with my eyes and also where to refer me for treatment with another optometrist. He didn't refer me because he worked for ophthalmologists and had been disciplined for giving a similar referral.

I spent the next six months of my life on a wild goose chase trying to find someone to help me so that I could get back to school. I finally found an optometrist, but with the delay, I had further damaged my eyes. I graduated two years late.

As for assisted suicide, the proposed bill is promoted as safe, in part because it requires a second doctor to review each case.

But what is the purpose of the second doctor, if he or she can only say "yes." (Do or refer)

With "do or refer," assisted suicide proponents show us their true nature. They don't want to give us choice, they want to railroad us to death.

I hope that Wisconsin will reject the proposed assisted suicide bill.

• Massachusetts assisted suicide bill may force doctors to refer for assisted suicide.

Margaret Dore is an attorney in Washington State where assisted suicide is legal. She is also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia worldwide. See www.choiceillusion.org and www.margaretdore.org  

Patient's recovery convinces doctor to fight euthanasia laws.

This article was published by The Australian on November 11, 2017, link, for pdf, link.

By Cameron Stewart

Dr. Kenneth Stevens

When American doctor Kenneth Stevens heard about Victoria’s plan to introduce assisted dying for the terminally ill he couldn’t help but recall the story of his patient Jeanette Hall.

Hall, then 55, came to Stevens in 2000 after being diagnosed with inoperable colon cancer in Portland, Oregon, a state that in 1997 introduced laws enabling doctors to prescribe fatal pills to the terminally ill. She walked into Stevens’ office and told him she wanted to die, but Stevens, a cancer specialist, disputed the diagnosis of her original doctor.

“I told her that I believed this was potentially curable but she said ‘Dr. Stevens, you don’t understand, I voted for the law and I don’t want to go through all the treatment, I don’t want to lose my hair, I don’t want to go through all that’,’’ Stevens says.

The specialist delayed her ­request to write a prescription for the fatal drugs and instead tried to talk her out of it.

Jeanette Hall

“I learned she had a son who is in the police academy and I said, ‘wouldn’t you like to see him graduate, wouldn’t you like to see him get married’ and eventually she realized she really did have something to live for,” Stevens says.

Hall, a bookkeeper and a single mother, agreed to have radiotherapy and chemotherapy. Within months, Stevens says her tumor “just melted away.” “She’s still alive 17 years later with no evidence of any recurrence of the cancer and one of her favourite phrases is ‘it’s great to be alive’,” he says.

Hall’s unusual story turned Stevens from being merely an opponent of assisted suicide into an activist against it. A professor emeritus and a former chair of the Department of Radiation Oncology at the Oregon Health & Sciences University in Portland, he has treated thousands of patients with cancer.

He says he came to oppose assisted suicide from his observations as a doctor, rather than from any religious standpoint.

“Actually, my first wife died 35 years ago of cancer so I’ve seen it not only from the professional side but also from the family side,” he says. “I continue to be against because I don’t feel that is the role of a doctor to kill a patient or to order them to die.”

Hall, now 72, no longer wants to speak to the media about her story because of the attention it has garnered after it was co-opted by campaigners against assisted suicide.

But several years ago she wrote of her experience. “I did not want to suffer,” she wrote. “I wanted to do our law and I wanted Dr Stevens to help me. Instead, he encouraged me to not give up and ultimately I decided to fight the cancer. I had both chemotherapy and radiation. I am so happy to be alive.” “If Dr. Stevens had believed in assisted suicide, I would be dead. Assisted suicide should not be legal.”

When Stevens read about Victoria’s proposed assisted suicide laws he wrote to The Australian in a letter published this week.

“With the legalisation of assisted suicide, Oregon’s health plan has been empowered to offer patients suicide in lieu of treatments,’’ he wrote. “Don’t let legal assisted suicide come to Victoria.”

Victorian politicians say they have closely followed the Oregon model for the state’s voluntary assisted dying scheme, which will go before the upper house for a final vote next week.

The scheme’s authors say they were drawn to the Oregon model because after 20 years it was still regarded internationally as one of the most conservative schemes. 

Cameron Stewart is also US contributor for Sky News Australia.

Margaret Dore: Analysis Opposing Victoria Australia Euthanasia Bill

Margaret Dore

I. Introduction

I am an attorney in Washington State USA where assisted suicide is legal.[1] I am also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. Last year, I met with a parliamentary delegation from the Legal and Social Issues Committee, Parliament of Victoria, to discuss Oregon’s law and related issues.

Washington’s law is based on Oregon’s law. Both laws are similar to the proposed bill, titled the “Voluntary Assisted Dying Bill.” The bill, however, is not limited to voluntary deaths or to people near death. I urge you to reject this measure.

II. Definitions

Assisted suicide occurs when a person provides the means or information for another person to commit suicide, for example, by providing a gun or lethal drug. If the assisting person is a physician, a more precise term is “physician-assisted suicide.”[2]

“Euthanasia” is the direct administration of a lethal agent to cause another person’s death.[3] Euthanasia is also known as “mercy killing.”[4]

III. Assisting Persons Can Have An Agenda

Persons assisting a suicide can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton in Oregon. Two days after his death by assisted suicide, she sold his home and deposited the proceeds into bank accounts for her own benefit.[5]

In other US states, reported motives for assisting suicide include: the “thrill” of getting other people to kill themselves; a desire for sympathy and attention; and “want[ing] to see someone die.”[6]

Medical professionals too can have an agenda, for example, to hide malpractice. There is also the occasional doctor who just likes to kill people, for example, Michael Swango, now incarcerated.[7]

IV. Push-back Against Assisted Suicide

Several US states have strengthened their laws against assisted suicide. These states include Alabama, Arizona, Georgia, Idaho and Louisiana.[8]

Last year, the Supreme Court of the State of New Mexico overturned a decision recognizing physician aid in dying, meaning physician assisted suicide.[9] Physician-assisted suicide is no longer legal in the State of New Mexico.

V. Few States Allow Assisted Suicide

Oregon and Washington State legalized assisted suicide through ballot measures in 1997 and 2008, respectively. Since then, just three US states and the District of Columbia have passed similar laws.[10] In the fine print, these laws also allow euthanasia.

VI. How The Victoria Bill Works

The Victoria bill has an application process to obtain the lethal dose, which may be administered by the patient.[11]

In the case of administration by a patient, there is no required oversight.[12] No witness, not even a doctor, is required to be present at the death.[13]

VII. The Bill Applies To People With Years To Live

The bill applies to people with a “disease, illness or medical condition,” which is expected to cause death in less than twelve months.[14] Such persons may, in fact, have years to live. This is true for three reasons:

A. Treatment Can Lead to Recovery. 

In 2000, Jeanette Hall was diagnosed with cancer in Oregon and made a settled decision to use Oregon’s law.[15] Her doctor convinced her to be treated instead, which eliminated the cancer.[16] Her declaration states:

It has now been 17 years since my diagnosis. If [my doctor] had believed in assisted suicide, I would be dead.[17]

B. Predictions of Life Expectancy Can Be Wrong 

Eligible persons may also have years to live because predictions of life expectancy can be wrong. This is true due to actual mistakes (the test results got switched) and because predicting life expectancy is not an exact science.[18]

Consider John Norton, diagnosed with ALS at age 18.[19] He was told that he would get progressively worse (be paralyzed) and die in three to five years.[20] Instead, the disease progression stopped on its own.[21] In a 2012 affidavit, at age 74, he states:

If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.[22] 

C. If Victoria Follows Oregon, the Bill Will Apply to People With Insulin Dependent Diabetes

The bill applies to people expected to die in less than twelve months due to a “disease, illness or medical condition.”[23] Oregon’s law applies to people expected to die in less than six months due to a terminal disease.[24]

In practice, Oregon’s law is interpreted to include chronic conditions such as “diabetes mellitus,” better known as diabetes.[25] These conditions qualify for assisted suicide when there is dependence on medication, such as insulin, to live. Oregon doctor, William Toffler, explains:

[P]eople with chronic conditions are “terminal” [such that they qualify for assisted suicide] if without their medications, they have less than six months to live. This is significant when you consider that a typical insulin-dependent 20 year-old will live less than a month without insulin.[26]

Dr. Toffler adds:

Such persons, with insulin, are likely to have decades to live.[27]If Victoria enacts the proposed bill and follows Oregon practice, the bill will apply to people with insulin dependent diabetes. Such persons, with insulin, can have decades to live.

VIII. The Bill Applies To Older People

According to government statistics from Oregon and Washington State, most people who die under their laws are elders, aged 65 or older.[28] This demographic is already an especially at risk group for abuse and financial exploitation. This is true in both the US and Australia.

A. Elder Abuse and Financial Exploitation

Elder abuse and exploitation perpetrators are often family members.[29] They typically start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or to coercing victims to sign over deeds to their homes, to change their wills or to liquidate their assets.[30] Amy Mix, an elder law attorney in the US, explains why older people are especially vulnerable:

The elderly are at an at-risk group for a lot of reasons, including, but not limited to diminished capacity, isolation from family and other caregivers, lack of sophistication when it comes to purchasing property, financing, or using computers . . . .  

[D]efendants are family members, lots are friends, often people who befriend a senior through church . . . . We had a senior victim who had given her life savings away to some scammer who told her that she’d won the lottery and would have to pay the taxes ahead of time. . . . The scammer found the victim using information in her husband’s obituary.[31]

B. Elder Abuse and Financial Exploitation Are Sometimes Fatal

In some cases, elder abuse and financial exploitation are fatal. More notorious cases include California’s “black widow” murders, in which two women took out life insurance policies on homeless men.[32] Their first victim was 73 year old Paul Vados, whose death was staged to look like a hit and run accident.[33] The women collected $589,124.93.[34]

Consider also, People v. Stuart in which an adult child killed her mother with a pillow, allowing the child to inherit. The Court observed:

Financial considerations [are] an all too common motivation for killing someone.[35]

C. Victims Do Not Report

In both Australia and the US, victims do not report abuse. For example, in Victoria, it is estimated that there are more than 20,000 unreported cases of abuse, neglect and exploitation each year and approximately 100,000 in Australia nationwide.[36] Meanwhile, in the US, it’s estimated that only 1 in 14 cases ever comes to the attention of the authorities.”[37] In another study, it was 1 out of 25 cases.[38] Reasons for the lack of reporting include:

Many who suffer from abuse . . . don’t want to report their own child as an abuser.[39]

IX. The Bill Creates The Perfect Crime

A. “Even If a Patient Struggled, Who Would Know?

”The bill allows a patient to administer the lethal dose in private, without a witness or doctor present.[40] In addition, the drugs typically used are water and alcohol soluble, such that they can be injected into a sleeping or restrained person without consent.[41] 

Alex Schadenberg, Executive Director for the Euthanasia Prevention Coalition, puts it this way:

With assisted suicide laws in Washington and Oregon [and with proposed bill], perpetrators can . . . take a “legal” route, by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over administration. Even if a patient struggled, “who would know?” (Emphasis added).[42]

B. The Cause of Death Will Be Registered as a “Disease, Illness or Medical Condition,” Which Will Prevent Prosecution for Murder

The bill amends the Births, Deaths and Marriages Registration Act 1996, by requiring a death under the bill to be registered as a “disease, illness or medical condition.” The amendment states:

The Registrar, on being notified by a doctor of a death under section 37 and in accordance with section 67 of the Voluntary Assisted Dying Act 2017, must register the death in the Register by making an entry about the death that records the cause of death as the disease, illness or medical condition that was the grounds for a person to access voluntary assisted dying. (Emphasis changed).[43]

The significance of requiring a disease, illness or medical condition to be listed as the cause of death is that it creates a legal inability to prosecute. The official legal cause of death is a disease, illness or medical condition (not murder) as a matter of law.

X. Patients Otherwise Lack Protection

A. Participants in a Patient’s Death Are Merely Required to Act in “Accordance” With the Bill, Which Renders Patient Protections Unenforceable

The bill has page after page of patient protections, including that the co-ordinating medical practitioner “must” refer the person to another registered medical practitioner for a consulting assessment and that the person’s final request “must” be according to a specified time frame.[44]

The bill also holds medical practitioners and other participants in a patient’s death to an “accordance” standard.[45] Indeed, the bill uses the term nearly 50 times.[46]

The bill does not define accordance.[47] Dictionary definitions include “in the spirit of,” meaning “in thought or intention.”[48] With these definitions, a participant’s mere thought or intention to comply with the bill is good enough. Patient protections are not enforceable.

B. In an Orwellian Twist, the Term, “Self-Administer,” May Allow Someone Else to Administer the Lethal Dose to the Patient

The bill repeatedly describes the lethal dose as being “self-administered” by the patient, a term which is not defined.[49] The term or a variation thereof is used in the bill at least 50 times.[50]

The bill does not define “self-administer.”[51] In Washington State, the term is specially defined to allow someone else to administer the lethal dose to the patient. Washington’s law states:

“Self-administer” means a qualified patient’s act of ingesting medication to end his or her life . . . (Emphasis added).[52]

Washington’s law does not define “ingest.” Dictionary definitions include:

[T]o take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing. (Emphasis added).[53]

With these definitions, someone else putting the lethal dose in the patient’s mouth qualifies as self-administration because the patient will be “swallowing” the lethal dose, i.e., “ingesting” it. Someone else placing a medication patch on the patient’s arm will qualify because the patient will be “absorbing” the lethal dose, i.e., “ingesting” it. Gas administration, similarly, will qualify because the patient will be “inhaling” the lethal dose, i.e., “ingesting” it.

With the bill’s failure to define “self-administer,” and given Washington’s definition, the bill may be determined to allow someone else, such as a family member, to administer the lethal dose. Family members are common abusers.[54] Patients will not necessarily be in control of their fate.

XI. Other Considerations

A. The Swiss Study: Physician-Assisted Suicide Can Be Traumatic for Family Members

A European research study addressed trauma suffered by persons who witnessed legal physician-assisted suicide in Switzerland.[55] The study found that one out of five family members or friends present at an assisted suicide was traumatized. These people,

experienced full or sub-threshold PTSD (Post Traumatic Stress Disorder) related to the loss of a close person through assisted suicide.[56]

B. My Clients Suffered Trauma in Oregon and Washington State

I have had two cases where my clients suffered trauma due to legal assisted suicide. In the first case, one side of my client’s family wanted her father to take the lethal dose, while the other side did not. The father spent the last months of his life caught in the middle and torn over whether or not he should kill himself. My client was severely traumatized. The father did not take the lethal dose and died a natural death.

In the other case, my client’s father died via the lethal dose at a suicide party. It’s not clear, however, that administration of the lethal dose was voluntary. A man who was present told my client that his father had refused to take the lethal dose when it was delivered, stating: "You're not killing me. I'm going to bed." The man also said that my client’s father took the lethal dose the next night when he (the father) was already intoxicated on alcohol. The man who told this to my client subsequently changed his story.

My client, although he was not present, was traumatized over the incident, and also by the sudden loss of his father.

C. In Oregon, Other Suicides Have Increased with Legalization of Physician-Assisted Suicide

Government reports from Oregon show a positive correlation between the legalization of physician-assisted suicide and an increase in other (conventional) suicides. This correlation is consistent with a suicide contagion in which legalizing physician-assisted suicide encouraged other suicides. Consider the following:

Oregon's assisted suicide act went into effect “in late 1997.”[57]

• By 2000, Oregon's conventional suicide rate was "increasing significantly."[58] 
• By 2007, Oregon's conventional suicide rate was 35% above the national average.[59]
• By 2010, Oregon's conventional suicide rate was 41% above the national average.[60]
• By 2012, Oregon's conventional suicide rate was 42% above the national average.[61]

For a more detailed discussion of suicide contagion in Oregon, see Margaret Dore, “In Oregon, Other Suicides Have Increased with Legalization of Assisted Suicide.”[62]

D. The Oregon Statistics Provide Little, If Any, Support for the Idea That the Passage Is Needed Due to Physical Pain

I am not aware of any case in which Oregon’s law has been used for physical pain. According to Oregon’s most recent annual report, there were 47 people who died under the law in 2016 who expressed the following concern:

Inadequate pain control or concern about it. (Emphasis added).[]

With use of the word, “or,” the total number of persons who had inadequate pain control could be zero. In the alternative, the total number could be as high as 47.

If, for the purpose of argument, all 47 had inadequate pain control, this would be 47 people out of approximately 35,000 deaths in Oregon, which is far less than one percent (.127%) and/or not statistically significant.

The Oregon statistics provide little, if any, support for the idea that passage of the bill is needed due to physical pain. The argument is not supported by the evidence.

XII. Conclusion
The bill allows administration of the lethal dose to occur in private without a doctor or witness present. Even if a patient struggled, who would know? The death record will list a “disease, illness or medical condition” as the legal cause of death, which will prevent prosecution for murder. The bill, if enacted, will create the perfect crime.

Elder abuse and financial exploitation are already a problem in Victoria. Passage of the bill will make a bad situation worse. People with years or decades to live will have their lives ended due to the desires, wants and greed of other people.

I urge you to reject the proposed bill seeking to legalize assisted suicide and euthanasia.

Respectfully Submitted,

Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, P.S.
Choice is an Illusion, a nonprofit corporation
www.margaretdore.com
www.choiceillusion.org
www.margaretdore.org
1001 4th Avenue, Suite 4400
Seattle, WA USA 98154
001 206 697 1217

Endnotes

[1] For more information, see my CV at this link: https://choiceisanillusion.files.wordpress.com/2016/04/dore-cv-04-22-16.pdf
[2] See e.g., The American Medical Association Code of Medical Ethics, Opinion 5.7 (defining physician-assisted suicide).
[3] Id., Opinion 5.8, “Euthanasia,” (lower half of the page).
[4] “Mercy killing” - The Free Legal Dictionary
[5] KTVZ.com, “Sawyer Arraigned on State Fraud Charges,” 07/14/11, at https://choiceisanillusion.files.wordpress.com/2016/10/sawyer-arraigned-a-63.pdf
[6] See: Associated Press for Minnesota, “Former nurse helped instruct man on how to commit suicide, court rules,” The Guardian, 12/28/15 (“he told police he did it ‘for the thrill of the chase’”) a; “Woman in texting suicide wanted sympathy, attention, prosecutor says,” CBS News, June 6, 2017; and Ben Winslow, “Teen accused of helping friend commit suicide could face trial for murder,” (Deputy Utah County Attorney argued that the defendant “wanted to see someone die”). Available at https://www.aol.com/article/news/2017/10/12/teen-accused-of-helping-friend-commit-suicide-could-face-trial-for-murder/23241619/
[7] See: CBSNEWS.COM STAFF, “Life in Jail for Poison Doctor, July 12, 2000, at https://www.cbsnews.com/news/life-in-jail-for-poison-doctor; James B. Stewart, “Blind Eye: The Terrifying Story of a Doctor Who Got Away With Murder,” Simon and Schuster, copyright 1999; and https://en.wikipedia.org/wiki/Michael_Swango
[8] See Margaret Dore, Alabama: Assisted Suicide Ban Act to Go Into Effect,” http://www.choiceillusion.org/2017/07/alabama-assisted-suicide-ban-act-to-go.html; Kansascity.com, “Brewer signs bill targeting assisted suicide,” available http://www.choiceillusion.org/2014/05/arizona-strengthens-its-law-against.html; Georgia General Assembly printout 06/08/15; Margaret Dore,“Idaho Strengthens Law Against Assisted-Suicide,” July 4, 2011, at http://www.choiceillusionidaho.org/2011/07/idaho-strengthens-law.html; and Associated Press, “La. assisted-suicide ban strengthened,” April 24, 2012.
[9] Morris v. Brandenburg, 376 P.3d 836 (2016). See also “New Mexico Upholds Assisted Suicide Prohibition,” July 1, 2016 at http://newmexicoagainstassistedsuicide.org/2016/07/new-mexico-upholds-assisted-suicide.html
[10] Vermont, California and Colorado.
[11] Bill Clause 45 (allowing a patient to “use and self-administer” a lethal substance). The bill also allows a medical practitioner to administer the lethal dose. See Clause 46 (allowing a “co-ordinating medical practitioner” to administer a lethal substance to cause the person’s death).
[12] See the bill in its entirety, available at http://www.legislation.vic.gov.au/domino/Web_Notes/LDMS/PubPDocs.nsf/ee665e366dcb6cb0ca256da400837f6b/D162E1F2FCC3F7C3CA2581A1007A8903/$FILE/581392bi1.pdf
[13] Id.
[14] The bill, Clause 9(1)(d), states:
[T]he person must be diagnosed with a disease, illness or medical condition that -
(i) is incurable; and
(ii) is advanced, progressive and will cause death; and
(iii)is expected to cause death within weeks or months, not exceeding 12 months ...
[15] Affidavit of Kenneth Stevens, MD, Hall declaration, in the appendix at A-33
[16] Id.
[17] Affidavit of Jeanette Hall, ¶ 4.
[18] Cf. Jessica Firger, “12 million Americans misdiagnosed each year,” CBS NEWS, 4/17/14, and Nina Shapiro, “Terminal Uncertainty — Washington's new 'Death with Dignity' law allows doctors to help people commit suicide — once they've determined that the patient has only six months to live. But what if they're wrong?,” The Seattle Weekly, 01/14/09.
[19] Affidavit of John Norton, 08/18/12
[20] Id., ¶ 1
[21] Id., ¶ 4
[22] Id., ¶ 5
[23] Bill Clause 9(1)(d).
[24] Oregon’s law states: “Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months. Or. Rev. Stat. 127.800 s.1.01(12)
[25] “Diabetes mellitus” is listed as a qualifying terminal disease in Oregon government reports. See Declaration of William Toffler, MD, pp. A-14 to A-15, ¶¶ 2-4, and report excerpts at A-17 & A-18.
[26] Toffler Declaration at A-15, ¶ 5.
[27] Id., ¶ 6
[28] Appendix, at A-34 and A-35
[29] See Met Life Mature Market Institute, Broken Trust: Elders, Family and Finances,” March 2009, https://www.metlife.com/assets/cao/mmi/publications/studies/mmi-study-broken-trust-elders-family-finances.pdf and Facts on Elder Abuse - Australia, at http://www.ohchr.org/Documents/Issues/OlderPersons/Submissions/ElderAbusePreventionAssociation.pdf
[30] Metlife supra, at p.14.
[31] Kathryn Alfisi, “Breaking the Silence on Elder Abuse,” Washington Lawyer, February 2015. https://www.dcbar.org/bar-resources/publications/washington-lawyer/articles/february-2015-elder-abuse.cfm
[32] See People v. Rutterschmidt, 55 Cal.4th 650 (2012) and https://en.wikipedia.org/wiki/Black_Widow_Murders
[33] Rutterschmidt, at 652-3.
[34] Id. at 652.
[35] 67 Cal.Rptr.3d 129, 143 (2007).
[36] Facts on Elder Abuse-Australia, available at http://www.ohchr.org/Documents/Issues/OlderPersons/Submissions/ElderAbusePreventionAssociation.pdf
[37] Nat’l Center on Elder Abuse, http://www.ncea.aoa.gov/Library/Data/
[38] Id.
[39] “Adult Abuse,” District of Columbia, Department of Human Services, as of April 5, 2016. See also http://dhs.dc.gov/service/adult-abuse
[40] See the bill in its entirety, at http://www.legislation.vic.gov.au/domino/Web_Notes/LDMS/PubPDocs.nsf/ee665e366dcb6cb0ca256da400837f6b/D162E1F2FCC3F7C3CA2581A1007A8903/$FILE/581392bi1.pdf
[41] The drugs typically used in Oregon and Washington State include Secobarbital, Pentobarbital and Phenobarbital, which are water and/or alcohol soluble. See excerpt from Oregon’s and Washington’s most recent annual reports, in the appendix at A-44 & A-45 (listing these drugs). See also http://www.drugs.com/pr/seconal-sodium.html, http://www.drugs.com/pro/nembutal.html and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2977013
[42] Alex Schadenberg, Letter to the Editor, “Elder abuse a growing problem,” The Advocate, Official Publication of the Idaho State Bar, October 2010, page 14, available at http://www.margaretdore.com/info/October_Letters.pdf
[43] The Bill, Clause 117.
[44] Id., Clauses 22 and 38.
[45] See, for example, the Bill, Division 2, “Protection from liability for those who assist, facilitate, do not act or act in accordance with this Act.” (Emphasis added). See also Bill Clause 79, which states:
A person who in good faith does something or fails to do something
(a) that assists or facilitates any other person who the person believes on reasonable grounds is requesting access to or is accessing voluntary assisted dying in accordance with this Act; and
(b) that apart from this section, would constitute an offence at common law or under any other enactment-does not commit the offense.
[46] See the bill in its entirety
[47] Id.
[48] See definitions in the appendix at A-57 and A-58.
[49] See the bill in its entirety
[50] Id.
[51] Id.
[52] RCW 70.245.010(12), in the appendix at A-67.
[53] www.yourdictionary.com, in the appendix at A-59.
[54] Facts on Elder Abuse-Australia, p. 2, in the appendix at A-49, "Victimisation Facts” (“Among known perpetrators of abuse and neglect, the perpetrator is a family member in 90 percent of the cases. Two-thirds of the perpetrators are adult children or spouses. The offender is most commonly a close relative ....”)
[55] “Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2012) 542-546, available at http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf (Cover page in the appendix at A-60)
[56] Id.
[57] Oregon’s assisted suicide report for 2014, first line, at http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf
[58] See Oregon Health Authority News Release, 09/09/10. ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000"). (Attached in the appendix at A-61).
[59] Report excerpts in the appendix at A-62 & A-63.
[60] Oregon Health Authority Report excerpts, attached in the appendix at A-64 & A-65.
[61] Oregon State Report attached in the appendix at A-66
[62] And http://www.choiceillusionsouthdakota.org/2017/06/in-oregon-other-suicides-have-increased_18.html (a different version)
[63] Oregon report excerpt for 2016 in the appendix at A-68. To view the entire 2016 report, click here
[64] See Oregon’s report for 2016 attached in the appendix at A-69 (listing 35,709 Oregon resident deaths in 2015).