Woman who sought assisted suicide 26 years ago is happy to be alive.

Alex with Jeanette Hall

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

We received a message from Jeanette Hall who commented on the article concerning France legalizing euthanasia. Jeanette wrote:

Alex. It is 26 years (July 17, 2000) that I learned I had terminal colon cancer and wanted to follow that same course with Oregon's law and asked Dr. Kenneth Stevens to help me end my life. I pray there are many Dr. Stevens in France that will want to see their patient live. Still "Great to be Alive."

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

 

The text from the youtube video explaining the story.

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.

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.

More information about Jeanettte Hall.

• Patients recovery convinces doctor to fight assisted suicide (Read).

Terminal Illness: What does it mean?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Dr Kenneth Stevens

I recently spoke at the British parliament about the experience with assisted suicide in America. The British parliament is currently debating the legalization of assisted suicide. The British assisted suicide bill, that is sponsored by Kim Leadbeater, is similar to an American style assisted suicide bill.

While in England, I had the opportunity to visit with a physician who practises palliative medicine. She told me about a meeting with a patient and her family to explain that the patient has a terminal condition but she is not terminally ill.

In 2011, Dr Kenneth Stevens, a long time radiation oncologist in Oregon, wrote an excellent article titled: Terminal Illness: What does it mean? In his article Dr Stevens writes about several of his patients who were diagnosed with a terminal illness.

The first story was a patient, Mr Jones, who was diagnosed with lung cancer that had spread to his brain. Dr Stevens explains:

He was not having any breathing problems and, except for headaches, the tumors in his brain were not causing any neurological or mental problems. Yet, his doctor had told him and his wife that he was "terminal."

Dr Stevens asks, what is the meaning terminal? Does it mean "terminal" (nearing death) or a terminal condition? Dr Stevens continues:

A patient's terminal status can be dependent on treatment. A person with severe insulin-dependent diabetes mellitus could be considered terminal if they did not take insulin appropriately. However, with proper insulin treatment and diet, they can live a long time, even many decades. Patients with kidney failure requiring dialysis would die in a few days without dialysis; in that sense they may be considered terminal, but with dialysis they can live many years.

Dr Stevens tells the story of a family member who was diagnosed as terminal from pulmonary fibrosis. He writes:

four years after she received the "terminal" diagnosis, she still has terminal pulmonary fibrosis that requires constant supplemental oxygen and still lives in her home with her husband, who has his own significant medical problems.

Dr Stevens emphasized that his family member continued living and enjoying the companionship of her family.

He then told another story of a patient who was diagnosed as terminally ill. The man and his wife responded to the diagnosis by selling off their worldly items. They even planned to sell their house, but he didn't really feel sick. After more biopsies were done it was determined that he actually had a non-terminal condition. Stevens writes:

In the past seven years he has had CT scans of his chest and abdomen every six months. The abnormalities in his liver and lungs are still present but have not changed in number or in size. He has continued to work for a computer company and misses the tools that he sold at a great discount In the past seven years he has had CT scans of his chest and abdomen every six months. The abnormalities in his liver and lungs are still present but have not changed in number or in size. He has continued to work for a computer company and misses the tools that he sold at a great discount or gave away in garage sales when he was told he was terminal.

Dr Stevens tells the story of a patient who was diagnosed with liver cancer that had spread to her chest. She was told that she didn't have long to live but she was still alive 20 years later.

Dr Stevens tells us the story of an 18-year old college student who was diagnosed with the most malignant type of brain cancer. Dr Stevens write that many doctors did not expect him to live long. Dr Stevens writes:

However, he surprised them when he graduated from college, then attended and graduated from law school, passed the state bar exam, married, had two children, and was elected to his city's council. He lived a very successful and productive life for over 20 years from the time of his terminal diagnosis.

Dr Stevens brings the article together by telling us what happened to Mr Jones. He writes:

After evaluating the extent of Mr. Jones' tumors, I offered radiation and chemotherapy to shrink the tumors. He accepted that recommendation and successfully completed the treatments with his tumors markedly decreased in size. He lived to spend two very productive years with his wife and children. They traveled together, and he lived to see the arrival of two additional grandchildren. Both he and his wife were very grateful for his prolonged and very functional life.

Dr Stevens concludes by writing:

My 44-year experience as a doctor for many thousands of patients with cancer has made me realize that it is very difficult to predict the life expectancy of a particular individual. Doctors can make generalized predictions regarding probability of death for a group of patients in a particular period of time, but that is a probability based on the group as a whole and not on specific individuals within the group. There is great variability in the course of an illness, particularly in those who are predicted to die many months from now.

My palliative care doctor friend in Britain, who I first referred to, explained to her patient and family that she might have another two or more years to live and that she was graduating from palliative care.

This is important to the assisted suicide debate because people who have a terminal condition may qualify for assisted suicide.

The doctor asked me, with concern, what if assisted suicide was already legal in Britain? Would this woman be dead?

EPC-USA Disability Rights Opposition New Hampshire to Assisted Suicide Bill HB1283.

Dear Senator

Meghan Schrader

EPC-USA's Fact Sheet is testimony regarding the social harms attached to assisted suicide legislation like HB1283. However, given that assisted suicide’s negative impact is going to fall primarily on the disabled community, the EPC felt that we should submit a more detailed analysis of how assisted suicide undermines disability rights, and whose advice on this matter ought to be heeded by members of the Assembly.

Members of the EPC board with training in the fields of disability studies and advocacy have noted that some assisted suicide advocates are trying to hijack disability rights for their own purposes. For instance, an able-bodied man named Christopher Riddle has done pro-assisted suicide advocacy in the Northeast while presenting himself as a “disability rights advocate.” Riddle is a colleague of Udo Schuklenk, one of the architects of Canada’s euthanasia program, and Riddle enthusiastically approves of that program.

Moreover, Riddle’s theories about disability rights have been reasonably criticized as lacking any empirical grounding in the experiences of disabled people. He has no experience or personal stake in the practical implications of his ideas.

Furthermore, Riddle’s scholarship dehumanizes disabled people who are harmed by assisted suicide; he frames anyone who might be harmed by assisted suicide as the equivalent of a car accident statistic. He asserts that harm that assisted suicide might cause for people with disabilities “ought not to be of special concern.” Hence, Riddle is willing to sacrifice people with disabilities for the right to die movement’s agenda; he is not the “disability rights advocate” he claims to be.

For a more accurate understanding of how the disabled community has approached the issue of assisted suicide, we encourage you to watch a video created by disability studies ethicist Harold Braswell about disability rights opposition to assisted suicide. Braswell has studied the right to die issue extensively.

There are other very important facts that legislators must take into account when considering how assisted suicide is impacting the disabled community:

The American Association of Suicidology made a 2017 statement saying that “MAiD” was not suicide. But in 2023 the AAS had to retract that statement because it was used in the 2019 Truchon decision that expanded assisted suicide to disabled Canadians, which was opposed by the Canadian Association for Suicide Prevention.The consequences of the AAS’s statement are an example of how green lighting assisted suicide for the terminally ill easily results in violence against people with disabilities.

In 2021, the United Nations Special Rapporteur on the Rights of People with Disabilities asserted that all assisted suicide laws violate its Convention On The Rights of People with Disabilities.

Peer-reviewed research establishes that people are more likely to view suicide as acceptable if the victim is disabled, and people with disabilities often lack access to comprehensive suicide prevention care. This bill exacerbates that problem by laying the scaffolding for “MAiD” to become a substitute for the suicides of persons with disabilities.

Well-known right to die leader Thaddeus Mason Pope has tweeted that it’s good for disabled people to die by suicide; the director of Compassion and Choices appeared on Dr. Phil with Pope in 2023. If you pass this bill, you empower and reward a contingent of people who want disabled people’s suicides to be a “medical procedure.”

We urge you to allow HB1283 to die this session because regardless of its content, it rewards a movement that is hostile to people with disabilities. Exacerbating the oppression that disabled people already face so that the proponents can plan their deaths is unwise and unjust.

Sincerely,

Meghan Schrader, Disability Rights EPC-USA
Josephine L.A. Glaser, MD.,FAAFP
Colleen E. Barry, Chairperson
Kenneth Stevens, MD
William Toffler, MD
Gordon Friesen
Alex Schadenberg
Epc_USA@yahoo.com

Endnotes

1. https://twitter.com/cariddlephd/status/1373071051631038470
2. http://www.lpbr.net/2014/08/disability-and-justice-capabilities.html?m=1
3. https://www.tandfonline.com/doi/full/10.1080/09687599.2014.984931
4. https://philpapers.org/rec/RIDAD
5. https://www.dropbox.com/scl/fi/vdpwdt26wwq42ak0eraee/Braswell_PAS-Statement_To-Send-1.mov?rlkey=05vve2sis2s4sy51hma27jx2u&dl=0
6. https://www.slu.edu/arts-and-sciences/bioethics/faculty/braswell-harold.php
7. https://suicidology.org/2023/03/08/aas-update-on-previous-statement/
8. https://twitter.com/TrudoLemmens/status/1666067817035190272
9. https://suicideprevention.ca/media/statement-on-recent-maid-developments/
10. https://www.ohchr.org/en/press-releases/2021/01/disability-not-reason-sanction-medically-assisted-dying-un-experts
11. https://pubmed.ncbi.nlm.nih.gov/26402344/
12. https://www.youtube.com/watch?v=XXVrgtTNN2Y&t=2108s
13. https://twitter.com/ThaddeusPope/status/1669450726831976449

24 Years ago, Jeanette Hall had terminal cancer and she wanted assisted suicide. She is happy to be alive today.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

With contribution from Margaret Dore.

I was speaking this weekend in Oregon and Dr Kenneth Stevens gave us an incredible gift by bring Jeanette Hall to the event.

(Picture: Alex Schadenberg, Jeanette Hall, Kenneth Stevens, and Wesley Smith)

Oregon's assisted suicide law came into effect in 1998. In 2000, Jeanette Hall had cancer and she was give six to 12 months to live. Jeanette 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, but he also thought that Jeanette was a good candidate for treatment and indeed she was. She has been cancer free for 24 years. In a previous article, Jeanette stated:

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!

Jeanette told me that at the time of her assisted suicide request, she had lost hope. Her Aunt had died by cancer, her mother had Alzheimer's and her brother had recently died by suicide. She felt that there was no reason to live.

Jeanette with her son at his graduation.

Dr Stevens helped Jeanette find meaning and purpose by asking her about her son. Her son was in the police academy and Dr Stevens assured her that with treatment she would be able to attend her son's graduation. Jeanette not only attended her son's graduation but she overcame her cancer.

We are thankful that Dr. Stevens didn't give-up on Jeanette, that he convinced her to try effective treatment and that Jeanette is alive today.

As Jeanette said to me:

"It is now 24 years later and I am happy to be alive."

This article is based on previous articles concerning Jeanette Hall:

• If Dr Stevens had believed in assisted suicide - I would be dead (Link).
• Oregon woman changed her mind on assisted suicide after her doctor helped her find a reason to live. (Article Link).

EPC-USA Disability Rights Statement in STRONG OPPOSITION to New York Assisted Suicide Bill

Dear Members of the New York Assembly:

The EPC-USA has already submitted testimony regarding the social harms attached to assisted suicide legislation like A995A. However, given that assisted suicide’s negative impact is going to fall primarily on the disabled community, the EPC felt that we should submit a more detailed analysis of how assisted suicide undermines disability rights, and whose advice on this matter ought to be heeded by members of the Assembly.

Members of the EPC board with training in the fields of disability studies and advocacy have noted that some assisted suicide advocates are trying to hijack disability rights for their own purposes. For instance, an able-bodied man named Christopher Riddle has done pro-assisted suicide advocacy in New York while presenting himself as a “disability rights advocate.” Riddle is a colleague of Udo Schuklenk, one of the architects of Canada’s euthanasia program, and Riddle enthusiastically approves of that program.

Moreover, Riddle’s theories about disability rights have been reasonably criticized as lacking any empirical grounding in the experiences of disabled people. He has no experience or personal stake in the practical implications of his ideas.

Furthermore, Riddle’s scholarship dehumanizes disabled people who are harmed by assisted suicide; he frames anyone who might be harmed by assisted suicide as the equivalent of a car accident statistic. He asserts that harm that assisted suicide might cause for people with disabilities “ought not to be of special concern.” Hence, Riddle is willing to sacrifice people with disabilities for the right to die movement’s agenda; he is not the “disability rights advocate” he claims to be.

For a more accurate understanding of how the disabled community has approached the issue of assisted suicide, we encourage you to watch a video created by disability studies ethicist Harold Braswell about disability rights opposition to assisted suicide. Braswell has studied the right to die issue extensively.

There are other very important facts that legislators must take into account when considering how assisted suicide is impacting the disabled community:

The American Association of Suicidology made a 2017 statement saying that “MAiD” was not suicide. But in 2023 the AAS had to retract that statement because it was used in the 2019 Truchon decision that expanded assisted suicide to disabled Canadians, which was opposed by the Canadian Association for Suicide Prevention.The consequences of the AAS’s statement are an example of how green lighting assisted suicide for the terminally ill easily results in violence against people with disabilities.

In 2021, the United Nations Special Rapporteur on the Rights of People with Disabilities asserted that all assisted suicide laws violate its Convention On The Rights of People with Disabilities.

Peer-reviewed research establishes that people are more likely to view suicide as acceptable if the victim is disabled, and people with disabilities often lack access to comprehensive suicide prevention care. This bill exacerbates that problem by laying the scaffolding for “MAiD” to become a substitute for the suicides of persons with disabilities.

Well-known right to die leader Thaddeus Mason Pope has tweeted that it’s good for disabled people to die by suicide; the director of Compassion and Choices appeared on Dr. Phil with Pope in 2023. If you pass this bill, you empower and reward a contingent of people who want disabled people’s suicides to be a “medical procedure.”

We urge you to allow A995A to die this session because regardless of its content, it rewards a movement that is hostile to people with disabilities. Exacerbating the oppression that disabled people already face so that the proponents can plan their deaths is unwise and unjust.

Sincerely,

Meghan Schrader, Disability Rights EPC-USA

Josephine L.A. Glaser, MD.,FAAFP

Colleen E. Barry, Chairperson

Kenneth Stevens, MD

William Toffler, MD

Gordon Friesen

Alex Schadenberg

Letter to New York Legislators opposing assisted suicide Bill S.2445.

Euthanasia Prevention Coalition-USA Statement in STRONG OPPOSITION to S.2445: Assisted Suicide–also known as “Medical Aid in Dying” 

Dear Senator:

Please let S.2445 die this session. Assisted suicide laws disguised as legally contrived, confusing, and euphemistic term, "medical aid in dying" is not healthcare. Assisted suicide proponents are trying to sell you a "pig in a poke." It's not about pain or a quick, peaceful death. It spawns more suicides and provides less healthcare. EPC-USA's physicians and disability advocates express strong opposition to assisted suicide.

The Euthanasia Prevention Coalition USA supports public policy that promotes positive measures to improve the quality of life of people living with a terminal illness and their families; we oppose euthanasia and assisted suicide. We are aging and disability advocates, lawyers, doctors, nurses and politicians.

Any safeguards are part of a deliberate bait and switch tactic by assisted suicide advocates to get a bill passed and then come back to amend it by gutting those safeguards. This was openly acknowledged by J.M. Sorrell, Executive Director of Massachusetts Death with Dignity, who was quoted on a similar bill saying, “Once you get something passed, you can always work on amendments later.” (Link) Oregon, Washington, California, Vermont, Hawaii, and New Mexico all have provisions that dramatically waive safeguards. 

This incremental strategy to promote legal and social acceptance of assisted suicide in the U.S. state by state since 1997 is confirmed by the Compassion & Choices (Link) strategic plan. 

It’s Not about Pain  

“I’m often asked if I want people to die in pain. You probably have been asked that question, too.” Dr. Lonny Shavelson, a California assisted suicide provider says promoting “aid in dying” as avoiding pain is a political sales pitch. See webinar minutes 25:24-27:53. He says people choose assisted suicide because they are low energy or afraid of losing control.  A Review of Oregon’s assisted dying law finds significant data gaps (Link). The review revealed that information on clinical complications is often missing, while key information on the factors behind medical decision-making, the effectiveness of the lethal drugs used, and the extent of palliative care support is not collected.

It’s Not about a Peaceful or Quick Death 

Dr. Shavelson says the idea that assisted suicide creates a peaceful beautiful death is another myth. See webinar minutes 37:35-41:00. 

No amount of bill language can change the fact that some people will suffer prolonged and agonizing deaths from the experimental lethal drug cocktails, with some regaining consciousness only to die of their terminal illness. Medical science cannot guarantee the peaceful death proponents claim. If lethal injections administered for capital punishment have resulted in inhumane deaths, oral ingestion of lethal drug compounds is far more likely to do so.

Assisted Suicide Spawns More Suicides and Attempted Suicides.

Assisted suicide laws send a message that suicide is an acceptable way to solve problems. Publicity about suicide also leads to more suicides. This is called suicide contagion. A special concern with NY High School students, as discussed in an article on Centers for Latina Girls.

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

Insurance Companies Use Assisted Suicide to Deny Curative Life-Saving Treatment

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

People of color understand this will be used to provide them poorer care. 

Even with insurance, people of color get poorer hospital care and pain relief. According to a New York Times (Link) article, people of color disproportionately died of COVID-19. So, it is unsurprising Black and Latinx people oppose Assisted Suicide by 2-1 margins. (Link) ... the voting results from Ballot Question 2 in 2012 show Assisted Suicide pits wealthier, whiter districts against those with poorer people of color according to Second Thoughts - Massachusetts.

EPC-USA's physicians remind us that Assisted Suicide laws exacerabate systematic inequalities that disabled people experience with respect to suicide prevention. A "Federal study found that the nation's assisted suicide laws are rife with dangers to people with disabilities" (Link)

EPC-USA’s physicians remind us that Physicians are fallible. Misdiagnoses and unreliable terminal prognoses are documented in at least three cases: Jeanette hall (Link), John Norton, (Link) and Rahamim Melamed an Rahamim Mlamed-Cohen (Link).

In 2023, American Association of Suicidology (AAS) national organizations recognized their mistake and retracted their support for assisted suicide and its legally constructed term“MAiD”:

In 2017, the American Association of Suicidology (AAS) published their statement that “MAiD” was not suicide. In 2023, the AAS retracted their 2017 statement because their 2017 statement was used by assisted suicide advocates in the 2019 Truchon decision that expanded assisted suicide to disabled Canadians. The Canadian Association for Suicide Prevention opposes the expansion of MAiD legislation to include mental illness.

EPC-USA’s Disability Rights Advocates remind us Assisted Suicide for the terminally ill very clearly normalizes discussions about whether it might be ok to help disabled people die by suicide. Without realizing it we can be blind to the reality that supporting Assisted Suicide individually and corporately is an example of ableism and perpetuates systemic racism for the poor, disabled, lonely, vulnerable and marginalized young and elderly individuals.

Highly educated advocates for assisted suicide laws like Christopher Riddler and Udo Schuklenk are known for their assisted suicide advocacy in New York and Canada while misrepresenting themselves as a "disability rights advocates" Their philosophy blinds NY legislators in the reality of their ableist philosophy. 

No change in language alters the fact that offering suicide prevention to most people while offering suicide assistance (legally constructed as “medical aid in dying”) to an ever-widening subset of disabled people undermines disability rights and perpetuates lethal disability discrimination. Passing an assisted suicide law in New York is unwise and unjust.

 As the cheapest state-sponsored “treatment,” assisted suicide diminishes patient choice and takes away patient autonomy of the most vulnerable. Assisted suicide combined with a broken health care and home care system is a deadly mix for people who are economically poor, lonely, vulnerable, elderly, disabled, and historically marginalized in the US healthcare system. 

Advocates of assisted suicide assert that there has never been one case of abuse related to laws legalizing assisted suicide under the legally constructed and euphemistic term "medical aid in dying." Setting aside the inherent flaw of making such a broad assertion, the Disability Rights Education and Defense Fund (DREDF) has catalogued a long list of abuse cases (Link).

We urge you to oppose policies that provide legal immunity to assisted suicide providers and allow them to use their medical license to legally harm / kill patients who are not yet at death's door by prescribing them lethal drugs.

We urge you to allow S.2445 to die this session - a harmful, dangerous and deadly assisted suicide law.

Sincerely, 

Colleen E. Barry, Chairperson 347-245-9476

Josephine L.A. Glaser, MD.,FAAFP

Kenneth Stevens, MD

William Toffler, MD

Gordon Friesen

Alex Schadenberg

Euthanasia Prevention Coalition USA

Epc_USA@yahoo.com

Oregon assisted suicide law, lax safeguards

The following letter to the Editor was published by the Oregonian on October 31, 2021.

By Dr Kenneth Stevens

The Oct. 17 article “Why more Oregonians took their lives through Death with Dignity in 2020 than any other year” provided valuable information. The Oregon Health Authority data shows an exponential increase in the number of Death with Dignity Act prescriptions and deaths over the years. Future numbers can be predicted by using a semi-log plot that shows a linear pattern of the numbers of prescriptions and deaths from drug overdoses. 

People who favor such deaths fear disability more than they fear death. They are the “white, well-off, worried, well.” As a physician, I am concerned that the proponent organization for assisted suicide is promoting it among underserved communities and minority groups. There are many problems with assisted suicide. There is lack of transparency. Although the prescribing physician is to refer a patient for psychological evaluation if there may be depression or other conditions impairing patient judgment, only 4% of those dying from the drugs received such evaluation (only 0.5% in 2020). Recent changes in Oregon’s law have removed many safeguards from Oregon’s Death with Dignity law. 

There are many problems with assisted suicide. The Oregonian/ OregonLive should investigate further into what is happening in Oregon.

Similar article: Oregon 2020 assisted suicide report. 28% increase in assisted suicide deaths (Link)

Do not follow Oregon’s example. It is dangerous for patients and society. Vote No to Connecticut Bill 6425.

State of Connecticut General Assembly Committee on Public Health

Vote NO on Bill No. 6425, An Act Concerning Aid in Dying for Terminally Ill Patients

Dr Kenneth Stevens

Testimony of Dr. Kenneth R. Stevens, Jr., MD,
Professor Emeritus, Radiation Oncology, Oregon Health & Science University, Portland, OR

February 24, 2021

To Members of the Committee on Public Health,

I have been a cancer doctor in the practice of Radiation Oncology for 52 years in Oregon, treating cancer patients from 1969 to 2019.

I have studied and closely followed the implementation of Oregon’s assisted-suicide law since its passage in 1994. I have also continued to teach and practice medicine in a society where there exists such a law, taking note of its tragic results. The more I have learned and witnessed, the more I realize the significant harm and danger of assisted suicide to the vulnerably ill and to society. The following includes some of those harms and dangers.

There has been a profound negative shift in attitude towards terminally ill patients in Oregon. The commitment to care has become a commitment to the option of killing. There has been a distinct change of attitude in society and in members of the medical profession to patients who are terminally ill and eligible for assisted suicide. There is reduced incentive to evaluate and provide for the palliative care needs of patients who are eligible for assisted suicide. The legalization of assisted suicide results in a deterioration of caring for patients’ medical needs and symptoms.

Oregon’s assisted suicide law is not necessarily for only patients who are dying. Many who request/use the law are not dying already. The mere presence of legal assisted suicide steers patients to suicide.

As in Oregon, Bill 6425 supposedly applies to patients predicted to have less than six months to live. In 2000, I had a cancer patient named Jeanette Hall. She was referred to me with an inoperable low rectal cancer. She plainly told me that she did not want to be treated, and that she was going to “do” our law, i.e., end her life with a lethal dose of barbiturates. She had voted for the law and it was a very much settled decision for her. Her referring surgeon, who had determined that her cancer was inoperable, informed her that without treatment (radiation & chemotherapy) that she had a six month to one year life expectancy, so she qualified for Oregon’s assisted suicide law. Patients refusing appropriate treatment may be deemed “terminal” under current interpretation of the Oregon law. After consulting with her, I informed her that her cancer was treatable with chemotherapy and radiation and her prospects were good. She was not interested in treatment. She had made up her mind, but she continued to see me. On the third or fourth visit, I asked her about her family and learned that she had a son in his late 20s. I asked her how he would feel if she went through with her plan. Shortly after that, she agreed to be treated, the cancer melted away, and she is alive and active today. Twenty years later, she says “It’s great to be alive”. For her, the mere presence of legal assisted suicide had steered her to suicide. An 18-year-old girl with insulin-dependent diabetes would be eligible, if she stopped taking life-sustaining insulin.

Pain is not the issue. It is very significant that there are many cases of assisted suicide being used to address psychological and social concerns, but it is very rare for assisted suicide to be used in the case of actual untreatable pain.

Depressed people are dying from assisted suicide in Oregon. In 2008, researchers at Oregon Health & Science University reported 25% of terminally ill patients pursuing assisted suicide in Oregon met criteria for depression.  Yet, the Oregon Health Department annual reports for the years 2018 and 2019 reported that only 1% (4 of 366) of patients dying from assisted suicide had a psychiatric evaluation. Your bill dangerously permits social workers to evaluate patients’ mental status.

There is no real monitoring of Oregon’s assisted suicides. When David Prueitt’s failed suicide was made public in 2005, the Department of Health Services (DHS) publicly stated that they had “no authority to investigate individual Death with Dignity cases. The state law authorizing physician-assisted suicide neither requires of authorizes investigations by DHS.”

We are dependent on self-reporting by doctors, and in in most cases the prescribing doctor is not present when the drugs are taken.

There are financial and societal dangers that assisted suicide may be pressured as a cost savings. The Oregon Health Plan (Medicaid) pays for assisted suicide and does not pay for some cancer treatment to extend life. In 2008, cancer patients Barbara Wagner and Randy Shoup received letters from the Oregon Health Plan that the Plan would not pay for beneficial chemotherapy, but would pay for [among other things] physician-assisted suicide. Ms. Wagner’s comment to the media was “they will pay for me to die, but won’t pay for me to live.” 

Oregon’s regular suicide rate has increased since the legalization of assisted suicide. According to the U.S. Center for Disease Control (CDC), Oregon had the 2nd highest suicide rate in the U.S. for the years 1999-2010.

I urge you to vote no on this bill. Do not follow Oregon’s example. It is dangerous for patients and society.

Thank you,
Dr. Kenneth R. Stevens, Jr., M.D.

Doctors say No to Washington state assisted suicide expansion bill HB 1141.

No on Washington state HB 1141,

by Kenneth R. Stevens, Jr., MD,

Professor Emeritus & former Chair Department of Radiation Oncology,

Oregon Health & Science University.

President, Physicians for Compassionate Care Education Foundation, pccef.org

When the citizens of Washington state voted in 2008 in favor of Initiative 1000, Washington’s Death with Dignity Act, they did it with the understanding that there were “safeguards” in the new law.

HB 1141 seeks to remove some of those safeguards.

1) It removes the safeguard that only medical physicians can be both the attending and consulting physicians. It expands qualifications to those with lesser medical expertise. That was not the intent of the original I-1000 initiative.

2) Instead of evaluation by mental health professionals, such as psychiatrists and psychologists, it expands the law to include mental evaluation by others with lesser credentials. That was not the intent of I-1000

3) It removes the 15-day and the 72-hour waiting periods. I-1000 and the current law allowed for this time period for the person to really understand and reflect on the decision to end their life by lethal drugs. This bill will remove that protection promised in I-1000. If passed this bill would permit a person to receive lethal drugs and end their life on the same day that they have made a decision to use the law! That was not the intent of I-1000.

4) It reduces the security of delivery of the lethal drugs by permitting delivery by expanding the type of delivery. This is dangerous.

If these changes, which remove some safeguards in the law, had been in the original initiative petition, I doubt that the voters of Washington state would have approved. They would not have voted to legalize assisted suicide in Washington state in 2008.

Eliminating safeguards will eliminate vulnerable people!

The following link tells of my patient, Jeanette Hall, who requested lethal drugs in 2000, and who is grateful to still be alive 20 years later. (Link).

I urge Washington state legislators to not remove “safeguards” from the Washington “Death with Dignity Act”.

"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.

Vote NO to the fatally flawed assisted suicide bills.

To whom it may concern:

Alex Schadenberg

As the Executive Director of the Euthanasia Prevention Coalition, I am well aware that you are receiving information supporting and opposing the assisted suicide bill. As an elected representative your role is crucial, especially when considering issues such as assisted death.

Before voting on the legislation I ask you to watch the these film clips that are part of the Fatal Flaws film that was released last year. This film features personal stories and interviews with doctors, legislators, and individuals who have direct life experience with assisted death.

The following stories are compelling:
 
Dr. Charles Bentz, Internal Medicine Specialist in Oregon had a depressed patient who died by assisted suicide rather than receiving treatment for depression. (Link to the story).

Dr. Kenneth R. Stevens is a Radiation Oncologist in Oregon who had a patient, Jeannette Hall, who asked for assisted suicide. Dr Stevens helped her find a reason to live and 19 years later she is grateful to be alive (Link to the story).

Nancy Elliott is a former three term New Hampshire State Representative who began to actively oppose assisted suicide based on her personal experience when her husband was sick (Link to the story).

Candice Lewis (25) from Newfoundland, Canada, was born with multiple disabilities. Candice was pressured by her doctor in 2016 to ask for an assisted suicide death (Link to the story).

This is the link to the Fatal Flaws film trailer. (Link).

You may support assisted suicide in theory. In reality assisted suicide laws give doctors the right to be involed with causing the death of their patients when the patient is at the lowest time of their life.

Vote NO to assisted suicide.

Alex Schadenberg
Executive Director – Euthanasia Prevention Coalition
info@epcc.ca or 1-877-439-3348

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