Assisted suicide would make elder abuse worse.

By Sara Buscher

Every year, some 5 million older adults are abused, neglected, or exploited to the tune of about $2.6 billion; only about one in five of these crimes are ever discovered.[i]

June 15 has been World Elder Abuse Awareness Day since 2006. The UN International Plan of Action acknowledges elder abuse as a public health and human rights issue.[ii]

Elder financial exploitation is widespread, expensive, and even deadly[iii] in the U.S.

• One in nine seniors reported being abused, neglected or exploited in the past twelve months.
• The rate of financial exploitation is extremely high, with 1 in 20 older adults perceiving financial mistreatment occurring in the recent past.
• Elder abuse is vastly under-reported; only one in 44 cases of financial abuse is ever reported.
• Elder abuse victims are four times more likely to go into a nursing home. As discussed below, they are also more likely to die and become suicidal.
• 90% of abusers are family members or trusted others.
• Almost 10% of financial abuse victims will turn to Medicaid, which is funded by tax dollars, as a direct result of their own monies being stolen from them.

Allowing People a Free Pass to Assist or Coerce Others to Suicide Rewards Elder Abuse

Most people who die of lethal assisted suicide drugs in states[iv] giving assisted suicide a free pass are 65 and over,[v] the same demographic at risk for elder abuse. Abused seniors are three times more likely to die than those who are not abused.[vi]

Elder abuse is significantly linked to suicidal ideation.[vii] Here is a real case. A 79-year-old man[viii] attempted suicide after being financially exploited by two cousins. They moved in, forced him to sign over the deed to his house, sold it and spent the money on drugs.

In all states, murderers cannot inherit from their victims.[ix] In the seminal case, a judge refused an inheritance to a man who poisoned his grandfather to avoid being written out of the Will.[x]

Not allowing killers to inherit deters deadly abuse. Ninety percent of abusers are family members or trusted others,^[xi] who otherwise stand to inherit from the abused.

When states decriminalize assisted suicide, they allow those who “assist” or abuse the elder into suicide to inherit by treating the death as caused by the deceased instead of a crime committed by the “helpers”.

Assisting Persons with Agendas Should not be Rewarded

Ulterior motives are often mixed with other motives in crimes of assisted suicide.[xii]

Consider Tammy Sawyer, trustee for Thomas Middleton of Oregon, who financially exploited him. According to news accounts,[xiii] after Mr. Middleton moved into Sawyer’s home, he deeded his house to the trust she managed, directing her to rent it, not sell it. Ten days after moving into her home, he died of assisted suicide. Before he died, she had already signed papers to list his house and two days after he died, she listed the house for sale. She deposited the sale proceeds into accounts for her own benefit.

In other cases, reported motives for assisting suicide include: the “thrill” a former nurse got in getting other people to kill themselves;[xiv] a desire for sympathy and attention by a girl who repeatedly texted her 18 year old boyfriend to kill himself;[xv] and “want[ing] to see someone die.”[xvi]

Sara Buscher is a Wisconsin lawyer and member of the EPC - USA board.

---

[i] https://www.acl.gov/news-and-events/events-and-observances/world-elder-abuse-awareness-day

[ii] Id.

[iii] http://www.napsa-now.org/policy-advocacy/exploitation/; https://www.ncoa.org/public-policy-action/elder-justice/elder-abuse-facts/

[iv] Only six states ̶  Oregon, Washington, Vermont, California (law is void per courts, appeals in process), Colorado and the District of Columbia ̶  allow assisted suicide by statute; Montana allows physicians a consent defense to a homicide charge. https://euthanasia.procon.org/view.resource.php?resourceID=000132

[v] Oregon Annual Death with Dignity Report for 2017. http://www.oregon.gov/oha/ph/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Pages/ar-index.aspx Washington Death with Dignity Report for 2018 https://www.doh.wa.gov/Portals/1/Documents/Pubs/422-109-DeathWithDignityAct2017.pdf

[vi] Dong X MD, et al., Elder Self-neglect and Abuse and Mortality Risk in a Community-Dwelling

Population, JAMA. 2009 Aug 5; 302(5): 517–526.

[vii] Dong X MD, et al., The Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the U.S., Gerontology. 2015 December; 62(1): 71–80.

[viii] http://www.napsa-now.org/about-napsa/success/financial-exploitation-case-study/

[ix] R Konsdorf, Killing Your Chances of Inheriting…, 39 ACTEC L.J. 399 (2013). Only one state that criminalizes assisted suicide allows those who assist to inherit. In Lemmer v. Schunk, 2008 WIApp 157, 314 Wis.2d 483, 760 N.W.2d 446, the mother and daughter who left their suicidal husband and father alone with the loaded gun he used on himself could be found guilty of assisting a suicide and still inherit.

[x] Supra, note 9 at 403.

[xi] Supra, note 3.

[xii] Model Penal Code Part II Commentaries, Vol. 1. 91 at 101 (1980).

[xiii] Arrest warrant for Tami Sawyer: Indictment lists criminal mistreatment, aggravated theft 7/9/2011 The Bend Bulletin http://www.bendbulletin.com/topics/1597751-151/arrest-warrant-for-tami-sawyer ;

Employee: Investor money paid debts 4/8/2009The Bend Bulletin

http://www.bendbulletin.com/slideshows/1457129-151/employee-investor-money-paid-debts

[xiv] 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’)”.

[xv] Michelle Carter, “ Woman in texting suicide wanted sympathy, attention, prosecutor says,” CBS News, 6/6/2017.

[xvi] 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”).

Assisted suicide lobby admits - California assisted suicide law was struck down.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On May 15, Riverside Superior Court Judge, Daniel Ottolia, invalidated the California assisted suicide law by ruling that the legislature acted outside the scope of its authority when it enacted the law.

California passed it's assisted suicide law in a special health care funding session after the legislature failed to pass the assisted suicide bill in its normal session.

Judge Ottolia, held that:

“the End of Life Option Act does not fall within the scope of access to healthcare services,” and that it “is not a matter of health care funding.”

The Fourth District Court of Appeals upheld Judge Ottolia's decision.

Compassion & Choices (C & C), an assisted suicide lobby group, stated in their May 24 media release that:

the law remains in effect and patients can still access it.

EPC USA Attorney, Sara Buscher, responded by stating:

“This is a declaratory judgment which means that once the judge declared the law unconstitutional, the law no longer exists. No need for an injunction to invalidate the law. I would argue the law has never existed-- void ab initio. 

Local district attorneys can now enforce the law and prosecute the doctors for assisting suicide when writing deadly prescriptions.”

Hon. William O'Brien

Former New Hampshire House Speaker and EPC USA board member, the Hon. William O’Brien said;

“Compassion and Choices should not be saying that this preserves the law even temporarily. 

If it was unconstitutionally enacted, there is a very strong argument it never came into effect and no doctor should be relying on it. That can - and should be - the effect of the final order in this case.”

Alex Schadenberg

And I stated in my article:

I am convinced that C & C is baiting pro-assisted suicide doctors to continue prescribing lethal drugs to enable them to create a legal challenge to the decision that correctly found that the California assisted suicide law is unconstitutional.

On May 26, C & C sent out a fund-raising letter admitting that the California assisted suicide law has been invalidated and then they ask people to "rush a donation" to C & C. They state in their fund-raising email:

for the time being physicians are no longer authorized to write prescriptions for medical aid-in-dying (better known as lethal assisted suicide drugs)

C & C decided to confuse the media while acknowledging the truth in order to raise money from their supporters.

The Euthanasia Prevention Coalition recognizes that this is the opportunity to convince California legislators that prescribing lethal drugs is not about freedom or autonomy but rather its an abandonment of people at a vulnerable time and to reject assisted suicide.

Compassion and Choices is spreading incorrect information that could put doctors in jail.

Media release EPC-USA - May 25, 2018.

California doctors can be prosecuted for assisted suicide.

California’s 4th District Court of Appeal denied the stay requested by the Attorney General, Xavier Becerra pertaining to the state’s so called “Death with Dignity” law commonly known as Assisted Suicide. It was in response to last week’s California, Riverside County’s Superior Court Judges’ ruling that California’s legislature acted outside the scope of its authority when it decriminalized Assisted Suicide.

There was a special session of the California Legislature convened by the Governor to address Medicaid funding shortfalls, services for the disabled and in-home support services. The bill for Assisted Suicide was introduced in this special session.

Nancy Elliott

Nancy Elliott, Chairman of Euthanasia Prevention Coalition USA stated; 

“The judges decisions were right in ruling that Assisted Suicide does not have anything to do with Medicaid funding shortfalls, services for the disabled or in-home support services unless the proponents of Assisted Suicide are saying that encouraging people to kill themselves would fix Medicaid’s funding shortfalls. I hope no one is that callous.”

Compassion and Choices, a proponent of Assisted Suicide sent out a press release telling California doctors it was "OK" to continue writing lethal prescriptions and falsifying death certificates.

William O'Brien

Former New Hampshire House Speaker and Euthanasia Prevention Coalition USA board member, the Hon. William O’Brien disagrees stating;

“Compassion and Choices should not be saying that this preserves the law even temporarily. 

“If it was unconstitutionally enacted, there is a very strong argument it never came into effect and no doctor should be relying on it. That can - and should be - the effect of the final order in this case.”

This was confirmed by EPC USA Attorney Sara Buscher; 

“This is a declaratory judgment which means that once the judge declared the law unconstitutional, the law no longer exists. No need for an injunction to invalidate the law. I would argue the law has never existed-- void ab initio.

Local district attorneys can now enforce the law and prosecute the doctors for assisting suicide when writing deadly prescriptions.”

Chairman Elliott further stated; 

“We are very pleased with the rulings. The absence of this law will make the state of California much safer for seniors, those with a disability and those who are ill. We are concerned for doctors that may listen to the baseless propaganda being put out by our opponents and wind up in very serious trouble.”

• California's assisted suicide law is unconstitutional, decision upheld by appeals court.

Warning — Hospice Abuse Can Kill You.

Hospice abuse can be euthanasia without consent. The Euthanasia Prevention Coalition (EPC) supports good hospice care, but we are also extremely concerned about hospice abuse. Good hospice care leads to less support for euthanasia and assisted suicide while hospice abuse leads to a greater demand for the legalization of euthanasia and assisted suicide.

By Sara Buscher, an attorney from Appleton Wisconsin. She was elected to leadership positions in Elder Law and in Civil Rights Law, working as an advocate on behalf of people with disabilities and the elderly.

Bud Coffey with his sister.

What do Bud Coffey, Jim Carlen, Roseann Gillespie and Beverly Garguilo have in common? Their deaths from apparently lethal doses of morphine and sedatives while in hospice. These cases are described in a Washington Post exposé by award-winning investigative journalist Peter Whoriskey.[1] They were not dying nor in extreme pain when they enrolled in hospice, but were given excessive doses of painkillers, dying a few days or weeks later.

So how does it work? A 2009 front page New York Times article explained that a strong sedative, typically lorazepam, and a strong pain killer, typically morphine, are supplied drip by drip through an IV until heart rate and breathing are slowed to the point of making it impossible to eat or drink.[2] “In so doing, it can intentionally hasten death.” This practice goes by various names, including “terminal sedation”, “palliative sedation” and “slow euthanasia.” An earlier national survey found 83% of doctors said it is ethically permissible.[3]

The Washington Post article reports on complaints from around the country illustrating the potential dangers of hospice for patients who are not near death, but who are prescribed lethal doses. Yet no data is collected about such abuses.

The article explains that as the hospice industry has grown, more are enrolling patients who aren’t close to death. Lawsuits have sought to recover more than $1 billion in federal money from hospices who have “fraudulently” billed Medicare for these patients. To qualify for Medicare hospice payments, patients must be certified as having terminal conditions likely to lead to death in six months.

Medicare tracks the number of patients who leave hospice alive as a check on honest enrollment practices. The proportion of “hospice survivors” has increased to the point where some experts believe hospices are deliberately enrolling patients who aren’t dying. They can collect $155 a day ($4,650 a month), without visiting them at home. At hundreds of U.S. hospices, more than one in three patients were released alive, according to a new study funded by Medicare. A “hospice survivor profiled in the article refused to take the drugs while she got better. She was finally given a blood test that proved she did not have cancer, but only after spending a year of her life in hospice.

Sadly, Bud Coffey’s family realized too late that the drugs they were giving him per hospice directions had likely ended his life.

Whether patients are nearing death with a terminal condition or not, EPC opposes the intentional ending of peoples lives with lethal doses. Families and patients should avoid inappropriate hospice enrollment. If a hospice is willing to falsify records to get paid by Medicare, in the US, that hospice is more likely to engage in other unethical practices.