A Case against Assisted Suicide for Mental Illness

A contact sent me this article and wishes to remain anonymous.

The Cracks and the Light

“There is a crack in everything; that is how the light gets in…” Leonard Cohen

This is not a story about miraculous healing or cure. This is a story about living with my “cracks,” having moments of despair, and living, letting the light in and shining my unique light out to others in their moments of hopeless. I am a survivor of suicidal ideation, and of living a life that many times I believed was not worth living.

I lived with a mental health condition since childhood. If you want to die; I get it. I am not going to tell you that your feelings are invalid, or that life is always amazing.

“Life is so beautiful and life is so hard…” - Kate Bowler.

That being said, new legislation proposals around allowing assisted suicide for mental illnesses has prompted huge personal reflection on my part and also pursued me to plead the case against allowing this to pass. I hope to give a voice to those who may be unable to write their story.

I have learned that recovery is not either/or, recovery does not necessarily mean “cure.” We can have chronic illnesses and we can live with meaning at the same time. Although, we cannot do this alone; we need support, and connection with others who can share in this vision of recovery.

Dr. Pat Deegan is a psychologist and she is also someone who lives with schizophrenia. Much of her work has focused on the ideas of mental health recovery; 

"Recovery is not the urge to become normal. The goal is to embrace our human vocation of becoming more deeply, more fully human…Living in mental health recovery is not an end goal…but an ever deepening acceptance of our limitations and the doorway to what we can do and contribute." (Pat Deegan)

Recovery includes setbacks and joys. We can live with a chronic, incurable conditions, experience intolerable suffering…and not be assisted in our death, even if we may feel we want this when facing despair and emotional pain.

Our feelings and us being allowed to “act on it” are different.

I have learned that living with mental illnesses does not mean searching for perfect wellness. It can mean redesigning a life that is meaningful for us which includes all emotions, all experiences. Recovery will mean both moments of hopelessness and moments of peace.

We can both want death sometimes, and not actively pursue it. I have come to a place in my own journey where I am able to not only survive painful emotions and experiences, but also to allow resurrection out of my own suffering to bloom into positive for others. This has taken a long a time and had this legislation been passed years ago, I may not be here writing.

Allowing assisted suicide for mental illness opens the door for us to act. It changes the vision of the “light at the end of the tunnel” to become dreams of death rather than dreams of hope and our continued striving to find what we need to live and thrive with our perhaps “incurable conditions.” Through this legislation we may stop fighting for those who are so close to finding their irreplaceable way of letting the light in through the cracks and shining their very special light out to others…

Thank you.

Join the 33,000 Canadians who signed the petition: Reject euthanasia Bill C-7 (Link).

Dr. Anne Hanson's Testimony Opposing Assisted Suicide

Suicide Contagion; Safeguard Failures; and Implications for the Practice of Psychiatry 

This article was published by Choice is an Illusion.

Anne Hanson MD

The Maryland Psychiatric Society opposes HB 643, the End-of-Life Option Act. Since this bill was first introduced in 2015, the Maryland Psychiatric Society has extensively deliberated the legislation within the organization through several listserv discussions, a member survey, and a four hour pro-con debate sponsored jointly with the Maryland somatic physician's organization, Med Chi. In addition to reviewing the legislation each year, we considered information contained in the American Psychiatric Association's resource document on assisted suicide (APA 2017) and other literature as cited in the references below.

The Maryland Psychiatric Society recognizes that this is a divisive issue and that some of our members disagree with the organization's position. Those members have been encouraged to contact their elected officials to contribute their thoughts and we welcome consideration of both sides of this serious policy.

The Maryland Psychiatric Society maintains its opposition to HB 643. There are three general areas of concern.

1. Suicide Contagion

Promotion of this bill, and assisted suicide laws generally, transmit a dangerous message to vulnerable Maryland citizens. According to the Centers for Disease Control,  at any given point in time 4% of people are experiencing suicidal thoughts. One-sixth of those individuals will attempt suicide (1.4 million Americans), and 3% will die (Shreiber and Culpepper 2020). Translated into Maryland numbers, this means that 242,000 people are presently thinking of killing themselves, 40,333 will attempt suicide, and 1210 will die.

Suicide clusters and contagion are well established phenomena with documented connections to media coverage and publicity (Blasco-Fontecilla 2013). The Centers for Disease Control and the World Health Organization both promulgate guidelines for the media coverage of high profiles suicides (Carmichael 2019). These guidelines advise against the portrayal of self-destruction as a “brave,” or “romantic,” and discourage reports which idealize suicidal behavior. They also caution against explicit discussion of suicide methods. These recommendations were developed in part due to a study which demonstrated that deaths by helium asphyxiation increased by more than 400% in New York following publication of the book Final Exit in 1991 (Marzuk 1993).

Proponents of assisted suicide laws violate these public health recommendations when they describe self-destruction as a “graceful” or “beautiful” expression of personal autonomy (Death With Dignity 2020). To date there have been no well designed studies to clarify the relationship, if any, between adoption of assisted suicide laws and states rates of un-assisted suicide. However, following the highly publicized death of Brittany Maynard in 2014 the number of assisted deaths by lethal medication in Oregon nearly doubled, from 71 in 2013 to 132 in 2015 (Oregon 2015). In a letter to the Colorado Springs Gazette, Dr. Will Johnston documented the case of a young man who was inspired to research suicide methods online after being impressed by, and admiring, Brittany Maynard's suicide video (Johnston 2016).

Here in Maryland, two people with serious mental illness have sought psychiatric help to die on the basis of their mental illness. One was a resident of the Maryland state hospital system and made a request for lethal medication on the day the 2019 bill failed in the Senate (Hanson, personal communication). Another was a resident of the Eastern Shore with schizophrenia who contacted several forensic psychiatrists for a capacity assessment in order to apply for euthanasia in Switzerland (Neghi and Crowley, personal communications).

Adoption of this law carries serious implications for people with mental disorders who would demand equality under the law. People with serious and treatment-resistant eating disorders could qualify, since qualification is based upon prognosis rather than diagnosis.

2. Safeguard Failures

The Maryland Psychiatric Society considers the statutory safeguards to be inadequate. Furthermore, they historically have been ignored without consequences to the negligent physicians.

Between 1998 and 2012 a total of 22 Oregon physicians were referred to the Board of Medical Examiners for non-compliance with the provisions of the Death With Dignity Act. None could be sanctioned due to the “good faith” protections of the law, even when required witness attestations were missing. No attempt has been made by Oregon, or any independent researchers, to document unreported cases in Oregon since the entry into force of the DWDA. The true reporting rate in Oregon is therefore unknown (Lewis 2013).

Similarly, in the first year of the Colorado law all prescribing physicians attested that they followed the law even when 42 cases were missing the consultant's evaluation, 22 had no written request, and nine of 69 cases were not reported at all by the physician (Colorado 2017).

In 2016 the Des Moines Register investigated ten years of data in Washington and Oregon, and found that in 40% of cases the reports were missing key data.

Failure to submit required reports, or to hold physicians accountable for reporting failure, is a substantial weakness of this legislation. Even if all required documents were accounted for, there has been no study to date to confirm the accuracy and specificity of these statutory safeguards.

In Maryland, one physician was even willing to violate our state's criminal prohibition. The late Dr. Lawrence Egbert admitted participation in the assisted suicide deaths, by helium asphyxiation, of six non-terminally ill Maryland residents. Three of those patients had co-existing clinical depression. His actions were discovered purely by accident. He was never charged or prosecuted in Maryland. He admitted in an interview with the Baltimore Sun that he had been involved in 15 suicides in Maryland and 300 nationwide (Dance 2014).

If Maryland is unwilling to enforce criminal prohibitions, the enforcement of statutory safeguards is even less likely. Connecticut's Division of Criminal Justice acknowledged that the statutory construction of their legislation would have prohibited prosecution for murder (Connecticut 2015).

3. Implications for the Practice of Psychiatry

This legislation has the potential to significantly complicate the practice of psychiatry in Maryland, for both the treating clinician and when functioning as an evaluator of decision-making capacity.

This law would carve out a class of people who theoretically could be categorically exempt from emergency evaluation procedures or civil commitment. Given that some individuals live for more than one year after receiving a lethal prescription, and that capacity may deteriorate over that time, it is unclear whether a qualified patient who has lost capacity could be assessed and treated for mental illness under this law.

There is no provision to correct an error if lethal medication is given to a patient who has concealed his or her psychiatric history from a prescribing physician. A treating psychiatrist who discovers an error would have no legal means to take custody of or dispose of the medication given to a patient. There is no procedural mechanism to challenge a faulty or erroneous capacity assessment.

A psychiatrist charged with assessing capacity must also rule out the possibility of coercion. In order to do this, the evaluator must be at liberty to interview any individual with relevant information. Under this law, a coerced individual could refuse permission for the evaluator to speak with anyone who has knowledge of the coercion.

The law allows the patient to ingest the medication at the time and place of his or her choosing. Thus, a participating facility could require an inpatient psychiatric unit to allow ingestion on the ward in violation of ward suicide prevention policies. This would be particularly detrimental on units designed for the treatment of eating disorders or in geriatric units, where it would be most likely to occur. People with mental illness also develop co-occurring serious medical conditions such as diabetes; since the law does not require the patient to accept any treatment, this condition would qualify as “terminal” if the individual refuses insulin (Oregon Health Authority 2018). California's health department regulations mandate that state psychiatric facilities must carry out assisted suicides within their units under certain conditions (9 CCR §4601).

Conclusion

Several additional deficiencies have been identified by other opponent groups, and the Maryland Psychiatric Society endorses these concerns. These include:

1.  No requirement for decisional capacity at the time of ingestion.
2.  No requirement for an independent or law enforcement observer at the time of ingestion.
3.  No mechanism to detect a negligent, incompetent, or malicious prescriber.
4.  The risk to third parties in the home (depressed or mentally ill family members).
5.  Detrimental psychological effects on the involved medical professional.
6.  No requirement for a doctor to notify a power of attorney or guardian that a prescription has been requested.
7.  Potential federal civil rights violations if the eligible person is institutionalized in a correctional facility or state hospital where prevention of suicide is an affirmative obligation.
8.  The lack of mental health screening instruments validated in this population for this purpose.
9.  No mandatory reporting or whistleblower protection for healthcare providers aware of negligent or malicious prescribers

References:

Anfang S et al. APA Resource Document on Physician Assisted Death. American Psychiatric Association 2017.

Blasco-Fontecilla, Hilario. “On Suicide Clusters: More than Contagion.” The Australian and New Zealand Journal of Psychiatry 47, no. 5 (May 2013): 490–91. https://doi.org/10.1177/0004867412465023.

California. Petitions to the Superior Court and Access to the End of Life Option Act. 9 CCR §4601 (2016).

Carmichael, Victoria, and Rob Whitley. “Media Coverage of Robin Williams’ Suicide in the United States: A Contributor to Contagion?” PLOS ONE 14, no. 5 (May 9, 2019): e0216543. https://doi.org/10.1371/journal.pone.0216543.

Colorado End-of-Life Options Act, Year One 2017 Data Summary. Available at: https://drive.google.com/open?id=1kBXgAFzHl6kcfsvtLHfOQ94Unk9mDa-  Accessed February 2, 2020

Connecticut Division of Criminal Justice. Written Testimony Regarding HB7015. 2015. Available at https://www.cga.ct.gov/2015/JUDdata/Tmy/2015HB-07015-R000318-Division%20of%20Criminal%20Justice%20-%20State%20of%20Connecticut-TMY.PDF. Accessed February 4, 2020

Dance, Scott. 2014. “Maryland Strips Doctor of License for Assisting in Six Suicides - Baltimore Sun.” Baltimore Sun, December 30, 2014. https://www.baltimoresun.com/health/bs-hs-suicide-doctor-20141230-story.html.

Death with Dignity National Center. Stories. Available at: https://www.deathwithdignity.org/stories/  Accessed February 2, 2020.

Johnson, Will. 2016 “Brittany Maynard’s Story Sends the Wrong Message to Young People.” Accessed February 2, 2020. https://www.choiceillusioncolorado.org/2016/10/brittany-maynards-story-sends-wrong.html.

Lewis, Penney, and Isra Black. “Reporting and Scrutiny of Reported Cases in Four Jurisdictions Where Assisted Dying Is Lawful: A Review of the Evidence in the Netherlands, Belgium, Oregon and Switzerland.” Med Law Int 13, no. 4 (2013): 221–39.

Marzuk PM, Tardiff K, Hirsch CS, Leon AC, Stajic M, Hartwell N, Portera L (1993) Increase in suicide by asphyxiation in New York city after the publication of Final Exit. N Engl J Med 329:1508–1510.  https://doi.org/10.1056/NEJM199311113292022

Munson, Kyle, and Jason Clayworth. 2016. “Suicide with a Helping Hand Worries Iowans on Both Sides of ‘Right to Die.’” Des Moines Register, November 25, 2016. https://www.desmoinesregister.com/story/news/investigations/2016/11/25/too-weak-kill-herself-assistance-legal/92407392/.

Oregon. Death With Dignity Annual Reports. Available at: https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Pages/ar-index.aspx Accessed February 2, 2020
Oregon Health Authority. 2018. Responses to Fabian Stahle. Available at: https://drive.google.com/file/d/1XopTDjBA2SAVBGBxpDazNN899eTHixSe/view. Accessed February 4, 2020

Shreiber, J, and L Culpepper. 2020. “Suicidal Ideation and Behavior in Adults.” Up-to-Date, January. https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-adults.

Uruguay bill would legalize wide open euthanasia and assisted suicide.

Alex Schadenberg

Executive Director, Euthanasia Prevention Coalition

A bill to legalize euthanasia and assisted suicide was introduced on March 11 in the Uruguayan Congress. The Uruguay bill lacks definition allowing it to be have a wide interpretation.

My commentary of the bill is based on a google translation of the text of the bill.

Article one of the bill provides legal protection for doctors who are willing to cause the death or assist the suicide of:

“a person of legal age, psychologically fit, ill with a terminal pathology, irreversible and incurable or afflicted by unbearable suffering, kills you or helps you kill yourself.”

It is clear that the bill legalizes euthanasia and assisted suicide because it states that the doctor will kill you or help you kill yourself makes.

Euthanasia is an intentional act to kill a person, upon request, who is disabled, sick or suffering. In most countries, euthanasia is prohibited by homicide or murder laws.

Assisted suicide is to intentionally provide the means for another person to kill oneself.

The Uruguay bill allows for a wider interpretation because it does not define the terms terminal pathology or unbearable suffering. 

The bill does not require a person to try effective treatments. There are many terminal conditions, where the person, with treatment may have years to live.  The term unbearable suffering is subjective. Some people find their condition to be unbearable but once they have received pain or symptom management, they change their mind. If terms are not defined or subjective, the doctors who participate in euthanasia will interpret the meaning of these terms over time.

Article two of the bill requires a second doctor to examine and confirm the medical diagnosis of the person requesting death.

Article three of the bill requires the primary doctor to confirm that the person requesting death is competent, free from coercion, has a continuous desire to die, and knows about alternatives. This article requires a second interview be done at least 30 days after the first request. The bill allows someone else to sign for the person requesting death. Allowing another person to sign-off is inappropriate and dangerous.

Article four of the bill requires the formal request for death to be made 3 days after the second interview. Once again, the bill allows someone else to sign. The bill also allows one of the witnesses to be a beneficiary. In most jurisdictions, a beneficiary is unable sign a will. This issue deals with life and death, rather than property and finances.

Article five of the bill states that the request is revocable.

Article six of the bill requires that the doctor who prescribes the lethal drugs (assisted suicide) must assure that the drugs are only used by the person who they are prescribed for. If the prescribing doctor is not present at the time of death, how will the prescribing physician assure that this happens?

Article seven of the bill requires the doctor who does the act or prescribes the lethal drugs to report the death to the Commission on Bioethics and Integral Quality of Health Care of the Ministry of Public Health, whether the doctor was present at the death or not.

This bill provides the physician with the: power to decide if the person should die, legal protection to cause the death, and then legal oversight to self-report the death to the authorities. Self-reporting systems provide the perfect legal cover since the only person who would know if the law was broken is the person who is dead.

Comments: The bill does not define the key terms, therefore the Uruguay euthanasia and assisted suicide bill can be interpreted in wide manner. For instance, most US states define terminal illness with a six month prognosis. 

The bill does not require a person to at least try effective treatments. There are many medical conditions that, if untreated, become terminal. Unbearable suffering is a subjective term. A person may be depressed or experiencing suicidal ideation and decide that their health condition is unbearable in order to be put to death.

Canada’s euthanasia law does not define key terms, creating a natural slippery slope with the number of euthanasia deaths and reasons for killing expanding very quickly.

The bill gives the power to decide life or death to the primary doctor with confirmation by a second doctor. Nowhere does the bill prohibit doctor shopping which is common in jurisdictions that have legalized medical killing.

This bill is accurate when it states that the doctor can kill you or help you kill yourself. Most jurisdictions employ softened language such as assisted death or medical aid in dying.  We must call it what it is.

Legalizing euthanasia permits medical murder. It kills the patient, who is in need of care not killing, and it changes the doctor who turns from healing to killing.

Uruguay needs to rejects this bill.

Suicide Prevention Researchers Leave Out Assisted Suicide

This article was published by National Review online on May 22, 2020.

Wesley Smith

By Wesley J Smith

It almost never fails. A learned article in a medical or bioethics journal laments our suicide crisis and urges greater efforts at prevention. And yet somehow, the authors never once mention the elephant in the room: i.e., the impact of ubiquitous suicide promotion by “death with dignity” activists, boosted by media commentators, in popular culture features, and as furthered by politicians.

It just happened again. An article published in the AMA’s JAMA Psychiatry: promises to “flatten the curve” of our rising suicide numbers, but doesn’t once mention assisted suicide as a contributor to the problem:

To drive this research agenda, we are acting on research that indicates suicide prevention efforts in health care settings have the potential to significantly reduce suicide rates. Nearly 30% of decedents had a health care visit in the 7 days before suicide; half were seen in health care settings within the preceding 30 days; and around 90% had visits in the year before death. Second, applying universal screening in the emergency care setting could double the number of individuals identified within usual care. 

Similarly, the application of risk prediction algorithms to electronic health records can enhance prediction of suicide attempts and deaths, particularly when the data are enriched with screening information. Third, there is a growing suite of effective interventions and care practices that include medications and psychotherapies, a brief safety plan intervention, and follow-up efforts at high-risk, critical points of care transition such as “caring communication” contacts, and telephone calls to encourage ongoing social connection and care engagement. These practices can improve function and reduce the frequency of suicide attempts between 30% to 50% over the following year. The NAASP recommends that these practices be combined in a system of care and that health care organizations strive for this “Zero Suicide” approach.

I’m all for it. But pretending assisted-suicide deaths are not “suicide,” as most laws require, doesn’t make them not suicide, and merely sweeps that aspect of our crisis under the rug.

Active suicide promotion for the ill and disabled is something new in our history. Unless suicide-prevention researchers include the impact of such advocacy in their studies, assess the consequences of the “some-suicides-are-good” message communicated by laws legalizing doctor-prescribed death, and explore the shameful failure of doctors and hospice professionals to call in prevention services when someone asks for help in dying where assisted suicide is legal, this will be for naught.

To paraphrase Lincoln, we can’t be half suicide prevention and half suicide promotion. Sooner or later, we will be all one or the other.

Jacques Campeau did not get the care that he needed.

This article was published by Toujours Vivant - Not Dead Yet on May 15, 2020, with an article on pandemic policies. (Link)

No Free Choice: Jacques Campeau

By Amy Hasbrouck

In July of 2019 several Québec media outlets reported on the suicide death of Jacques Campeau, who had Multiple Sclerosis. The stories focused on his family’s anger over the fact that he was denied euthanasia several times because he was not at the “end of life;” the family brought his death to the attention of the media in order to put pressure on politicians and the courts to loosen this eligibility criteria. But details from the articles show that Mr. Campeau really needed help to live, not to die.

According to his daughters, Mr. Campeau was “increasingly despondent and withdrawn” and his wife said he had talked about suicide for a year. “I would come home every evening afraid he had done it.” Depression is a well-known problem associated with MS, both as a reaction to flare-ups, and as part of the disease itself. It can be made worse by pain and fatigue that often come with MS. If Mr. Campeau was not being treated for depression, he was not getting the care he needed.

The articles not only showed that Mr. Campeau had low self-esteem, but also reinforced those beliefs about people living with MS and other chronic diseases. According to the Journal de Montréal, he told his family that he was nothing more than a digestive tract. The reporter described his «suffering» by saying he used a wheelchair and incontinence products, and “hadn’t seen the light of day since November.” His daughter said he had “no quality of life,” and that he was a “prisoner of his body.” Rather than asking if Mr. Campeau had received peer support or “dignity therapy” to deal with his existential distress, the journalists repeated negative stereotypes of life with a disability as a fate worse than death.

Media reports suggested Mr. Campeau was losing autonomy, but there was no mention of in-home assistance. His daughter told of receiving a call at work “telling her [Mr. Campeau] had fallen at home and had been lying on the floor for two hours, waiting to call when he knew she was on break.”

Mr. Campeau’s family expressed disappointment over not getting a chance to say good-bye. “We would have preferred to have a last moment with him ... to have a dinner with him, tell him that we love him. We would have liked to talk to him before he did this." They believe a planned death would have met their need for closure.

The only other sources cited by the journalists were spokespeople for “Dying with Dignity” and a pro-euthanasia doctor. The reporters included a link to the family’s petition to change the “end-of-life” eligibility criterion. The articles did not quote people living with MS or experts in palliative care or suicide prevention. The Journal de Montréal included information on how to obtain MAiD and the suicide prevention telephone number.

The tragedy here is not that Mr. Campeau didn’t die by euthanasia, or even that he committed suicide. The tragedy is that those who surrounded him seemed to think that MS, a chronic illness that includes flare-up and remission, was a terminal illness, and that his life was not worth living because of his disability. The tragedy lies in the fact that he did not have the services and supports he needed to adapt to his changing condition, feel good about himself, maintain his independence, and get peer counseling and suicide prevention services that could have improved the quality of his life, and ultimately saved it.

Amy Hasbrouck is the President of the Euthanasia Prevention Coalition and the founder of Toujours Vivant - Not Dead Yet (TVNDY) a non-religious organization by and for disabled people.

Oregon’s Suicide Crisis Worsens

This article was published by the National Review online on March 5, 2020.

Wesley Smith

By Wesley J Smith

Oregon, a state that has considerably liberalized its assisted-suicide laws, has an ongoing youth and general suicide crisis on its hands. From an Oregon Health Authority press release:

In February the Centers for Disease Control and Prevention released data showing that suicide was the leading cause of death among Oregon youth ages 10 to 24 in 2018, up from the second leading cause of death in 2017. Oregon is now ranked 11th highest in the nation for youth suicide death rates (up from 17th in 2017). 

The change in rank is due to multiple factors: There was a rise in the suicide rate as well as a drop in the rate of unintentional injury deaths, the former leading cause. The unintentional injury category includes overdose deaths and motor vehicle accidents. While the suicide rate has increased, the unintentional injury rate decreased from 2017 to 2018. 

“Suicide continues to be a concerning problem in Oregon across all age groups, including youth, as this new data confirms,” said Dana Hargunani, Oregon Health Authority’s chief medical officer. “We continue to prioritize work across Oregon to support young people in schools, at home and in our communities. Fortunately, we are able to apply best practices that work to prevent suicide, and there are many ways you can get involved.”

Of course, the state’s suicide numbers exclude the thousands of people who have died from assisted suicide since 1997, and state public-health bureaucrats remain clueless of the possibility that allowing assisted suicide for one group of people might give others the idea that self-killing is a splendid way to end suffering.

The OHA has conflicting mandates when it comes to suicide: promoting it for the sick while striving to prevent it among the young and others. Sorry, that’s not how life works.

Germany’s Highest Court Creates Right to ‘Self-Determined Death’

This article was published by National Review online on February 26, 2020

Wesley Smith

By Wesley Smith

The logic of euthanasia/assisted suicide has always pointed towards a right to death-on-demand. Assisted-suicide activists deny it for reasons of expediency. But the logic is irrefutable. If there is a “right to die,” how can it be limited to restricting categories?

Well, the Federal Constitutional Court, Germany’s highest judicial body, has gone there and without equivocation. In overturning a legal ban on “professional assisted suicide,” i.e., by doctors, the court ruled that there is virtually an unlimited right “to a self-determined death” — and to also receive help from others in achieving that end. From the AFP story (my emphasis):

Federal Constitutional Court

Judge Andreas Vosskuhle at the Federal Constitutional Court in Karlsruhe said the right to a self-determined death included “the freedom to take one’s life and seek help doing so”. 

The court also surprised observers by explicitly stating that the right to assisted suicide services should not be limited to the seriously or incurably ill. 

The freedom to choose one’s death “is guaranteed in all stages of a person’s existence”, the verdict read.

This right to receive help dying wouldn’t be limited do doctor-assisted suicide, by the way. An earlier ruling legalized assisted suicide for reasons that did not include a financial consideration.

In what seems more of an afterthought than a principled concern, the court said brakes could be tapped to delay a planned suicide, such as waiting periods. But ultimately, if somebody wants to commit suicide, the right to do so is apparently absolute based on the German constitution’s guarantee of the right to personal freedom and dignity:

Judge Vosskuhle acknowledged that the ruling would not please everyone but said the decision of those wishing to end their lives had to be respected. “We may regret their decision and try everything we can do change their minds but ultimately we must accept their freedom to choose,” he said.

It cannot be denied any longer. The long-predicted (here’s a 2007 warning from me) lethal logical end of accepting the values that underlie the assisted suicide/euthanasia movement — death for virtually anyone who wants to die for any reason — has officially been reached. This would seem to include at least mature children, since childhood is a stage of a person’s existence. Right?

So no more telling us that assisted suicide is only for the terminally ill! No more telling us that rigid guidelines will protect against abuse! Basta! Germany is now officially a suicide culture. If we keep hearkening to the siren song of death emanating from assisted/suicide euthanasia advocates here, sooner or later, we will be too.

Somewhere, Jack Kevorkian is smiling.

Assisted suicide goes against our values

This opinion article was published by the Concord Monitor on February 11, 2020

By Steven Wade
Executive Director of the Brain Injury Association

House Bill 1659 effectively gives physicians permission to prescribe drugs that result in patient suicide. We have serious concerns about the potential impact on New Hampshire’s at-risk population if this bill passes. It normalizes suicide as medical care and corrupts the doctor/patient relationship.

New Hampshire suicide rates are up nearly 50% over the past 10 years. New laws have been passed recently to beef up suicide prevention efforts because there are populations, including veterans, teens, people with disabilities, brain injury survivors and the elderly “pre-disposed” to suicide for reasons including depression, lack of autonomy and inability to engage in activities that make life enjoyable.

New Hampshire has a suicide crisis and has set an ambitious goal of zero suicides. This bill works against that goal. What sort of a message does it send to at-risk people if New Hampshire passes a law that says suicide is an easily achieved option?

The exploitation of the elderly is another significant problem in New Hampshire. This bill could enable exploiters to misuse the law to the detriment of those dependent on others for their care. Anyone with ulterior motives like convenience and cost will have the power to steer vulnerable members of our society – who are not necessarily dying – in the direction of death instead of care. Instead the state should be investing in greatly expanded access to palliative care and mental health services for those at-risk populations relying on the state for their care.

This bill calls into question the state’s power to set standards for quality of life. If it’s a terminal illness predicted to last six months now, what might it become in the future? Laws like this inevitably expand over time. If New Hampshire opens the door to assisted suicide, we will have to face whatever might be on the other side of that door.

HB 1659 goes against the very essence of who we are as citizens of New Hampshire. If we want to show that we value the lives of at-risk teens, the elderly, people with disabilities and veterans who have fought for our country, we should be focusing our energy on providing them with care, not with death.

(Steven Wade is the executive director of the Brain Injury Association of New Hampshire in Concord and a member of the N.H. Coalition Against Assisted Suicide.)

US Congress Resolution H.Con.Res.79: Assisted suicide puts everyone at risk of deadly harm.

(Link to the Congressional Resolution H.Con.Res.79)

Expressing the sense of the Congress that assisted suicide (sometimes referred to using other terms) puts everyone, including those most vulnerable, at risk of deadly harm.

IN THE HOUSE OF REPRESENTATIVES
December 12, 2019

Mr. Correa (for himself, Mr. Wenstrup, Mr. Peterson, Mr. Smith of New Jersey, Mr. Langevin, Mrs. Wagner, Mr. Lipinski, Mr. LaHood, Mr. Cartwright, Mr. Harris, and Mr. Abraham) submitted the following concurrent resolution; which was referred to the Committee on Energy and Commerce.

Whereas “suicide” means the act of intentionally ending one’s own life, preempting death from disease, accident, injury, age, or other condition;

Whereas “assisting in a suicide”, sometimes referred to as death with dignity, end-of-life options, aid-in-dying, or similar phrases, means knowingly and willingly prescribing, providing, dispensing, or distributing to an individual a substance, device, or other means that, if taken, used, ingested, or administered as directed, expected, or instructed, will, with reasonable medical certainty, result in the death of the individual, preempting death from disease, accident, injury, age, or other condition;

Whereas society has a longstanding policy of supporting suicide prevention such as through the efforts of many public and private suicide prevention programs, the benefits of which could be denied under a public policy of assisted suicide;

Whereas assisted suicide most directly threatens the lives of people who are elderly, experience depression, have a disability, or are subject to emotional or financial pressure to end their lives;

Whereas the Oregon Health Authority’s annual reports reveal that pain or the fear of pain is listed second to last (25 percent) among the reasons cited by all patients seeking lethal drugs since 1998, while the top 5 reasons cited are psychological and social concerns: “losing autonomy” (92 percent), “less able to engage in activities that make life enjoyable” (90 percent), “loss of dignity” (79 percent), “losing control of bodily functions” (48 percent), and “burden on family friends/caregivers” (41 percent);

Whereas the Supreme Court has ruled twice (in Washington v. Glucksberg and Vacco v. Quill) that there is no constitutional right to assisted suicide, that the Government has a legitimate interest in prohibiting assisted suicide, and that such prohibitions rationally relate to “protecting the vulnerable from coercion” and “protecting disabled and terminally ill people from prejudice, negative and inaccurate stereotypes, and ‘societal indifference’”;

Whereas clearly expressing that assisted suicide is not a legitimate health care service, Congress passed, with a nearly unanimous vote, and President Bill Clinton signed, the Assisted Suicide Funding Restriction Act to prevent the use of Federal funds for any item or service, including advocacy, provided for the purpose of causing, or assisting in causing, the death of any individual such as by assisted suicide, euthanasia, or mercy killing;

Whereas a handful of States have authorized assisted suicide, but over 30 States have rejected over 200 attempts at legalization since 1994;

Whereas States that authorize assisted suicide for terminally ill patients do not require that such patients receive psychological screening or treatment, though studies show that the overwhelming majority of patients contemplating suicide experience depression;

Whereas the laws of such States contain no requirement for a medical attendant to be present at the time the lethal dose is taken, used, ingested, or administered to intervene in the event of medical complications;

Whereas such State laws contain no requirement that a qualified monitor be present to assure that the patient is knowingly and voluntarily taking, using, ingesting, or administering the lethal dose;

Whereas such State laws contain no requirement to secure lethal medication if unwanted or if death occurs before such medication is used;

Whereas such State laws do not prevent family members, heirs, or health care providers from pressuring patients to request assisted suicide;

Whereas such States qualify some patients for assisted suicide by using a broad definition of “terminal disease” and “going to die in six months or less” that includes diseases (such as diabetes or HIV) that, if appropriately treated, would not otherwise result in death within six months;

Whereas it is extremely difficult even for the most experienced doctors to accurately prognosticate a six-month life expectancy as required, making such a prognosis a prediction, not a certainty;

Whereas reporting requirements vary by State, but when required, rely on prescribing physicians or dispensing pharmacists to self-report;

Whereas such reporting is neither conducted by an objective third party nor of sufficient depth and accuracy to effectively monitor the occurrence of assisted suicide;

Whereas there is an astounding lack of transparency in the practice of assisted suicide to the extent that State health departments and other authorities admittedly have no method of knowing if it is being practiced within the bounds of State laws and have no funding or authority to make such a determination;

Whereas some State laws actively conceal assisted suicide by directing the physician to list the cause of death as the underlying condition without reference to death by suicide;

Whereas the confidential nature of end-of-life decisions makes it virtually impossible to effectively monitor a physician’s behavior to prevent abuses, making any number of safeguards insufficient;

Whereas the cost of lethal medication is far less costly than many life-saving treatments, which threatens to restrict treatment options, especially for disadvantaged and vulnerable persons, as has happened in several known cases and presumably many more unknown in which insurers have denied or delayed coverage for life-saving care while offering to cover assisted suicide;

Whereas access to personal assistance services such as in-home hospice and palliative care, home health care aides, and nursing care/nursing assistance is regretfully limited and subject to long waiting lists in many areas, placing systemic pressure on patients in need of such personal assistance services to resort to assisted suicide; and

Whereas for all these reasons, assisted suicide undermines the integrity of the health care system: Now, therefore, be it

Resolved by the House of Representatives (the Senate concurring), That it is the sense of Congress that the Federal Government should ensure that every person facing the end of their life has access to the best quality and comprehensive medical care, including palliative, in-home, or hospice care, tailored to their needs and that the Federal Government should not adopt or endorse policies or practices that support, encourage, or facilitate suicide or assisted suicide, whether by physicians or others.

Euthanasia's never ending expansion.

This article was published by OneNewsNow on Nov 6, 2019.

By Charlie Butts

Proponents of assisted-suicide continue to show that once the practice is legalized, the list of those who qualify never stops expanding.

Alex Schadenberg

Advocates of an assisted end initially claim the practice is meant for people who are suffering serious pain. The laws passed in the U.S. include the restriction that the patient must have the prognosis of six months or less to live.

Alex Schadenberg of the Euthanasia Prevention Coalition tells OneNewsNow a Belgium lawmaker is now suggesting that people who believe they have lived a completed life also ought to qualify – a move that Schadenberg says often victimizes the elderly.

"What these people need more than anything else is not death or lethal injection," he contends. "They need visitors. They need friends. They need a culture that respects them. They don't need lethal injection."

He adds that it also helps when people stay in close touch with their elderly family members to make sure they know they are loved and valued and to ensure that they receive counseling and/or medication when they need it.

"Completed life, though, undercuts the basic euthanasia argument," the Coalition executive director asserts. 

"Where they're trying to legalize euthanasia, they talk about suffering, suffering, suffering. And when you look at the consequences of a completed life, it is about suicide, and the state provides the death."

Canada is currently considering expanding its euthanasia candidates to include children and the mentally ill.

• Belgian politician promotes euthanasia for completed life.

Montréal man says that psychologist urged him to kill his wife.

This article was published by Choice is an Illusion on November 4, 2019

That's Not Assisted Suicide, That's Murder.
 

Serge Simard & Miranda Edwards

Emily Campbell with CTV news Montreal reported that a Montreal couple is calling for disciplinary measures against a psychologist they say counselled one of them to kill the terminally ill other.

When Miranda Edwards was diagnosed with an aggressive form of cancer she said she was determined to fight it.

“I want to live, I want every medical intervention possible,” she said. “I will fight to the end. I will do every treatment, everything possible to stay alive.”

Her husband, Serge Simard, struggled as his wife’s health declined and eventually sought the services of a psychologist to help manage the stress.

Simard alleges the psychologist told him to overdose his wife with morphine she had been prescribed for her pain. He secretly recorded the session on his phone and on the recording the psychologist can be heard saying: 

“at one point it will be a dose too much and she just won’t wake up. It’s the best thing that could happen, really. She won’t be suffering anymore she’ll be in a better place.”

The psychologist cannot be identified as they haven’t been charged with a crime.

Simard said he was horrified by the advice.

“That’s not assisted suicide, that’s murder,” he said. “I will not murder my wife. If Miranda voices anything I will respect her wishes. Miranda has never voiced that she wanted to pass away.”

Dr Paul Saba

Family physician Paul Saba said he feared incidents like this could occur as a result of the legalization of medically assisted suicide....

The couple said they were disappointed that both Montreal and Gatineau police refused to pursue the case and didn’t rule out a civil court case.

Woman pressured boyfriend to suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Conrad Roy

Last February, the Massachusetts high court upheld the the voluntary manslaughter conviction of Michelle Carter for assisting the suicide of Conrad Roy who was 18 at the time of his death. Carter, who was 17 at the time of the death, was sentenced to 15 months in prison. The court found that Carter pressured Conrad to die by suicide.
 
Another young woman has been charged after pressuring or assisting her boyfriend to die by suicide.

Alexander Urtula

Inyoung You (21) has been charged with involuntary manslaughter in the suicide death of Alexander Urtula (22) who had an 18 month relationship. Mark Pratt reported for the Associated Press:

Inyoung You, 21, was “physically, verbally and psychologically abusive” to fellow Boston College student Alexander Urtula during an 18-month relationship, Suffolk District Attorney Rachael Rollins said at a news conference.

You sent Urtula, 22, of Cedar Grove, New Jersey, more than 47,000 text messages in the last two months of the relationship, including many urging him to “go kill yourself” or “go die,” Rollins said. You also tracked Urtula and was nearby when he died in Boston on May 20, the day of his Boston College graduation.

“Many of the messages display the power dynamic of the relationship, wherein Ms. You made demands and threats with the understanding that she had complete and total control over Mr. Urtula both mentally and emotionally,” Rollins said.

According to the Associated Press article You is currently in South Korea.

You is in her native South Korea, and it is unclear when she will be arraigned. Prosecutors are in negotiations with You's counsel to get her to return to the U.S. voluntarily, but if she does not, Rollins said, she will start extradition proceedings.

Last July, Massachusetts State Senator Barry Finegold and Representative Natalie Higgins introduced Conrad's Law, a bill to deter suicide coercion. Conrad's law would punish those who coerce others into committing or attempting to commit suicide, with punishment of up to five years in prison. The bill does not apply to assisted suicide, which is illegal in Massachusetts.

Similar to other assisted suicide cases, the person who dies may have been coerced or encouraged to suicide.

Lawyers for Michelle Carter argued that her texts were constitutionally protected free speech and yet the Massachusetts Supreme Judicial Court upheld her conviction. The Carter decision has been appealed to the U.S. Supreme Court, which hasn't yet decided whether it will take up the case.

To reach the National Suicide Prevention Lifeline, call 1-800-273-TALK (8255). You can also text a crisis counselor by messaging 741741.