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Friday, June 17, 2011

A Response to The Nation: Legal Assisted Suicide is a Recipe for Abuse; Health Care Providers are Empowered to Steer Patients to Suicide

Yesterday, NPR and The Nation featured a pro-assisted suicide commentary by Ann Neumann.[1]  Her commentary overlooked gaps in the Oregon and Washington assisted-suicide laws.  She uncritically accepted Compassion & Choices's marketing claims that it promotes patient choice for "terminal" patients.  This blog presents the other side.

A Recipe for Abuse

Physician-assisted suicide laws in Oregon and Washington have gaps that put patients at risk.[2] The most obvious gap is a lack of witnesses at the death.[3] Without disinterested witnesses, the opportunity is created for someone else to administer the lethal dose to the patient against his will. Even if the patient struggled, who would know?


Barbara Coombs Lee is a Former "Managed Care Executive" 

Neumann's commentary describes Compassion & Choices and its president, Barbara Coombs Lee, as promoters of patient choice.[4]  Compassion & Choices is the former Hemlock Society.[5]  It advocates for legal physician-assisted suicide, which it terms "aid-in-dying."

In 2008, Oregon resident Barbara Wagner wanted treatment for cancer.[6] The Oregon Health Plan (Medicaid) offered her assisted-suicide instead.[7]  After Wagner’s death, Barbara Coombs Lee wrote an editorial criticizing Wagner for her choice to be treated.[8]  Coombs Lee also defended the Oregon Health Plan, which had steered Wagner to suicide.[9]

Perhaps not a coincidence, Coombs Lee is a former "managed care executive."[10]  She argued against Barbara Wagner's choice.

Ending Lives

Compassion & Choices advocates for assisted suicide for "terminally ill adult patients," which as defined by Compassion & Choices would include young people with
 "decades" to live. This is what Compassion & Choices proposed in Montana in 2009.   See pages 1 to 3 at http://www.euthanasiaprevention.on.ca/ConnMemo02.pdf  (Opinion letter regarding a Connecticut lawsuit, discussing and attaching Compassion & Choices' Montana definition of "terminally ill adult patient," which would applying to young people with "decades" to live).

In Oregon and Washington, terminality is defined in terms of having less than six months to live.  Even then, the people at issue are not necessarily dying.  This is the point of a 2009 article from Washington State:  Patients can live years beyond expectations.[11]

With the topic of "aid in dying," the people at issue are not necessarily dying.  They may have years or even decades to live.  For these people, Compassion & Choices' advocacy is about ending their lives.

Fighting Back

In 2010, Compassion & Choices claimed that assisted suicide was legal in Idaho.  A former Chief Justice of the Idaho Supreme Court denounced the claim as "false."[12] In 2011, the Idaho legislature enacted a statute to strengthen Idaho’s law against causing or aiding a suicide.[13]

In 2011, proposed assisted suicide bills failed in Montana, Hawaii and New Hampshire.[14] In New Hampshire, the Committee report to defeat the bill stated:

"[T]his bill is a recipe for . . . abuse.  The committee also recognizes that doctors’ diagnoses and predictions may be incorrect; numerous cases exist where people have lived far beyond their doctor’s predictions, some of them having been cured from their terminal disease. . . .[T]his bill represents bad policy and practice . . ."  House Journal, Vol. 33, No. 28, scroll down to HB 513-FN. 

Conclusion

The claim that legal assisted suicide promotes patient choice is marketing rhetoric.  These laws are a recipe for abuse.  They empower health care providers to steer patients to suicide.  They encourage citizens to cut short their lives.  Don’t be fooled.

 * * *


[1]  The Nation: "Keeping the Right to Die Alive," by Ann Neuman, available at http://www.npr.org/2011/06/16/137217016/the-nation-keeping-the-right-to-die-alive#commentBlock
[2]  See e.g., Margaret K. Dore, "Death with Dignity: What Do We Advise Our Clients?  ," King County Bar Association, Bar Bulletin, Washington State Bar Association, Bar News, July 2009 (regarding Washington's act); and Margaret Dore, "'Death with Dignity': A Recipe for Elder Abuse and Homicide (Albeit not by Name)," Marquette Elder's Advisor, Vol. 11, No. 2, Spring 2010 (regarding Washington's and Oregon's acts)
[3]  Id.
[4]  The Nation, supra at Note 1.
[5]  Ian Dowbiggin, A Concise History of Euthanasia, 146 (2007)(In 2003, Hemlock changed its name to End-of-Life Choices, which merged with Compassion in Dying in 2004, to form Compassion & Choices).
[6]  Susan Harding and KATU Web Staff, "Letter noting assisted suicide raises questions," KATU.com, July 30, 2008; Susan Donaldson James, "Death Drugs Cause Uproar in Oregon," August 6, 2008; and Kenneth Stevens, MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, The official publication of the Idaho State Bar, September 2010.
[7] Id.
[8] Barbara Coombs Lee, "Sensationalizing a sad case cheats the public of sound debate," The Oregonian, November 29, 2008, available at http://www.margaretdore.com/pdf/Coombs_Lee_against_Wagner.pdf
[9]  Id.
[10]  http://www.margaretdore.com/info/coombs_lee_bio_001.pdf
[11] Nina Shapiro, “Terminal Uncertainty,” Washington’s new “Death with Dignity” law allows doctors to help people commit suicide - once they’ve determined that the patient has only six months to live. But what if they’re wrong?" available at http://www.seattleweekly.com/2009-01-14/news/terminal-uncertainty/
[12] http://www.margaretdore.com/info/September_Letters.pdf 
[13] http://legislature.idaho.gov/legislation/2011/S1070E1.pdf
[14] In Montana, SB 167 died in Committee.  In Hawaii, SB 803 was held in Committee.  In New Hampshire, HB 513 was defeated in Comittee and on the House Floor.  See http://www.gencourt.state.nh.us/bill_status/bill_docket.aspx?lsr=297&sy=2011&sortoption=&txtsessionyear=2011&txtbillnumber=hb513&q=1