“Audrey Cole is an activist, educator and lecturer with deep roots in the Community Living movement.Upon joining her local “Community Living”Association after her son Ian was born, she became intrigued by human rights issues She is known for her expertise on guardianship legislation and her work on supported decision making and on genetic discrimination and has written and lectured on these matters nationally and internationally. She is a Past President of the Brockville and District Association for Community Involvement, an Honourary Life Member of
Community Living Ontario and a Distinguished Associate and Honourary Life member of the Canadian Association for Community Living (CACL) She is an Associate of the Institute for Research on Inclusion and Society (IRIS) and currently serves on CACL’s Values and Ethics Task Force. In 1997, she was awarded the Order of Ontario in recognition of her tireless activism on behalf of people with disabilities.”

Vermont Assisted Suicide Bill Allows a Third Party to Speak for an Elder or Disabled Person

S. 77, the assisted suicide bill passed by the Vermont State Senate on Wednesday, endangers disabled people, elderly people and ill people.  The Vermont House should reconsider its earlier support of the legislation and work to protect the vulnerable citizens of Vermont.

Like the laws in Oregon and Washington, S.  77 provides no protection from an heir or other interested person misrepresenting an applicant’s wishes.

“Capable” means that a patient has the ability to make and communicate health care decisions to a physician, including communication through persons familiar with the patient’s manner of communication if those persons are available.**[§5281 (a)(2)]

And yet a person “familiar with the patient’s manner of communication” could be an heir or other interested person.  And that person could be pressuring the person to choose assisted suicide.

Washington elder law attorney Margaret Dore details how the bill, like the Oregon and Washington laws it is modeled on, invites fraud and abuse. Because no witness is required at the death, “the opportunity is created for the patient’s heir, or for another person who will benefit financially from the death, to administer the lethal dose to the patient without his consent.”    No matter what happened, charges of homicide would be difficult or impossible to bring in the face of the statute’s ironclad immunity.

Senator Peter Galbraith, whose vote switch got the bill through the Senate, said, “I understand and sympathize with the desire for people to have a say, to have some control, at the end of their lives.”  Unfortunately, neither he nor many other legislators have sympathy for people who are already threatened with loss of control.

Bill Peace writes at the Bad Cripple Blog that while he has much respect for Vermonters’ sense of strong community, “I would speculate Vermonters have embraced a type of individualism that does not permit them to think about vulnerable populations and the risks they can encounter.”

He recounts the story of Vermonter Amanda Baggs, a leading disability rights activist who is autistic.  But when she recently needed the insertion of a feeding tube to save her life, she was barraged by hostile hospital staff with urgings to consider “the alternative” – which could only be interpreted as doing nothing and dying.  Peace also links to his own harrowing story of being encouraged to give up and die during a hospitalization.

This is the discrimination at the heart of assisted suicide legislation.  When disabled people come into contact with medical professionals, they judge our quality of life to be so poor that death may be preferable.  When some members of society consider the possibility of acquiring disabling conditions, they believe that it might be better to “choose” death.  Amy Hasbrouck of Not Dead Yet Canada expressed this perfectly in her recent piece, Suicide Celebration Instead of Suicide Prevention.

Peter Galbraith based his initial opposition to legalized assisted suicide on the problem of involving the state in the practice.  In February, he said on the Senate floor that he wanted to “leave it to the doctor and the patient.”  He said that “opponents were concerned about a state-prescribed process for suicide.  The medical profession is concerned about a profession that is about prolonging life being involved in a process to end life.  The disabled community expressed concern to me that having a state-sponsored process would in some way diminish them in society.  These are sincerely held convictions.”

In my own conversation with Galbraith, I emphasized that any state run program would discriminate against people with disabilities by commending certain disability-related reasons as sufficient for suicide.  As demonstrated out in Oregon, these include losing certain physical abilities, “feeling like a burden”, and “loss of control of bodily functions.”

Vermont doctors, whose organization strongly opposed the legislation, will be made into gatekeepers of death, judging some reasons (e.g., embarrassment over incontinence) as rational reasons for suicide, but (presumably) rejecting others (e.g., being told by Martians to commit suicide) as not rational.  Disabled people’s concern is that these disability related reasons are the products of a complex array of social conditioning, stigma and failings in public policy, and should never be used to justify providing suicide assistance rather than suicide prevention. — John Kelly, Second Thoughts Massachusetts

The Burlington Free Press reports:

With the Senate’s passage, the bill goes back to the House, where it is scheduled to hit the floor Saturday, the last planned day of the 2013 legislative session. House Speaker Shap Smith, D-Morristown, said he expects the majority will go along with the Senate version, sending it to a supportive Gov. Peter Shumlin. It would take effect after the governor’s signature.

Opponents revived hope when Sen. Peg Flory, R-Rutland, found language in the bill that might place Medicare and Medicaid funding in doubt, but sponsors simply removed the sentence regarding advance directives, which by federal law cannot be required by insurers or medical providers.  Stalwart opponent Senator Richard Sears, D-Bennington, tried to coax the Senate into sending the bill to conference committee based on this flaw and others not yet found.  He predicted that the sunset provision of the bill, which would dissolve the Oregon-style public health program after three years, would be amended and eventually removed from the bill.  This objection did not catch fire, as proponents assured senators that after three years, assisted suicide would just become part of physician “best practices.”

True Dignity Vermont, which coordinated opposition to the assisted suicide bill, wrote this evening:

Either form of the bill will hurt many people in order to fulfill the wishes of a few who could easily accomplish on their own what they insist they want to do.  In particular, patients who have filled the lethal prescription will have absolutely no protection against being coerced or murdered by a greedy heir or an exasperated caregiver.

Anti-assisted suicide advocates continue to look over the bill for other flaws that might hold out hope of stopping the bill at the last minute. – John Kelly, Second Thoughts Massachusetts

Michael Reynolds of Lewiston is a writer and Web designer for Ability Maine, a disability rights website funded by Resources Organizing for Social Change, a nonprofit based in Monroe. He is a long-time activist and was born with cerebral palsy.

To add to that – Mike has been a long-time friend and supporter of NDY.  He’s a filmmaker who produced the memorable Million Dollar Bigot.

On Sunday, April 28, the Lewiston Sun Journal published on op-ed by Mike – summarizing some current attempts to legalize euthanasia and the historic fails of those attempts in New England in his essay titled “Bill allowing doctor-assisted suicide has troubling aspects.”:

More than a decade ago, the people of Maine soundly defeated a referendum regarding assisted suicide. Last year, the residents of Massachusetts also defeated legislation that would have legalized assisted suicide. Bills in Connecticut and Vermont were killed earlier in the year in those state legislatures.

Despite that overwhelming opposition to assisted suicide, Rep. Joseph Brooks, U-Winterport, has introduced LD 1065, “An act regarding patient care at the end of life” in the Maine Legislature, with a hearing scheduled for April 29.

The bill has many aspects that are troubling.

Unlike the assisted suicide law in Oregon, which has questionable safeguards in place — namely that two doctors need to agree with the terminal diagnosis — the proposed law by Rep. Brooks requires only “the opinion of one doctor,” and terminal diagnosis means only a limited life expectancy, saying nothing about whether that means six days, six months, or six years.

(Note – the Vermont bill has been resurrected and is ready to be debated and voted on in the House this week.)

Please read the rest of Mike Reynold’s essay here.

(Note – the op-ed mentioned below is included at the end of the media advisory, instead of just linked as stated in test)

CCD Media Advisory: Suicide Celebration Instead of Suicide Prevention

 

23 April 2013, WINNIPEG, MB 

 

According to media reports, Susan Griffiths’ assisted suicide will likely occur on Thursday (25 April 2013) at a Dignitas Clinic in Switzerland. Members of the Canadian disability community, who oppose assisted suicide, are available to discuss their concerns about assisted suicide with the media on Wednesday (24 April 2013) and Thursday (25 April 2013). Their contact information is listed below.

Attached you will find “Suicide Celebration Instead of Suicide Prevention”, an Op-Ed article by Amy Hasbrouck of Toujours Vivant – Not Dead Yet Canada, a project of CCD. In her article, Hasbrouck questions why Griffiths has not been offered suicide prevention support. The Council of Canadians with Disabilities (CCD) is a national organization of people with disabilities working for an accessible and inclusive Canada.

 

Link to: Suicide Celebration Instead of Suicide Prevention.

Link to: Célébration au lieu de prévention, du suicide.  

-30-

The following are available to discuss the Susan Griffiths case:

Amy Hasbrouck, Toujours Vivant – Not Dead Yet (Canada), Tel.: 450-921-3057, Email: tigrlily61@gmail.com  (Available for interviews in French and English.)

Laurie Beachell, CCD National Coordinator, Tel.: 204-947-0303, Email: laurie@ccdonline.ca

Dean Richert, Co-chair CCD Ending of Life Ethics Committee, Tel.: (204) 989-2775, Email: drichert@odgb.mb.ca

 

Dr. Nancy Hansen, PhD, Director, Interdisciplinary Master’s Program, University of Manitoba, Tel.: 204-474-6458, Email: Nancy.Hansen@ad.umanitoba.ca

Ruth Enns, Author, Tel.: 204-831-7952, Email: ruthenns@mymts.net

Clare Simpson, Tel.: 204-947-0303, Email: clare@ccdonline.ca

Colleen Watters, Chairperson, MLPD Ethics Committee, Tel.:204-945-5304, Email: cpwatters@shaw.ca

********************

Suicide Celebration Instead Of Suicide Prevention

By Amy Hasbrouck

of Toujours Vivant-Not Dead Yet:

A Project of the Council of Canadians with Disabilities (CCD)

 

Amy Hasbrouck with John Kelly

Sue Griffiths of Winnipeg, MB is the latest person to publicize her desire for assisted suicide, and to have her efforts celebrated by the press.

 

Last week, her plea for parliament to re-open the assisted suicide question was widely reported as she prepared to go to Dignitas, a clinic in Switzerland that helps people kill themselves.

 

Ms. Griffiths has Multiple Systems Atrophy, a degenerative neurological condition which causes pain in about half the people who have it. Photos show her standing, walking and using her hands; she is certainly not a person who is “physically unable to commit suicide without help.” She is described as a person who is in charge of her life, but she apparently wants to have someone else take charge of her death.

 

The reasons she gives for wanting to kill herself are related to disability, needing help with personal care and other daily activities, having to use adaptive equipment, losing independence. The subtext is that, as a person with a disability, she believes she will be less worthy, less dignified, less than fully human.

 

In point of fact, disability is NOT a fate worse than death. When people become disabled, they must grieve the loss of abilities they had, just as a parent might grieve the loss of a child, or one grieves the loss of one’s home after a natural disaster. But no one would suggest it’s a good idea for the bereaved parent or survivor of a natural disaster to commit suicide, much less that she/he be helped to die.

 

We have a policy to prevent suicides, and rightfully so. We apply this policy to people whose despair arises from social as well as psychological stresses; bullied adolescents, LGBT people who’ve been persecuted, Aboriginal people struggling with poverty and loss of cultural heritage, and survivors of domestic violence. People with disabilities who lack services and supports to live in their homes and be integrated in their communities face the same discrimination and social stressors. Suicide prevention policies and services should be applied equally to disabled and non-disabled people, without bias or prejudice about the quality of life with a disability. And society must begin to address the underlying discrimination and stigma that create the conditions in which people with disabilities live.

 

We should really be asking: Why is no one trying to stop Susan Griffiths from committing suicide? Does the media orgy around Griffiths story mean that we believe the everyday realities of living with a disability are reason enough to get help to die? And should the media rise to the bait every time a person with a disability flaunts their suicide in the public square.

 

Not Dead Yet has worked with NCD in the past, most notably on their position paper and update on assisted suicide.

Periodically, NCD has “comment opportunities” for stakeholders in the disability community.  You can attend and comment in person or by phone.  There is a list of meeting and events here.

Here’s the comment that Diane Coleman offered today via phone:

Comments by Diane Coleman and Not Dead Yet Before the National Council on Disability – April 22, 2013

I’m commenting today to urge NCD to take a leadership position in addressing the problem of so-called futile care laws and policies which allow doctors to deny life-sustaining treatment to people with disabilities who want and need it. The common thread running through stories we hear is that our lives with disability are seen as less worth living, so much less that health care providers too often think that death is the correct course. They press this viewpoint on us, our families and sometimes even overrule us when we disagree.

Futility policies are not a new thing, but there are indications that doctors have become increasingly comfortable using them to withdraw life-sustaining treatment to end our lives. They provide doctors a legal safe harbor to act based on whatever medical predictions and quality of life judgments that they may feel are consistent with community standards.

Texas has the most infamous futility law, which requires an ethics committee consultation and then, after only 10 days, allows doctors and hospitals to withdraw treatment. Repeated efforts to amend the Texas law have failed. This year’s amendment proposal is so weak that disability advocates have had to oppose it. Bob Kafka, a national ADAPT leader who is also the head of Not Dead Yet of Texas, testified against SB 303:

“Our opposition … is based on our experiences with the medical community, who with all good intentions, make recommendations/decisions that if implemented would have resulted in the death of people who now are living members of our organizations. . . . Right now most of the appeal process is focused on ethics committees in hospitals that have them. Currently there are no standards for ethics committees in regard to size, membership, procedures or even having one. We believe that there is an inherent conflict of interest to have a committee convened at the hospital that the doctors have privileges.

“ADAPT/NDY recommends that a conflict free process outside of the hospital setting be established that has substantial membership of the disability community as members.”

Last year the National Disability Rights Network issued a report condemning decisions to withhold medical treatment from individuals with disabilities without a terminal condition or permanent unconsciousness as a denial of our basic constitutional rights. The report states that reliance on ethics committees and consultations is insufficient protection.

I’ve communicated with protection and advocacy (P&A) attorneys in several states who had to go to court to save a disabled person’s life from a decision made by a surrogate or unilaterally by a doctor or hospital. Because of P&A intervention, lives have been saved in Illinois, Connecticut, Kansas, Montana and Pennsylvania. That’s just from my limited knowledge.

What I think the NDRN report tells us is that this futility problem is huge and we’ve just seen the tip of the iceberg. Some groundwork has been laid, but serous work remains to be done and I hope that NCD will help lead that effort.

We’ll be catching up this week with news and information that’s piled up over the past week or two.

]]> http://www.notdeadyet.org/2013/04/ndy-president-diane-coleman-submits-comments-on-futile-care-policies-to-national-council-on-disability.html/feed 9 http://www.notdeadyet.org/2013/04/exec-director-of-american-humanist-assoc-echoes-compassion-and-choices-exploitation-of-elderly-homicidesuicides.html http://www.notdeadyet.org/2013/04/exec-director-of-american-humanist-assoc-echoes-compassion-and-choices-exploitation-of-elderly-homicidesuicides.html#comments Tue, 16 Apr 2013 19:34:26 +0000 Stephen Drake http://www.notdeadyet.org/?p=6143 Roy Speckhardt, Executive Director of the American Humanist Association, published an essay today – April 16 – on Huffington Post.  His essay uses the tragedies of elderly suicide/homicides to build a case of assisted suicide, a tactic which will be familiar to readers of this blog.  Here’s an excerpt from his essay, titled “Getting the Freedom to Die“:

The issue of assisted suicide is in the public spotlight in Arizona following the sentence of probation for George Sanders, who admitted he shot his wife in response to her wishes after she was diagnosed with a gangrene infection that would require hospitalization and subsequent residence in a nursing home. After decades of suffering from a series of medical problems that eventually confined her to a wheelchair, court testimony revealed that Virginia “begged” her husband to end her life after the gangrene was discovered. People on both sides of this case have called it a “mercy killing,” and the judge agreed with a plea bargain that resulted in two years of probation for her husband instead of jail time.

***

This case and numerous others like it around the country, such as the tragic killing of a dying 83-year-old Pennsylvanian woman by her 86-year-old husband recently reported by Bertel King of The Inquisitor, shows why it’s time for the federal government to recognize that there is clearly a need for a dignified method of assisted suicide in the U.S. We know that in the presence of the current ban, people’s humanistic will to do what is right will lead them to break the law, sometimes in unfortunate ways such as that experienced by the Sanders.

Here is the comment I’ve submitted on Huffpo to the essay.  It’s the second comment so far:

Mr. Speckhardt is parotting a campaign launched by Compassion & Choices a couple of years ago, in which they exploited the tragedy of elderly homicide/suicides. Speckhardt was more careful in choosing his examples, in that most of these homicide/suicides happen in the absence of evidence that the victim wanted to die. (It’s almost always men who do the killing, in spite of the fact that women, who live longer than men, end up as caregivers more often.)

Even so, there’s no questioning of whether or not George Sanders’ wife could have received in-home support to avoid a nursing home – or if they’d had more support, whether her gangrene could have been averted.

As I said, though, the idea that somehow an assisted suicide law would avert men killing their wives even though most don’t ask the victim if they want to be killed is ludicrous.

More about the Compassion and Choices campaign (and real research on this phenomenon) here:
http://www.notdeadyet.org/2010/09/assisted-suicide-advocates-advance.html

Note that the link in my submitted comment is a different link than the one I posted above.  That’s because Compassion and Choices kept pushing this tactic.  I guess they’re getting surrogates to do their dirty work now – “dirty work” in that this tactic relies in a great deal more exploitation and distortion of available data than their usual means of selling their agenda.

Here’s a “reality check” on elderly homicide/suicides:

It turns out that mutual suicide pacts and motivations of real compassion are rare in such murders or murder/suicides. Julie E. Malphurs and Donna Cohen have conducted several studies on this increasing type of domestic violence.

Donna Cohen, in a media release from Carers New Zealand, shared some of the research findings:

“These are not acts of love. They are not compassionate homicides. They are acts of desperation and depression, other forms of psychopathology, or domestic violence.”

Dr Cohen’s research indicates that older men – who almost always initiate the acts – routinely proceed without their wife’s knowledge or consent. She says true pacts occur in perhaps one half of 1 per cent of elder homicide-suicides.

Of the hundreds of homicide-suicide deaths in the US each year, the rate amongst over 55s is twice that of under 55s. Homicide-suicides now account for about three per cent of all suicides, and about 12 per cent of homicides in the older population.

“One of our most distressing findings is evidence that older women who are killed are not knowing or willing participants,” says Dr Cohen. “Often they are killed in their sleep or shot in the back of the head or chest.”

Her research indicates that about a third of elder homicide-suicides occur in a context of domestic violence, an ugly contrast to the Norman Rockwell image of loving clan matriarch and patriarch.

Note – the last link has been fixed.  It now links to a capture of the original page and story courtesy of the Internet Archive.

John Wallace is a 72-year-old man with metastatic pancreatic cancer. At time of diagnosis, the cancer was metastatic to his regional lymph nodes and liver. He was treated with palliative chemotherapy, but the disease continued to progress. Recently he has become jaundiced, and he has very little appetite. He has been seeing a palliative care physician and a social worker on an ongoing basis. His abdominal pain is now well controlled with high-dose narcotics, but the narcotics have caused constipation. In addition to seeing the social worker, he has also been seeing a psychologist to help him to cope with his illness.

The response against assisted suicide is written by J. Donald Boudreau, M.D., Margaret A. Somerville, A.u.A. (pharm.), D.C.L.  Here’s an excerpt – read right after vignette:

Permitting physician-assisted suicide creates a slippery slope that unavoidably leads to expanded access to assisted suicide interventions — and abuses. Advocates of euthanasia deny that slippery slopes exist, arguing that legal constraints and administrative safeguards are effective in preventing them. But the evidence is clearly to the contrary, as the High Court of Ireland recently affirmed. In upholding the constitutionality of the prohibition on assisted suicide, the justices wrote, “. . . the fact that the number of LAWER (`life-ending acts without explicit request’) cases remains strikingly high in jurisdictions which have liberalised their law on assisted suicide . . . speaks for itself as to the risks involved.”2 Vulnerable communities in our societies — persons who are old and frail and those who are disabled or terminally ill — perceive themselves to be threatened.3 Physicians must not be willfully blind to these serious dangers.

The response in favor of assisted suicide is written by Nikola Biller-Andorno, M.D., Ph.D. – her response can be found in the “option 2” page, which is identical to the page with the response against assisted suicide – same vignette, and the comments after the response are also the same ones.

Now for the really important part: This whole section of this NEJM issue is free and open to the public.  You can leave a comment and vote in their poll.  At the time I typed this, there were 157 comments.  And the poll was running 72% against assisted suicide vs. 27% in favor.

This is an excellent forum in which to get your voice heard and to cast your vote.  Click on this link to get started.