Finally this November, a mainstream media source, the Des Moines Register, investigated some of the problems with legalized physician-assisted suicide in other states such as complications during the process, prolonged deaths, non-existent or incomplete data in assisted suicide and even the “disputed meaning of ‘self-administer’” of the lethal overdose. This is crucial since Iowa is considering an assisted suicide bill in the legislature.
However, the Register’s reporting ignored one of the most dangerous legal problems in assisted suicide laws: immunity for doctors from “civil or criminal liability or professional disciplinary action for participating in good faith compliance” with the assisted suicide law. In addition, the secrecy and often yearly destruction of even the minimal information self-reported by the doctors as well as falsified death certificates listing such deaths as natural effectively destroys any pretense of an enforceable law.
This has made enforcement of so-called “safeguards” virtually impossible in states with legalized assisted suicide and affects even a state like my home state of Missouri that has a law with penalties to prohibit assisted suicide.
THE MISSOURI EXPERIENCE
Missouri’s law against assisted suicide states:
A person commits the crime of voluntary manslaughter if he knowingly assists another in the commission of self-murder.
Mo. Rev. Stat. § 565.023.1
Yet despite years of failure, the pro-assisted suicide forces are again trying this year to get the standard assisted suicide bill passed in the Missouri legislature.
However, enforcement of the current Missouri law has been problematic. In the only case involving a health care professional, just a five years probation plea agreement was reached before a trial despite a nurse admitting she killed the patient, not assisting a suicide.
In 2001, Daillyn Pavia, RN faced murder charges after she admitted giving a lethal dose of morphine to a new patient who had just had a stroke and was taken off life support. According to police, Pavia admitted to co-workers that she had “without authorization and within a half-an-hour of taking charge of Julia Dawson as her patient … intentionally (given) Ms. Dawson 15 times the maximum dosage of morphine that had been prescribed” as well as Propofol, a strong sedative, that was not prescribed. The victim’s son defended the nurse’s action, saying it was done out of compassion and should not be prosecuted.
In 2003, 2 years later, nurse Pavia pleaded guilty to voluntary manslaughter and was sentenced to 5 years probation. Nurse Pavia did not show up at a hearing before the Missouri State Board of Nursing which noted that Pavia was placed “on five years of supervised probation with the special condition that she surrender her nursing license.”
(Ironically, this decision followed on the heels of the decision not to prosecute Dr. Lloyd Thompson, then head of the Vermont Medical Society, for intentionally giving a paralyzing, “life ending drug” to an elderly woman with terminal cancer whose breathing machine had been removed. The family opposed prosecuting the doctor. Instead Thompson was reprimanded by the Vermont Medical Practice Board that required a monitoring and review of his care of all terminally ill patients. 10 years later, Vermont became the third state to legalize physician-assisted suicide.)
I could find only two other cases of people being charged with assisting a suicide in Missouri. One occurred in 1996 when Velma Howard, a woman with ALS died of suffocation in a motel with family members who admitted giving her sleeping medication, alcohol and a plastic bag. The prosecuting attorney later dropped charges against the family members.
The Jacob Runge assisted suicide case in 2010 resulted in a jury acquitting a young man who provided a gun to his emotionally disturbed friend in a self-described mutual suicide pact but said he could not go through with killing himself.
FALLOUT AND CONSEQUENCES
The fallout from these cases, like many others around the country, show that if someone-even a doctor or nurse-claims that they acted out of “mercy” it is unlikely that a person will face more than a slap on the wrist for ending or helping to end an ill or troubled person’s life.
In addition for those of us who are ethical and conscientious nurses, we feel the chilling effect discouraging us from even reporting other health care providers like nurse Pavia in such cases since we may face repercussions ourselves, including firing. There are apparently no real whistleblower protections for nurses (and thus the public) in such cases, especially since these cases routinely garner much media and public sympathy for the perpetrators and routinely result in minimal if any penalties. Conscience rights may not be enough to protect our patients and ourselves.
As a 2014 Medscape (password protected) article titled “Should Nurses Blow the Whistle or Just Keep Quiet? by a nurse/lawyer author explains with regard to patient safety violations (which, of course, should include reporting the killing of a patient) :
Am I recommending that nurses adopt the “see nothing, hear nothing, speak nothing” attitude? No. I am saying that under current law, it is safer for a nurse not to report than to report. That surprises me, and it may be right- or wrong-minded, but it’s the way it is. (Emphasis added.)
This is exactly what pro-assisted suicide groups like Compassion and Choices could have hoped for when they fashioned the immunity protections and the secrecy of even the minimal self-reporting standards in their assisted suicide laws. Eliminating the possibility of future potential lawsuits or prosecutions is what keeps their myth of “no problems, no abuses” alive.
Unfortunately, that is also what puts all of us and our loved ones at risk, especially when we are at our most vulnerable. With legalized assisted suicide laws now quickly expanding to other states, we must step up our efforts to educate the public and fight against the well-funded and relentless Compassion and Choices machine.
And there is one significant effort that any of us can do. Consider asking your own doctor or health care provider where he or she stands on assisted suicide and feel free to state your position. If your doctor is in favor of assisted suicide, you might want to consider asking for a referral to another doctor who refuses to provide assisted suicide. The life you save may be your own.