An Interview with an Assisted Suicide Doctor

It’s not often that we get a glimpse into the assisted suicide movement from the perspective of a medical professional who actually participates in terminating the lives of the terminally ill. Most seem to prefer anonymity.

But in a fascinating American Society of Clinical Oncology Post interview Examining the Impact of ‘Death With Dignity’ Legislation”, oncologist Charles D. Blanke MD, FACP, FASCO talked not only about his recent medical journal article “Usage of Oregon’s Death with Dignity Act” but also his surprises and concerns about the almost 20 year old Oregon law.

‘SURPRISING FINDINGS”

When Dr. Blanke was asked if anything had surprised him about the findings in his article, he replied

“I was a bit surprised by how rarely the prescribing or consulting physicians refer patients for a psychiatric consultation. According to our study, only 5% of patients received these referrals. In national surveys, many psychiatrists say that depression among terminally ill patients would disqualify them from participating in physician-aided death.

I was also surprised to learn how rarely a physician is present when the patient takes the medication—in only 17% of cases is that so. My guess is that physicians aren’t asking what their patients would prefer, because when I’ve asked my patients if they would like me to be present when they take the medication, 100% say “yes. (Emphasis added)

When asked about the spike in the numbers of lethal prescription in the last two years of his study,  Dr. Blanke replied that:

“There are several factors, including greater national awareness of this issue and the fact that there are several other states now with this legislation in place. Also, some of the medical societies that formerly opposed the law, such as the American Medical Association, have softened their stance and agreed to study whether they should be neutral on physician-assisted death.” (Emphasis added)

Note: Actually, the AMA has not officially changed it opposition to physician-assisted suicide although assisted suicide supporters hope for this. However, the American Society of Clinical Oncology has taken no official position on physician-assisted suicide, which is actual neutrality.

PALLIATIVE CARE, INFORMED CONSENT AND CONSCIENCE RIGHTS

Sadly, while Dr. Blanke says he is a big supporter of palliative care, he went on to also state:

“However, I strongly feel that there are some patients you simply cannot palliate. They have concerns about their quality of life and their ability to do the things they enjoy, they are suffering relentlessly, and they want to take back some control over their life. Physician-aided death not only doesn’t cause harm, in my estimation, it can give people that extra bit of control over their life, including the 33% of patients who fill the prescription but never take it. Just having the prescription on hand gives patients an immense feeling of control and comfort. (Emphasis added)

On informed consent, Dr. Blanke does acknowledge that:

“There certainly is worry that a family member might push the medication on a patient because of financial concerns, but that scenario is harder to measure. Rarely, you do get a sense that there may be some outside pressure on patients to take the medication” (Emphasis added)

Instead, Dr. Blanke says that in his experience, it usually is the patient who wants the lethal overdose and the family members who oppose it.  Ironically, assisted suicide laws do not require even notification of family members-at least until after death.

And on conscience rights for those medical professionals who refuse to participate or refer, Dr. Blanke  states that:

“Physicians have an ethical obligation—not to offer the option, if they are personally opposed to it—but to understand what the process entails, to be knowledgeable enough to explain to patients the pros and cons of their decision, and to refer them to a physician if they still want to pursue physician-assisted death….Sticking your head in the sand and refusing to take part at all during this critical time in a patient’s care does a huge disservice to that patient.” (Emphasis added)

Yet, responding to a question on the ethical or moral dilemmas assisted suicide laws pose for oncologists, Dr. Blanke states:

“We have patients who are suffering horribly, and we are helping to end their suffering, so I don’t see how that can be construed as harming our patients.

However, physicians are also faced with the reality of giving a patient a medication that is guaranteed to kill that patient, and regardless of your position on these laws, taking that action is very challenging for any human being, let alone a physician. ” (Emphasis added)

 

CONCLUSION

Over the years, I have seen some of my health care colleagues-like the general public-begin to tentatively approve assisted suicide in the usual polling question about a hypothetical case in which a person is terminally ill and in “unbearable pain”. (Ironically, Oregon’s law does not even mention “pain” or “suffering” as a necessary criteria to be approved  for assisted suicide.)

But I found there are very few fellow professionals who are actually willing to perform or even witness such a death. This is apparently why Compassion and Choices, the former Hemlock Society, also needs to provide help in finding doctors to write lethal prescriptions.

We must realize that there are no winners when assisted suicide is legalized-not the patient, the health care system, society or even the assisted suicide practitioner.

Health Care Bullying Over Conscience Rights

Years ago, some of my fellow nurses were talking about assisted suicide and two of them supported physician-assisted suicide. I asked if they were comfortable with participating in an assisted suicide. Both were shocked and said no.

They believed the myth that doctors just write lethal prescriptions that patients then go home and take privately. It never occurred to them that they could be involved if the assisted suicide occurred in a healthcare institution, home health situation, etc. where they-unlike the doctor-could not just walk away.

These nurses were unaware that there were already nursing journal articles like “Assisted Suicide: What Role for Nurses?”  (2000) that quoted one Oregon hospice administrator:

“Initially, when the law was designed, the assumption was that physicians would be the first ones to explore PAS with patients…but in reality, nurses are usually the ones in the line of fire.

While Compassion and Choices leaders now talk about “integrating” and “normalizing” assisted suicide in end of life care , this 17 year old article already stated that “Much of nurses’ roles lies behind the scenes long before the drama of PAS unfolds. Home care and hospice nurses actively help patients understand their rights, acting as advocates for those who are considering PAS.” (Emphasis added)

Now, two recent articles expose the lengths that assisted suicide activists will go to  legally bully health care professionals to participate in medically assisted suicide.

VERMONT

In an April 5, 2017 article titled “This State is Trying for Force Doctors and Health Care Workers to Give Patients Info on Assisted Suicide”, the Alliance Defending Freedom organization  filed a lawsuit against Vermont’s Act 39, arguing that

“Vermont’s Act 39 makes the State the first and only one to mandate that all licensed healthcare professionals counsel terminal patients about the availability and procedures for physician-assisted suicide, and refer them to willing prescribers to dispense the death-dealing drug. Act 39 coerces professionals to counsel patients about the ‘benefits’ of assisted suicide—benefits that Plaintiffs’ members do not believe exist—and in addition stands in opposition to a federal law protecting healthcare professionals who cannot participate in assisted suicide for conscientious reasons.” (Emphasis added)

CANADA

In a stunning March 28, 2017 Canadian Catholic Register article titled “Doctors being ’bullied’ over assisted suicide, legislators told at Bill 84 hearings” , doctors in Ontario, Canada spoke out about “being bullied, silenced and coerced in a pro-euthanasia environment which is forcing those who object to medically assisted suicide to provide an “effective referral” for patients who wish to die”. (Emphasis added)

Dr. Jane Dobson testified about the pressure she has faced: “If I don’t comply, I face fines and the possible suspension of my license.”

University of Toronto School of Medicine professor Dr. Maria Wolfs added that medical schools are facing pressure to “weed out students who might object to assisted suicide”. (Emphasis added)

Psychiatrist Dr. Janice Halpern testified that the policy is also “at odds with the subtleties of a psychiatric doctor-patient relationship and asked how long can a psychiatrist work with a patient “on finding their will to live again” before referring the patient for assisted suicide.

The Canadian Supreme Court legalized physician-assisted suicide in 2015 and as of the end of 2016, at least 744 people have died from physician assisted suicide with Ontario having the highest number.

One doctor who assisted the suicide of at least 40 patients in 2016 said that those numbers will increase “to the point of the Netherlands and Belgium because their laws are similar to ours, and that would mean about 5 % of all deaths.”

UNEXPECTED CONSEQUENCES

Ironically, there has been an unusual backlash in Canada.

According to a February 2017 article in Canada’s National Post newspaper , an increasing number of doctors performing assisted suicide are now saying “‘Take my name off the list, I can’t do any more”.  As the article states:

“In Ontario, one of the few provinces to track the information, 24 doctors have permanently been removed from a voluntary referral list of physicians willing to help people die. Another 30 have put their names on temporary hold.”

And

“The Canadian Medical Association says reports of doctors backing away from the act are not just anecdotal. “I can’t tell you how many, but I can tell you that it’s enough that it’s been noted at a systemic level,” said Dr. Jeff Blackmer, the CMA’s vice-president of medical professionalism.”

CONCLUSION

Groups like Compassion and Choices depend on assisted suicide being portrayed as a victimless and necessary medical intervention while, at the same time, they oppose conscience rights for ethical doctors and nurses trying to help and protect their patients and their professions.

However, it is hard to escape the reality that legally forced participation in medically assisted suicide damages the health care system, health care providers and even patients.

Why Physician-assisted Suicide Cannot be a Civil Right

Although groups like Compassion and Choices insist that assisted suicide is a civil right despite the 1997 US Supreme Court unanimously finding no constitutional right to assisted suicide,  this is a recipe for disaster.

Civil rights means equality under the law so equality in assisted suicide means that the “right” to assisted suicide logically cannot remain limited to just mentally competent adults with a prognosis of 6 months and able to give themselves lethal overdoses by mouth. What about the non-terminally ill person with paralysis who can’t take the lethal overdose by himself or herself? What about the person with Alzheimer’s who is no longer mentally competent to make the decision for medically assisted suicide? What about the lucid chronically mentally ill person who wants to end years of struggling?

It is inevitable that assisted suicide as a civil right must necessarily expand to anyone using any prescribed method for any situation deemed intolerable.

We have already seen this happen in European countries like Holland and Belgium as well as the current lethal injection assisted suicides in Canada and now even paired with organ donation.

ECONOMICS AND BURDENS

A recent Canadian study predicted that physician-assisted suicide could save Canada up to $139 million dollars each year.

The study’s author states that “Neither patients nor physicians should consider costs when making the very personal decision to request, or provide, this intervention” but the reality is that people, especially older individuals, do worry about being a financial and/or physical burden on their families and almost 50% of assisted suicide victims in the latest 2016 Oregon report cited “burden on family, friends/caregivers” as a concern.

I am not surprised. My own mother often told me that she never wanted to be a burden on her family even before she developed Alzheimer’s and terminal cancer. Mom thought she was just being a loving mother without realizing that such an attitude and statement can have lethal consequences even outside of assisted suicide.

For example, years ago when I worked in oncology, I cared for a delightful elderly woman with cancer whose doctors recommended another chemo treatment. My patient confided that she did want to try it but feared becoming more of a “burden” on her daughter’s family with whom she lived.

I told her that I had just spoken to her daughter the day before and the daughter told me how grateful she was for her mother’s presence and help. For example, the daughter said that since she and her husband both worked, they were relieved to have the mother there for their school-age children when classes ended. The daughter told me how the children loved climbing into bed with grandma and telling her about their day.

My elderly patient was almost reduced to tears but by this revelation but then she laughed and admitted that sometimes she fell asleep when the children were talking to her.

I told my patient that whatever else she needed to consider before agreeing to the chemo, fear about being a “burden” should be eliminated.

CONCLUSION

People with disabilities are especially right to be concerned about the coercion of economics and perceived “burdens” of living when assisted suicide is legalized.

I learned this first hand when my daughter Karen was born with Down Syndrome and a severe heart defect. Even though I insisted that my daughter be treated the same as any other child with this condition, I was shocked by the responses of some fellow health care providers.

One doctor actually said that “People like you shouldn’t be saddled with a child like that”.  I was shocked and challenged him that, since my husband and I were medical professionals and especially able to care for a child with a heart problem and Down Syndrome, exactly who were these “right kind” of parents? Apparently none.

Later on, when Karen was secretly made a Do Not Resuscitate while hospitalized for pneumonia because I was supposedly “too emotionally involved with that retarded baby”,  I was shocked to how easily choice can indeed become an illusion when it comes to people with disabilities.

Unfortunately, it is a very small step from “I wouldn’t want to live (or have a child) like that” to “no one should have to live (or have a child) like that”.

Legalizing the demand for medical professionals to help end the lives of only certain people cannot be a true civil right or ultimately  even limited to “just” the mentally competent terminally ill.

Good News for Now

 

After sending written testimony to the Hawaiian health committee considering a physician-assisted law, I received the following email from a nurse:

“Hallelujah! The measure is deferred and will not become law in this session…. The testimony opposed (to assisted suicide) was very passionate. It really became clear that although Hawaii tends to be a very liberal, democratic state, the people are much more life-oriented than folks in Washington, Oregon, and the Netherlands. To hear a Native Hawaiian kamaka alii testify her opposition in the Hawaiian language was beautiful. I learned of even more reasons to oppose assisted suicide, and the legislators now have a long list of the flaws in this measure. The testimony changed the hearts of some committee members that were in support of the concept, but now seem to appreciate the risks.”

The bill failed despite public polls showing 80% support for assisted suicide.

Compassion and Choices as well as a lot of other people really thought this bill would make it out of committee but facts and passionate efforts seem to have made the difference!

In additional good news, a physician -assisted suicide bill in New Mexico also failed in the state Senate  by a vote of 22-20 .

Also,  legislation to legalize assisted suicide looks to have suffered final defeat this year in Indiana, Mississippi, New Mexico and Tennessee.

Of course, this will not stop the well-funded Compassion and Choices organization that will continue to reintroduce such legislation-often even yearly -in states that have rejected such laws in the past. Assisted suicide activists hope that their relentless public campaigns and the routinely positive mainstream media coverage of assisted suicide will sway more and more people to support assisted suicide.

With such support, Compassion and Choices can then even bypass state legislators and courts that usually study such bills more closely and just get assisted suicide passed by state voter referendums.

This happened in Colorado where assisted suicide bills were defeated in the legislature for 20 years until the strategy was changed to a state voter referendum placed on the ballot in 2016 that then passed.

Is your state at risk of legalizing assisted suicide this year?  Death with Dignity has a map of all US states and their status on assisted suicide as of March 28, 2017– although it does not include the failures in New Mexico and Hawaii yet.

In the end, ongoing public education about the factsthe very real “slippery slope” and the dangers to society and our health care system from legalized assisted suicide can not only defeat the pro-death movement but also spur a renewed commitment to the life and well-being of every person, especially those who are seriously ill or who have disabilities.

That is a goal worth fighting for!

 

 

 

What You Need to Know Now That the District of Columbia Has Become the Seventh Jurisdiction in US to Legalize Assisted Suicide

Despite emails and other efforts to encourage the US Congress to exercise its legal authority to stop the Washington D.C. assisted suicide law, the expected congressional action was not completed within the 30 legislative days required.

However, there may be hope on the horizon according to a  February 18, 2017 Washington Times article that said “Congress can still neutralize the Death with Dignity Act by cutting off its funding through the appropriations process.”

What went wrong with the process of nullifying the assisted suicide law in time?  No one seems to know.

But one thing we do know is that Compassion and Choices, the well-funded assisted suicide activist organization, will continue its relentless fight over and over again in every state without an assisted suicide law and in the courts to make assisted suicide legal throughout the US. But even that is not the final goal.

Ominously, we are now seeing assisted suicide leaders like influential lawyer Kathryn Tucker even criticizing the so-called “safeguards” in assisted suicide laws  as “burdens and restrictions”. She now argues that  assisted suicide should be “normalized within the practice of medicine”.

WHAT WE NEED TO KNOW AND DO NOW

We cannot just depend on lobbying our politicians and legislatures to fight assisted suicide only when such bills are introduced in states legislatures or as public initiative votes. We must constantly reinforce our message that every life is worthy of respect and care, not medical termination.

But we must also understand that the assisted suicide/euthanasia movement has had decades of experience in shaping and publicizing its lethal message through carefully crafted steps to convince the public that physician-assisted suicide must be legalized to prevent or end suffering.

As I wrote in my 2013 article “Then and Now: The Descent of Ethics”, the assisted suicide/euthanasia movement has been very busy in the last several decades. I included a short history of the movement that people should know:

The 1970s brought the invention of “living wills” and the Euthanasia Society of America changed its name to the Society for the Right to Die. The so-called “right to die” movement received a real boost when the parents of Karen Quinlan, a 21-year-old woman considered “vegetative” after a probable drug overdose, “won” the right to remove her ventilator with the support of many prominent Catholic theologians. Karen continued to live 10 more years with a feeding tube, much to the surprise and dismay of some ethicists. Shortly after the Quinlan case, California passed the first “living will” law.

Originally, “living wills” only covered refusal of life-sustaining treatment for imminently dying people. There was some suspicion about this allegedly innocuous document and, here in Missouri, “living will” legislation only passed when “right to die” advocates agreed to a provision exempting food and water from the kinds of treatment to be refused.

But, it wasn’t long before the parents of Missouri’s Nancy Cruzan, who was also said to be in a “vegetative” state, “won” the right to withdraw her feeding tube despite her not being terminally ill or even having a “living will.” The case was appealed to the US Supreme Court, which upheld Missouri law requiring “clear and convincing evidence” that Nancy Cruzan would want her feeding tube removed, but, in the end, a local judge allowed the feeding tube to be removed. Shortly after Nancy’s slow death from dehydration, Senators John Danforth and Patrick Moynihan proposed the Patient Self-Determination Act (never voted upon but became law under budget reconciliation), which required all institutions to offer all patients information on “living wills” and other advance directives. Since then, such directives evolved to include not only the so-called “vegetative” state and feeding tubes but virtually any other condition a person specifies as worse than death and any medical care considered life-sustaining when that person is deemed unable to communicate.

But this “choice” is becoming an illusion. In 1999, Texas became the first state to pass a medical futility law to allow doctors and/or medical committees to  override advance directives and patient or family decisions to continue life-sustaining treatment on the basis that doctors and/or medical committees know best when to stop treatment.

In the 1990s, Jack Kevorkian went public with his self-built “suicide machines”  and the “right to die” debate took yet another direction. By the end of the decade, Oregon became the first state to allow physician-assisted suicide. At first, the law was portrayed as necessary for terminally ill people to die with allegedly unrelievable pain. Within a short time, though, it was reported that “according to their physicians, the patients requested assistance with suicide because of concern about loss of autonomy and control of bodily functions, not because of concern about inadequate control of pain or financial loss.”

Other states eventually followed Oregon but efforts to pass assisted suicide laws often failed in other states so Compassion and Choices (the former Hemlock Society) promoted palliative/terminal sedation and VSED (voluntary stopping of eating and drinking) as a legal alternative to assisted suicide in states without such laws.

Compassion and Choices has found much success in working with sympathetic news outlets and pollsters to encourage the public and even medical professionals to support assisted suicide.

Even TV’s popular Dr. Phil McGraw hosted a 2012 segment featuring a Canadian woman who wanted her adult disabled children to die by lethal injection. Ironically, the mother, along with former Kevorkian lawyer Geoffrey Feiger, argued that removing their feeding tubes was an “inhumane” way to end the lives of the adult children. Tragically, when the studio audience was polled, 90% were in favor of lethal injections for the disabled adults. Disability organizations protested after the show, writing that “By conveying social acceptance and approval of active euthanasia of individuals with disabilities by their family members, the segment threatens their very lives”.

Exploiting the natural fear of suffering most people have has also led to a growing acceptance of the premise that it can even be noble to choose death instead of becoming a burden on family members or a drain on society. It is up to us to combat this attitude of despair by  not only educating ourselves and others about the facts and dangers of assisted suicide but also by offering hope and support to those of us most at risk.

My Submission to the AMA Opposing Neutrality on Physician-Assisted Suicide

Amid conflicting reports about whether or not the American Medical Association was going to consider a position of neutrality on physician assisted suicide, I was informed that the AMA’s Council on Ethical and Judicial Affairs was collecting data, position statements, etc. for consideration of assisted suicide and other topics before the June AMA Annual meeting. The deadline for submissions was February 15.

The following is my submission titled “Neutrality on physician assisted suicide also hurts nurses”

Dear AMA,

I have been a registered nurse since 1969. After working in critical care, hospice, home health, oncology, dialysis and other specialties for 45 years, I am currently working as a legal nurse consultant and volunteer as well as spokesperson for the National Association of Pro-Life Nurses. Over the years, I have cared for many suicidal people as well as people who attempt suicide.

I have served on medical and nursing ethics committees, served on disability and nursing boards. I have written and spoken on medical ethics-especially end of life issues-since 1984.

The dangers of the legalization of physician-assisted suicide are especially acute for us nurses. Unlike doctors, we nurses cannot refuse to care for a patient  in a situation like assisted suicide unless another willing nurse can be found which can be impossible. If we do refuse, that is considered abandonment and cause for discipline and even termination. And we are necessarily involved when the assisted suicide act occurs in home health, hospice or health care facility even though the doctor is not required to be there.

marievalko

Marievalko Picture of Marie Valko 1979-2009

As a nurse and the mother of a suicide victim (see picture above), I am alarmed by reports that the AMA is considering a position of neutrality on physician-assisted suicide. I beg you to uphold the legal and ethical standard that medical professionals must not kill their patients or help them kill themselves. Suicide is a tragedy to be prevented if possible, not a civil right.

MY DAUGHTER KILLED HERSELF USING AN ASSISTED SUICIDE TECHNIQUE

In 2009, I lost a beautiful, physically well 30-year-old daughter, Marie, to suicide after a 16-year battle with substance abuse and other issues. Her suicide was like an atom bomb dropped on our family, friends and even her therapists.

Despite all of our efforts to save her, my Marie told me that she learned how to kill herself from visiting suicide/assisted suicide websites and reading Derek Humphry’s book Final Exit. The medical examiner called Marie’s suicide technique “textbook final exit” but her death was neither dignified nor peaceful.

Marie was not mere collateral damage in the controversy over physician-assisted suicide. She was a victim of the physician-assisted suicide movement, seduced by the rhetoric of a painless exit from what she believed was a hopeless life of suffering.

SUICIDE CONTAGION

Adding to our family’s pain, at least two people close to Marie became suicidal not long after her suicide. Luckily, these two young people received help and were saved, but suicide contagion, better known as “copycat suicide”, is a well-documented phenomenon. Often media coverage or publicity around one death encourages other vulnerable people to commit suicide in the same way.

STUDY SHOWS LEGALIZING PHYSICIAN-ASSISTED SUICIDE IS ASSOCIATED WITH AN INCREASE RATE OF TOTAL SUICIDES

A 2015 article in the Southern Medical Journal titled “How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?” came to these conclusions:

“Legalizing PAS has been associated with an increased rate of total suicides relative to other states and no decrease in nonassisted suicides. This suggests either that PAS does not inhibit (nor acts as an alternative to) nonassisted suicide, or that it acts in this way in some individuals but is associated with an increased inclination to suicide in other individuals.”

THE HEALTH AND ECONOMIC COSTS OF SUICIDE

My Marie was one of the almost 37,000 reported US suicides in 2009. In contrast, only about 800 assisted-suicide deaths have been reported in the past 16 years in Oregon, the first state to legalize physician-assisted suicide. According to the Centers for Disease Control (CDC) suicide was the 10th leading cause of death for Americans in 2012, with “More than 1 million people reported making a suicide attempt in the past year” and “More than 2 million adults reported thinking about suicide in the past year.” The CDC estimates that suicide “costs society approximately $34.6 billion a year in combined medical and work loss costs”, not to mention the emotional toll on families.

Obviously our real health-care crisis here is a staggering and increasing rate of suicides, not the lack of enough assisted suicides.

BRITTANY MAYNARD

There was a media frenzy in October 2014 when Brittany Maynard, a young newlywed woman with a brain tumor, announced plans to commit physician-assisted suicide on November 1 and raise money to have physician-assisted suicide legalized in all US states. There was an immediate and unprecedented media frenzy surrounding Ms. Maynard’s tragic story that routinely portrayed her pending assisted suicide as “heroic” and even counting down the days to her suicide. Personally, I thought this looked like a crowd on the street shouting for a suicidal person on a window ledge to jump.

In the end, Brittany hesitated for a day before she went through with her pledge to take the lethal overdose.

Now, assisted suicide supporters even deny that physician-assisted suicide is suicide, insisting that media stories use euphemisms like “aid-in-dying” and “death with dignity” in cases like Ms. Maynard’s to make assisted suicide more palatable to the public. However, this defies common sense when the definition of suicide is the intentional taking of one’s own life.

PHYSICIAN-ASSISTED SUICIDE AND MEDICAL DISCRIMINATION

I have been a registered nurse for 47 years, working in intensive care, oncology, hospice and home health among other specialties. Personally and professionally, I have cared for many people who attempt or consider killing themselves.

Some of these people were old, chronically ill or had disabilities. Some were young and physically healthy. A few were terminally ill. I cared for all of them to the best of my ability without discrimination as to their condition, age, socioeconomic status, race or gender. I will do anything to help my patients — except kill them or help them kill themselves.

Suicide prevention and treatment works, and the standards must not be changed just because some people insist their desire for physician-assisted suicide is rational and even a civil right.

Emergency re-post: Write to Your Legislators in Congress Now!

On January 21, I wrote the following post (see below) to encourage all assisted suicide opponents to contact their own state’s legislators with instructions on how to find your state’s legislators and how to contact them.

There are only 30 legislative days (not calendar days but rather official working days for Congress which are impossible to predict) to contact your own state’s legislators to support a house and senate resolution bill disapproving the D.C. assisted suicide law before it automatically takes effect. The bills are S.J.Res. 4 for the Senate and H.J.Res.27 for the House and both are titled “Nullify District of Columbia Assisted Suicide Law”. You can also find and contact your legislators at those links.

It does not matter if your state has already approved assisted suicide or not. This is a way to let your legislator know you oppose it and this can educate him or her on what a constituent actually wants.

If you can, tell your story about why you oppose legalizing assisted suicide. Speak from your heart. It could be as simple as “I am a senior citizen and I fear giving doctors the right to kill”. Shorter messages are actually more likely to be read.

Thank you.

Nancy Valko RN ALNC

Urgent: Will Congress Stop the Washington D.C. Assisted Suicide Law in Time? Write Now!

January 21, 2017 nancyvalko assisted suicide, Compassion & Choices, law, medical ethics,

Washington D.C. Mayor Muriel Bowser  quietly signed an assisted suicide bill into law on December 19, 2016 after a majority of the city council voted for it.

Under the U.S. Constitution, the Congress has exclusive legislative authority over the District of Columbia. Congress has just 30 legislative days to review a law of the District of Columbia once it is passed by the city government. Resolutions of disapproval must be passed by both houses and be signed by the president to block a D.C. law.

In a race against time, the first step  to block the assisted suicide law was taken January 12, 2017 by Sen. James Lankford (R-Okla.) who introduced introducing a resolution in the Senate that opposes D.C.’s  “Death With Dignity Act”.

A companion resolution was introduced in the House by Rep. Brad Wenstrup (R-Ohio) and Rep. Jason Chaffetz (R-Utah) also said that he would push to block the law.

COMPASSION AND CHOICES HAS ALREADY STARTED A LETTER WRITING CAMPAIGN TO LEGALIZE ASSISTED SUICIDE IN WASHINGTON, D.C.

In a message to assisted suicide supporters, Compassion and Choices claims that “more than 2400 supporters” have “sent more than 7,000 messages to members of Congress”.  The organization also emphasizes “the importance of including your personal testimony” as “often the most effective way to change the minds of lawmakers”.

HOW TO CONTACT YOUR CONGRESSMAN OR CONGRESSWOMAN TO OPPOSE  ASSISTED SUICIDE IN WASHINGTON, D.C.

The National Right to Life Committee has a website link   to “Nullify District of Columbia Assisted Suicide Law” to contact your Senators and a separate link to contact your House representative(s). Enter your zip code in the box provided and you will be taken to a list of your congresspersons and a form you fill out to send an email to those representatives or senators with your comments.

HOW TO WRITE COMMENTS

Keep your comments respectful  and address the points that most move you. If you have a personal story about why you are against assisted suicide, write it as clearly and concisely as possible.

PROBLEMS WITH THE ASSISTED SUICIDE BILL

While many legislators (as well as the public) are persuaded by the “safeguards” to support assisted suicide laws, the Washington D.C. bill has many of the same problems with “safeguards” that other assisted suicide bills have. (For example, see my blogs “The slippery Slope-Tactics in the Assisted Suicide Movement” and “Pain and ‘Choice’“.)

In the D.C. assisted suicide law, such problems include:

1.The extraordinary immunity protections against civil, criminal liability or professional  disciplinary actions for doctors who participate in “good faith compliance” with the law.

  1. Protection from life or annuity insurance problems due to suicide (“Neither may a qualified patient’s at of ingesting a covered medication have an effect upon a life, health, accident, insurance, or annuity policy”)
  2. Minimal reporting requirements and secrecy in public records (“The Department will generate and make available to the public an annual statistical record of information collected”) Emphasis added.
  3. Require mental health evaluation only for the purpose of determining if the person is mentally capable to make the decision to end his or her life. (“‘Counseling’ means one or more consultations as necessary between a state licensed psychiatrist or psychologist  and a patient for the purpose of determining that the patient is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.”)

CONCLUSION

There are many reasons to oppose legalizing assisted suicide including risk for elder abuse, discrimination against people with disabilities and/or terminal or chronic conditions, the destruction of the most basic rule of medical ethics to not kill patients or help them kill themselves, suicide contagion, etc.

Assisted suicide, legalized and approved by society, is a manifestation of despair and abandonment-not empowerment. We cannot afford to be bystanders while others like Compassion and Choices continue to demand that we all accept legalized assisted suicide as a constitutional and civil right.

 

 

Urgent: Will Congress Stop the Washington D.C. Assisted Suicide Law in Time? Write Now!

Washington D.C. Mayor Muriel Bowser  quietly signed an assisted suicide bill into law on December 19, 2016 after a majority of the city council voted for it.

Under the U.S. Constitution, the Congress has exclusive legislative authority over the District of Columbia. Congress has just 30 legislative days to review a law of the District of Columbia once it is passed by the city government. Resolutions of disapproval must be passed by both houses and be signed by the president to block a D.C. law.

In a race against time, the first step  to block the assisted suicide law was taken January 12, 2017 by Sen. James Lankford (R-Okla.) who introduced introducing a resolution in the Senate that opposes D.C.’s  “Death With Dignity Act”.

A companion resolution was introduced in the House by Rep. Brad Wenstrup (R-Ohio) and Rep. Jason Chaffetz (R-Utah) also said that he would push to block the law.

COMPASSION AND CHOICES HAS ALREADY STARTED A LETTER WRITING CAMPAIGN TO LEGALIZE ASSISTED SUICIDE IN WASHINGTON, D.C.

In a message to assisted suicide supporters, Compassion and Choices claims that “more than 2400 supporters” have “sent more than 7,000 messages to members of Congress”.  The organization also emphasizes “the importance of including your personal testimony” as “often the most effective way to change the minds of lawmakers”.

HOW TO CONTACT YOUR CONGRESSMAN OR CONGRESSWOMAN TO OPPOSE  ASSISTED SUICIDE IN WASHINGTON, D.C.

The National Right to Life Committee has a website link   to “Nullify District of Columbia Assisted Suicide Law” to contact your Senators and a separate link to contact your House representative(s). Enter your zip code in the box provided and you will be taken to a list of your congresspersons and a form you fill out to send an email to those representatives or senators with your comments.

HOW TO WRITE COMMENTS

Keep your comments respectful  and address the points that most move you. If you have a personal story about why you are against assisted suicide, write it as clearly and concisely as possible.

PROBLEMS WITH THE ASSISTED SUICIDE BILL

While many legislators (as well as the public) are persuaded by the “safeguards” to support assisted suicide laws, the Washington D.C. bill has many of the same problems with “safeguards” that other assisted suicide bills have. (For example, see my blogs “The slippery Slope-Tactics in the Assisted Suicide Movement” and “Pain and ‘Choice’“.)

In the D.C. assisted suicide law, such problems include:

1.The extraordinary immunity protections against civil, criminal liability or professional  disciplinary actions for doctors who participate in “good faith compliance” with the law.

2. Protection from life or annuity insurance problems due to suicide (“Neither may a qualified patient’s at of ingesting a covered medication have an effect upon a life, health, accident, insurance, or annuity policy”)

3. Minimal reporting requirements and secrecy in public records (“The Department will generate and make available to the public an annual statistical record of information collected”) Emphasis added.

4. Require mental health evaluation only for the purpose of determining if the person is mentally capable to make the decision to end his or her life. (“‘Counseling’ means one or more consultations as necessary between a state licensed psychiatrist or psychologist  and a patient for the purpose of determining that the patient is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.”)

CONCLUSION

There are many reasons to oppose legalizing assisted suicide including risk for elder abuse, discrimination against people with disabilities and/or terminal or chronic conditions, the destruction of the most basic rule of medical ethics to not kill patients or help them kill themselves, suicide contagion, etc.

Assisted suicide, legalized and approved by society, is a manifestation of despair and abandonment-not empowerment. We cannot afford to be bystanders while others like Compassion and Choices continue to demand that we all accept legalized assisted suicide as a constitutional and civil right.

The Slippery Slope-Tactics in the Assisted Suicide Movement

I first saw this tactic  in the mid-1980s when Missouri was considering a “living will” law to allow a person to refuse “death prolonging procedures” if a person became terminally ill and unable to speak for himself or herself.  Some of us warned about a broader agenda, citing court cases involving feeding tubes and seriously brain-injured but non-terminally ill patients like Paul Brophy and Claire Conroy in New Jersey and Massachusetts . In  response, “right to die” activists (as they were known then) added the ”safeguard” of not allowing the withholding of food and water to the Missouri law  and the bill was passed.

Not surprisingly, Missouri soon faced the Nancy Cruzan case  involving the withdrawal of a feeding tube from a non-terminally ill young woman in a so-called “persistent vegetative state”.  Soon after that,  a Missouri Designated Health Care Decision Maker Act was passed that would allow a person to designate someone to make health care decisions (or a relative if there is no document) including withholding or withdrawing of feeding tubes when the person was incapacitated whether or not they were terminally ill or even in a so-called “vegetative state”.

Now, over 30 years later, we have legalized physician-assisted suicide in several states and the District of Columbia and the former “right to die” groups are now known as Compassion and Choices.

TODAY’S SLIPPERY SLOPE TACTICS

In a December 2016 commentary article titled “End of Life Liberty in DC” for a publication supported by the University of Pittsburgh School of Law, lawyer and long-time assisted suicide activist Kathryn L. Tucker surprisingly criticizes the new assisted suicide law quietly signed into law by the mayor of Washington, DC. this month.

While most people might believe that passage of yet another assisted suicide law would be cause for celebration for assisted suicide activists, Ms. Tucker is unhappy with the so-called “safeguards” in the DC law-just as “right to die” activists were with Missouri’s “living will” law.

Ms. Tucker now complains about the “many burdens and restrictions imposed” by these “safeguards” which, ironically, are added by assisted suicide activists themselves when they  “routinely face arguments of insufficient ‘safeguards’”.  Ms. Tucker lists some of these so-called “burdens and restrictions”:

  • Patients electing AID (aid in dying, the activists preferred term for physician-assisted suicide) must make at least three requests, two oral and one written.
  • The requests must be witnessed.
  • A second opinion confirming diagnosis and prognosis is required.
  • A mental health specialist must be consulted if the attending or consulting physician has concerns regarding the patient’s ability to make an informed decision.
  • A minimum fifteen-day waiting period must elapse between the two oral requests.
  • Physicians must collect and report a vast amount of demographic data on who chooses AID and why.

Ms. Tucker claims these so-called burdens and restrictions “impose heavy governmental intrusion into the practice of medicine, which is concerning because it creates barriers to patient access and to physician participation.” (Emphasis added)

Instead, Ms. Tucker proposes another, more expansive statute without the usual so-called “safeguards” that would provide:

a clear safe harbor (i.e. immunity) for physicians to practice aid in dying in conformity with standard of care. This reflected a positive step in the direction of normalizing AID within the practice of medicine. Medicine is not routinely governed by statute but, rather, by the type of care that a competent health care professional would render in similar circumstances —referred to as standard of care or best practice. (Emphasis added)

In other words, Ms. Tucker is proposing a policy that makes assisted suicide simply normal medical care with special protections against criminal, civil or disciplinary actions for doctors who participate even though such immunity is not given for other medical practices.

CONCLUSION

Ms. Tucker and other are deadly serious about this. When Vermont passed its assisted suicide law in 2013, the law contained a “sunset” provision that would end “nearly all regulation” after the first three years. Fortunately, this was repealed in 2015.

However, assisted suicide activists will not give up on this as Compassion and Choices makes clear:

We firmly believe — and experience demonstrates — that working within healthcare systems to normalize medical aid in dying will ensure fewer people suffer at the end of their life. (Emphasis added)

As Ms. Tucker demonstrates, assisted suicide advocates will promise anything to get assisted suicide laws passed but it appears that they will never be satisfied until assisted suicide becomes a private and unfettered practice using well-funded groups like Compassion and Choices as the potentially taxpayer-funded “experts” in charge of policies, referrals, training and education.

Pain and “Choice”

It was 1969 and I was fresh out of nursing school when I was assigned to a patient I will call “Jenny” who was thirty two years old and imminently dying of cancer. She was curled up in her bed, sobbing in pain and even moaned “just kill me.” The small dose of Demerol I injected into her almost non-existent buttocks every four hours “as needed” was not helping. I reassured Jenny that I was immediately calling the doctor and we would get her more comfortable.

However, I was shocked when the doctor said no to increasing or changing her medication. He said that he didn’t want her to get addicted! I told him exactly what Jenny said and also that she was obviously very close to death so addiction would not be a problem. The doctor repeated his no and hung up on me.

I went to my head nurse and told her what happened but she told me I had to follow the doctor’s order. Eventually, I went up the chain of command to the assistant director of nursing and finally the Chief of the Medical Staff. The verdict came down and I was threatened with immediate termination if I gave the next dose of Demerol even a few minutes early.

I refused to abandon Jenny so for the next two days before she died, I spent my time after my shift sitting with her for hours until she fell asleep. I gave her whatever food or drink she wanted. I stroked her back, held her hand and told stories and jokes. I asked her about her life. I did everything I could think of to distract her from her pain and make her feel better. It seemed to help, although not enough for me. I cried for Jenny all the way home.

And I was angry. I resolved that I would never watch a patient needlessly suffer like that again.

So I educated myself by reading everything I could about pain medicine and side effects. I also pestered doctors who were great at pain control to teach me about the management, precautions and rationale of effective pain management. I used that knowledge to advocate and help manage my patients’ pain as well as educating others.

I was delighted to see pain management become a major priority in healthcare and even called “the fifth vital sign” to be evaluated on every patient. I saw new developments like nerve blocks, new drugs and regimens to control pain and other techniques evolve as well as other measures to control symptoms like nausea, breathlessness and anxiety. Now we also have nutritional, psychological and other support for people with terminal illnesses and their families.

Best of all was that I never again saw another patient suffer like Jenny despite my working in areas such as ICU, oncology (cancer) and hospice.

TWENTY-FOUR YEARS LATER

When my oldest daughter was 14, she attended a public high school where the science teacher unexpectedly started praising the infamous Dr. Jack Kevorkian and his public campaign for legalized assisted suicide and euthanasia.  Kevorkian’s first reported victim was Janet Adkins, a 54 year old woman with Alzheimer’s in no reported physical pain who was hooked up to a  “death machine” in the back of a rusty van. Mrs. Adkins was just the first of as many as 130 Kevorkian victims, many if not most of whom were later found to have no terminal illness. Kevorkian escaped prosecution-even after he harvested a victim’s organs and offered them for transplant-until the TV show 60 Minutes aired Kevorkian’s videotape showing him giving a lethal injection to a man with ALS (Lou Gehrig’s disease). Shockingly, Kevorkian served only 8 years in prison before he was paroled and eventually became a media celebrity peddling assisted suicide and euthanasia.

My daughter, who never before showed any interest in my speaking and writing on the topic of assisted suicide, now stood up and peppered her teacher with facts about Kevorkian. The teacher asked her where she learned her information and she answered “From my mom who is a cancer nurse”.

Sarcastically, he responded “So your mother wants to watch people suffer?” My daughter responded “No, my mother just refuses to kill her patients!” End of discussion.

CONCLUSION

But not the end of the story. Tragically, we now have legalized assisted suicide in several states and serious efforts  to expand it to include people without physical pain but with conditions like Alzheimer’s, mental illness or other psychological distress as well as even children.

As Wesley Smith recently and astutely observed :

 Moreover, the statistics from Oregon and elsewhere show that very few people commit assisted suicide due to physical suffering. Rather, the issues are predominately existential, such as fears of being a burden or losing dignity

The public is being duped by groups like Compassion and Choices that campaign for legalized assisted suicide on the alleged basis of strict criteria for mentally competent, terminally ill adults in unbearable physical pain to freely choose physician-assisted suicide with (unenforceable) “safeguards”.

The emerging situation throughout the world is more like Kevorkian’s dream of unfettered and universal access to medical termination of the lives of “expendable” people. How much easier is that when people with expensive mental health problems, serious illnesses or disabilities can be encouraged to “choose” to be killed?