February 12, 2020
John B. Kelly
New Hampshire House Judiciary Committee
In Opposition to HB 1659
“Death with Dignity Act”
On behalf of Not Dead Yet and Second Thoughts Massachusetts
Chair Smith, Vice-Chair Keans, Members of the committee:
My name is John Kelly, and I am the New England Regional Director for Not Dead Yet, the national disability rights group that has long opposed euthanasia and assisted suicide. I am also the director of Second Thoughts Massachusetts: Disability Rights Advocates against Assisted Suicide.
Please reject HB 1659, the “Death With Dignity Act.” Its passage would lead to the deaths of people who are not dying. It would devalue the lives of seriously ill and disabled people, and turn the state into a promoter of suicide.
Last May, the legislature took the bold, progressive step of abolishing the death penalty. One of the main objections to capital punishment is the unavoidable fact that of all executed people, a number – a conservative estimate is 4% – are innocent. Many of us opponents can’t bear the thought of the state killing even one innocent person on our behalf.
HB 1659 would create another kind of death penalty. Its enactment would inevitably cause the needless, tragic deaths of people who are not dying. People lose their lives by way of mistaken doctors, cost-cutting insurers, social pressure and coercion, and unrecognized depression. Today I concentrate on misdiagnosis and the disability prejudice at the heart of assisted suicide bills.
Doctors incorrectly diagnose people all the time. Based on hospice data, at least 12% to 15% of people diagnosed as having 6 months or fewer to live are not actually dying. That 12% to 15% means that assisted suicide threatens 3 to 4 times as many people as the death penalty. And it’s not just a matter of a few months lost to doctor error. A significant number of misdiagnosed people live years and even decades longer than predicted.
Just 6 weeks ago in the high-profile case Kligler vs. Mass, Massachusetts Judge Mary K. Ames ruled against any right to assisted suicide. She wrote that decision-makers like the legislature
could rationally conclude that predicting when a patient has six months to live is too difficult and risky for purposes of [assisted suicide], given that it involves the irreversible use of a lethal prescription. The Commonwealth put forward expert testimony that while doctors may be able to accurately predict death within two or three weeks of its occurrence, predictions of death beyond that time frame are likely to be inaccurate.
As just one example of getting it wrong, Jeanette Hall’s 2011 letter to the Boston Globe detailed her terminal diagnosis, request for assisted suicide, and finally, her decision to try the additional treatment recommended by her new doctor. She wrote
I am so happy to be alive! It is now 11 years later. If my doctor had believed in assisted suicide, I would be dead. I thank him and all my doctors for helping me to choose “life with dignity.”
Jeanette Hall still lives, now 19 years after an assisted suicide law almost killed her.
There are certainly people, now dead, who but for the existence of these laws, would today be as alive and well as Jeanette Hall, grateful that their terminal diagnoses were incorrect. This inevitable, unnecessary and tragic loss of life under assisted suicide laws is unacceptable.
Whatever else assisted suicide is, it is not about pain. Pain is a medical problem that palliative care can control. As renowned palliative care expert Dr. Ira Byock has testified,
If I thought lethal prescriptions were necessary to alleviate suffering, I would support them. In 34 years of practice, I have never abandoned a patient to die in uncontrolled pain and have never needed to hasten a patient’s death. Alleviating suffering is different from eliminating the sufferer. Allowing a person to die gently is importantly different from actively ending the person’s life.
I congratulate the authors of HB 1659 for their honesty in explaining why they think assisted suicide should be legalized. They just come out and say that the state needs assisted suicide because the prospect of becoming disabled and reliant on others causes some people “unrelenting” “mental anguish.” People who need help with their personal care suffer “embarrassing indignities.” The authors claim that these people must have the right
to choose to die with dignity. Many terminally ill patients experience severe, unrelenting suffering, mental anguish over the prospect of losing control and independence, and/or embarrassing indignities for long periods while they are waiting to die from terminal illness.
As we disabled advocates have been saying all along, assisted suicide is all about distress over disability. We see the same distress in the suicide motives (“end-of-life concerns”) reported by prescribing doctors in Oregon. They revolve around negative reactions to dependence on others, loss of abilities, loss of social respect (“loss of dignity”), feeling like a burden on others, and shame around uncontrollable body functions like incontinence. (Pain, even when combined with fear of pain, is only the sixth listed concern.)
We categorically renounce the implication in this bill that some people have less dignity before the state and its laws. Either tthe state upholds the inherent and equal dignity of everyone, or it undermines democratic principles by setting up a two-tiered society in which some people receive suicide prevention services and other people – old, ill, and disabled – receive encouragement to die.
Assisted suicide laws both reflect and add to the massive prejudice disabled people face in the medical care system, which is all too ready to have us die without treatment. I know people with disabilities living vibrant, active lives contributing to the community who have been encouraged to sign Do Not Resuscitate orders or decline life-saving treatment.
So, enough with the charade! People who experience unrelenting suffering at the prospect of depending on other people need our assistance in emotionally coping, not killing themselves. The rest of us, meanwhile, have the right to remain safe from reckless terminal diagnoses and the implication that everyone would be better off without us around.
Instead of targeting one group of people for state-supported death, let’s make sure that all people – especially, old, ill, and disabled people – have the choice and support to live comfortably at home with necessary supports. Invidious quality-of-life judgments have no place in social policy.
Please reject this bill. Thank you.
John B. Kelly
66 The Fenway APT 22
Boston, MA 02115
CITATIONS
4% of people sentenced to die innocent
Innocent Project, “National Academy of Sciences Reports Four Percent of Death Row Inmates are Innocent.” April 28, 2014.
https://www.innocenceproject.org/national-academy-of-sciences-reports-four-percent-of-death-row-inmates-are-innocent/
12-15% of hospice enrollees outlive six-month terminal window
Pamela Harris, et al., “Can Hospices Predict which Patients Will Die within Six Months?,”
J Palliat Med. 2014 Aug 1; 17(8): 894–898. doi: 10.1089/jpm.2013.0631
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4118712/
Quote from Judge Mary K. Ames, ruling against a right to assisted suicide in Kligler vs. Mass, December 31, 2019.
Dr. Lachlan Forrow, Chair of the Massachusetts Department of Public Health’s Interdisciplinary Advisory Council on Palliative Care and Quality of Life, held in an affidavit that “It is crucial to recognize that the limits in any physician’s ability to predict a patient’s future have dramatically different implications when what is at stake is possible referral to hospice, rather than the possible provision of a lethal prescription.” (Emphasis in the original)
Jeanette Hall,
Jeanette Hall, “She pushed for legal right to die, and – thankfully – was rebuffed,” letter to the editor, Boston Globe, October 4, 2011:
http://archive.boston.com/bostonglobe/editorial_opinion/letters/articles/2011/10/04/she_pushed_for_legal_right_to_die_and___thankfully___was_rebuffed/
Ira Byock quote
Ira Byock, “Vermont: Testimony of Ira Byock, MD to Vermont Senate Committee on Health and Welfare Hearing on End of Life Choices,” January 31, 2013.
http://tinyurl.com/kuolula
2018 Oregon Death with Dignity report
Oregon Health Authority, “Oregon 2018 Death with Dignity Act,”
https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year21.pdf