Assisted Suicide Is A Deadly Mix With Our Profit-Driven Healthcare System

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In the debate over the public policy of legalizing assisted suicide, proponents of so-called “Death With Dignity” acts often tell personal stories of a loved one’s difficult experiences while dying.

When I hear that someone was screaming in pain, my first thought is “malpractice.”  My father died of bone cancer, a very painful type of cancer, and he had pain medications prescribed by his oncologist, but was still in a lot of pain and could barely stand to move.  Then he agreed to forego aggressive treatment and go into hospice.  The hospice nurse adjusted his medications, and his pain virtually disappeared – he got up, went to see his neighbor and played putt-putt golf in the living room.

He lived about three more months, and stayed under the care of that nurse until the end.  Sadly, she told me that she was being forced to spend increasing amounts of time documenting care due to managed care, rather than providing care to her patients, and as she tried to do both, her work was eating into her time with her family, so she decided to quit.  That was 15 years ago.

So when I hear stories of painful deaths, I think about my dad’s well-meaning but ignorant oncologist, the wonderful hospice nurse, and the ensuing progress in palliative care.  When a nationally respected palliative care physician like Dr. Ira Byock says that assisted suicide is not progressive, people should listen.  But personal stories carry so much more weight.

So we need to tell our stories.  People with disabilities have a lot of experience with doctors, hospitals and health insurance.  That’s just reality.  And our experiences profoundly affect how we see the assisted suicide issue.  All of the major national disability organizations that have taken a position on assisted suicide oppose legalization.  I think that is a direct reflection of the shared experiences of our community.

One common experience is having a need for health care treatment that is not covered because it costs too much.  Do you know why Medicare doesn’t cover hearing aids?  I used to work for a federally funded assistive technology center, so I asked this question of a federal official during a conference call training.  The answer was that so many seniors need hearing aids that it would cost too much, so hearing aids are not covered by Medicare.

In the assisted suicide context, denial of needed health care is very relevant.  The Disability Rights Education and Defense Fund coined the phrase “Deadly Mix” to refer to this concern:  Assisted suicide is a deadly mix with our profit-driven healthcare system.  At $100-$300, assisted suicide will be the cheapest treatment. Assisted suicide saves insurance companies money.

The infamous cases of “Deadly Mix” from Oregon are those of Barbara Wagner and Randy Stroup, who received letters from Oregon Medicaid denying coverage for prescribed chemotherapy but mentioning that the state would cover the $100 cost of assisted suicide.  In response to media coverage of the letters, the Oregon Medicaid agency stopped sending this type of letter, but that doesn’t change the economic realities.

There have been some powerful personal stories in Connecticut on the Deadly Mix issue.  One came from Elaine Kolb, a lesbian disability rights activist and songwriter who wrote and sings a song entitled “Not Dead Yet”, recorded during a March 14 press conference and posted on You Tube.  At the March 17 assisted suicide hearing in Hartford, Elaine testified powerfully about the pressures health care providers put on her partner to forego life-sustaining treatment.  To see Elaine’s testimony, readers can go to the Connecticut legislative website recording, beginning at 2 hours and 30 minutes.  CT News Junkie also reported a central concept of the disability witnesses and quoted Elaine.

People with disabilities have been among the bill’s most outspoken opponents. While supporters often refer to the legislation as “death with dignity,” some with disabilities see the term as a disparaging statement that likens a loss of faculties with a loss of dignity.

“They are saying that ‘I’d rather be dead than be you,’” Elaine Kolb, a disabilities activist, said. “. . . This is something that people are saying to people with disabilities and there is contempt in it and there is contempt in this bill.”

Cost cutting pressures also impact our nation’s elders.  Elaine called my attention to the personal story of a friend of hers, Joan Cavanagh, identified as “a life-long human rights and anti-war activist.”  The New Haven Register published her op-ed describing her experience fighting for her mother’s life:

I had a painful and frightening time for many years trying to get my Mom life-sustaining treatment. The health care system had no use for her because she was old, suffering from dementia, and poor. . . .

I had been her primary caregiver for 16 years while she lived at home and her health care agent while she was in a nursing home for four years. In the later years, I was continually pushed by medical providers to limit her treatment, change her code status to DNR/ DNI [Do Not Resuscitate/ Do Not Intubate], and/or put her under hospice care, against both her wishes and mine. During one emergency room visit, a doctor actually said that “society should not be expected to bear the cost” of trying to find out whatever was causing her current problem at age 86. (At that time, it turned out to be an easily treatable urinary tract infection.)

For Cavanagh’s whole story, which she noted is not uncommon among other caregivers she knows, go here.  In my view, her conclusion is inescapable:

Given the current health care system, its increasing focus on “cutting medical costs” and the fact that some lives are clearly deemed expendable, it is neither compassionate nor wise to support any measure that would, intended or not, legalize further pressure and abuse. When I think of the incessant harassment to which I was subjected to make a decision that I could not in conscience make, I have no doubt about the even greater coercion to which a seriously ill person (and their caregivers) would be subjected to end their too expensive life if assisted suicide is made legal.

I served on the boards of statewide Medicaid consumer advocacy organizations for many years, often as the only person with a disability in a group of progressive healthcare policy advocates.  The logic of the Deadly Mix argument is grounded in health care system failings that we fought at every turn.  The only reason I can think of that more progressives have not taken a stand against legalization of assisted suicide is that our opponents got the jump on us in the media years ago by framing the debate as “compassionate progressives” versus the “religious right.”  It’s time for everyone to catch up.  Health care cost cutting pressures and legalized assisted suicide are a bad combination.  It’s not rocket science, just simple economics. – Diane Coleman

 

Minnesota Supreme Court Rules Online Suicide Predator Melchert-Dinkel Protected by First Amendment

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Yesterday, March 19th, the Minnesota Supreme Court issued a decision that affects two cases in Minnesota.  From the Christian Science Monitor:

The Minnesota Supreme Court on Wednesday reversed the convictions of a former nurse accused of encouraging two people whom he met online to kill themselves.

The court ruled that the language in the state’s assisted-suicide law that pertains to “encouraging” suicide is unconstitutional. It violates the right to free speech. However, the court upheld the part of the law that bans “assisting” suicide.

“We conclude that the State may prosecute Melchert-Dinkel for assisting another in committing suicide, but not for encouraging or advising another to commit suicide. Because the district court did not make a specific finding on whether Melchert-Dinkel assisted the victims’ suicides, we remand for further proceedings consistent with his opinion,” wrote Justice G. Barry Anderson in the majority opinion.

His 360-day jail sentence had been on hold pending the outcome of the appeal.

Melchert-Dinkel, 51, was convicted on two counts of aiding suicide in the deaths of two people: Mark Drybrough, 32, of Coventry, England, who hanged himself in 2005; and Nadia Kajouji, 18, of Brampton, Ontario, who jumped into a frozen river in 2008.

His attorney argued that he was exercising his right to free speech, and that the law — which states that anyone who “intentionally advises, encourages, or assists another in taking the other’s own life” is guilty of a crime — was too broad.

In addition to his free speech claim, Melchert-Dinkel argued that he had no influence on either person’s actions. But prosecutors say his speech wasn’t protected and that he played an integral role in the deaths, including giving step-by-step instructions.

Evidence showed that Melchert-Dinkel sought out depressed people online. When he found them, he posed as a suicidal female nurse, feigned compassion and offered instructions on how they could kill themselves.

Melchert-Dinkel told police he did it for the “thrill of the chase.” According to court documents, he acknowledged participating in online chats about suicide with up to 20 people and entering into fake suicide pacts with about 10, five of whom he believed killed themselves.

Prosecution of Final Exit Members have been on hold pending the outcome of this case.  Theoretically, prosecutions in both the Melchert-Dinkel and Final Exit Network cases are possible in terms of suicide assistance, but in reality probably much less likely in the case of Melchert-Dinkel, who never came into physical contact with his targets.  There’s a stronger case for assistance in terms of the Final Exit Network, with several members facing various charges regarding their roles in the suicide of  Doreen Dunn.

As for Melchert-Dinkel, it’s highly likely he’ll be free of all criminal charges when the dust settles.  And that’s disturbing – to put it bluntly, the man is a predator. He searched for vulnerable people struggling with suicidal feelings online. Once he found one, he adopted a persona that would “befriend” that person and work toward a sham suicide pact (with Melchert-Dinkel trying to get the other person to webcast their own suicide).  He got off on it.

If cleared of all criminal charges, he’ll have a clean record.  And there’s no reason to assume he can’t regain internet access and resume his favorite sport again, secure in the knowledge that he has a free pass from now on.  Even the court acknowledged the “depravity” of his actions, which you can read in the decision, available here in pdf.

From Second Thoughts Massachusetts: Once again – assisted suicide proponents falter, MA legislation sent to study committee and gone from this year’s session

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“If you pass this law, you will be putting the power of

who lives and who dies out of the individual’s hands

and into that of an unscrupulous society,

who do not think that we have lives worth living.”

~Kate Ryan, Autistic Self Advocacy Network

 

From John B. Kelly, Executive Director – Second Thoughts Massachusetts

www.second-thoughts.org

617-536-5140

John.B.Kelly@verizon.net

 

We thank the cross disability, and mental health recovery communities for powerful and effective testimony against assisted suicide.  As assisted suicide goes down for the second time in two years, disability rights advocates are taking up the leading positions against assisted suicide.

Disability rights voices are now undeniable in the battle against assisted suicide, we join with medical societies and hospice associations against assisted suicide.

We thank the Joint Committee on Public Health for hearing our concerns on how dangerous assisted suicide is to ill and disabled people.  That’s twice in two years now that first voters and now the legislature has had second thoughts about assisted suicide.  Massachusetts is rightly seen as a leader in social issues, and its solid rejection of assisted suicide should be heard across the nation.

Disabled who experience depression can breathe easier, who might be depressed and feeling hopeless, or in an abusive situation.

A similar effort in the New Hampshire Legislature was also recently defeated.

 

Not Dead Yet Issues Statement in Support of ADAPT and the Community First Choice Option

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As many of our readers know, Not Dead Yet has a close relationship with ADAPT, the grassroots disability activist group that is fighting for our right to stay in our own homes and not be forced into nursing facilities (we don’t call them nursing “homes” because they are not homes) and other institutions.  I hope you’ve seen the ADAPT/NDY ad in Times Square.  Even though long term care in people’s homes is less costly to the taxpayer than sticking people in nursing facilities, ADAPT has been fighting for 24 years to change entrenched public policies and win our right to freedom.

ADAPT won a major victory with the enactment of the Community First Choice Option, a Medicaid long term care option.  Now the focus is on getting each state to choose the CFC Option and implement it.  In New York, we are almost there, with the Governor and state Senate ready to go, but the Assembly is blocking a needed amendment to state nursing laws.

Today, ADAPT activists from NDY’s headquarters in Rochester have travelled to the state capitol to once again push for our freedom.  Not Dead Yet is with them in spirit, and calls on the disability community and our allies to join in supporting them.  To send a message to the NY Assembly, go here.

Press Release: Disability Activists from Not Dead Yet and Second Thoughts to Testify in Opposition to Connecticut Assisted Suicide Bill

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John Kelly, Not Dead Yet’s regional director for the New England states, and disability activists from Second Thoughts Connecticut will be testifying today in Hartford against an assisted suicide bill, HB 5326.  Sporting stickers saying “Got Second Thoughts?”, members of Second Thoughts Connecticut held a press conference last Friday to explain the reasons for their opposition to the bill.

Disability activists have received increasing attention to their opposition stance since forming the Second Thoughts Connecticut organization.  Modeled after the Massachusetts group of the same name, which was instrumental in defeating an assisted suicide ballot referendum in that state in 2012, the group says that a closer look at the details of assisted suicide proposals give people “second thoughts.”

“The bill would establish a government recommendation that doctor-prescribed suicide is sometimes the best treatment,” said Kelly.  “Innocent people who are not terminal and are not making a voluntary and informed choice will lose their lives as a result.”

According to Oregon’s assisted suicide reports, 97.6% of program suicides in Oregon have been white, in a state 22% nonwhite.  “Assisted suicide proponents are also overwhelmingly white,” said Kelly.  “The Pew Research Center found last year that, while whites support assisted suicide 53%-44%, black and Latino voters register 65% opposition.  The election map for Question 2 in Massachusetts revealed these same trends.”

Cathy Ludlum is a disability activist who has given presentations to several groups, including the Human Rights and Responsibilities Section of the Connecticut Bar Association, about the assisted suicide issue.    “Contrary to what you will hear from proponents, people do not generally ask to end their lives because they can’t escape from the pain,” Ludlum told the bar association members.  The suicide factors identified in the Oregon assisted suicide reports, “perceived loss of autonomy, loss of dignity, and decreasing ability to be active are completely disability issues,” she said.  Ludlum uses a motorized wheelchair and employs personal care attendants to assist her in activities of daily living.  “Why do some people equate needing help with basic bodily functions to a loss of dignity?” Ludlum asks.  “If people are literally dying from embarrassment, there is something wrong.”

Second Thoughts member Stephen Mendelsohn criticized the stickers from the bill’s proponents, which say “My Life. My Death. My Choice.”  “They don’t care about all of the collateral damage assisted suicide legislation causes,” Mendelsohn said.

Mendelsohn described several aspects of the bill that concern him but, he said, fail to concern proponents.  Referring to the issue of suicide contagion, “Rep. Betsy Ritter is quoted in the Yale Daily News saying ‘her research team found no rise in states that have right-to-die laws,’” said Mendelsohn.  “But according to the Centers for Disease Control, Oregon’s already high suicide rate has increased much faster than the national average from 1999 through 2010—49% versus 28% for ages 35-64.”

Mendelsohn also stated that “HB 5326 is a prescription for elder abuse on a massive scale. . . . The law protects greedy heirs and Compassion and Choices simply doesn’t care.”

Every year in Connecticut, it is estimated that out of 660,000 people over age 60, there are 73,000 reported and unreported cases of abuse.  Connecticut has a poor record in this area – 32nd out of 35 states surveyed in funding, and fifth worst in number of “substantiated” complaints.

At the conclusion of Friday’s press conference, WTNH reported that Second Thoughts member Elaine Kolb of West Haven was “singing the battle cry of the disability rights movement against the latest version of the assisted suicide bill.”  Her song, entitled “Not Dead Yet” after the national disability group, included lyrics about cuts to Medicaid, Medicare and services, indicating a cost cutting fear:  “Since death is cost-effective, Do you want us dead or alive?”

[Editor’s Note:  For the PRWeb version of this release, in pdf format, with a photo of Cathy Ludlum and testimonies attached, please go here.]