Progressives Against Medical Assisted Suicide Holds Press Conference; Members Testify at Public Hearing

Progressives Against Medical Assisted Suicide Holds Press Conference; Members Testify at Public Hearing on February 27th

Progressives Against Medical Assisted Suicide held a press conference at the Legislative Office Building in Hartford, CT on February 27th, just prior to a public hearing before the Public Health Committee to discuss this year’s proposed Connecticut assisted suicide bill, SB 1076. Co-sponsored by Second Thoughts Connecticut, speakers included Cathy Ludlum, a Second Thoughts leader; Dr. Diane Meier, Director Emerita and Strategic Advisor at the Center to Advance Palliative Care and Professor of Medicine at the Icahn School of Medicine at Mount Sinai; and PAMAS members Nancy Alisberg, Elaine Kolb, and Joan Cavanagh.

You can watch the press conference (thanks to Stan Heller, who videotaped it) here: 

 

Six PAMAS members also testified against the bill at the public hearing, including Alisberg and Cavanagh as well as Deborah Elkin, Paula Panzarella, Monica McGovern, and Frank Panzarella.

The Public Health Committee unfortunately passed the bill, at a meeting where none of the legislators who spoke even mentioned the many objections raised not only by PAMAS but also by disability justice activists. We expect that it will now be taken up by the Judiciary Committee. We will continue our struggle there to defeat this dangerous legislation. 

Joan Cavanagh

Progressives Against Medical Assisted Suicide 

Progressives Against Medical Assisted Suicide Mission Statement

Progressives Against Medical Assisted Suicide seeks to build a progressive, disability and human justice-based movement to prevent the legalization of medical assisted suicide and euthanasia and to end these practices where they exist. As progressives, we believe that these issues cut to the heart of what kind of society we want to live in.

We believe that the people who stand in the greatest danger of being further victimized by MAS are the poor, elderly, disabled, and people of color who are already marginalized, devalued, and threatened daily under the current medical system.

We stand for economic and civil justice; universal, comprehensive, quality, and unrestricted healthcare for all; reproductive rights; and justice and safety for LGBTQIA people. We work to open a path for our fellow progressives who share these values to also recognize the dangers of Medical Assisted Suicide and euthanasia and to join us in opposing these practices.

 progressivesagainstmas@hotmail.com

Oregon Assisted Suicide Data Analysis

Not Dead Yet, the Resistance

Oregon Assisted Suicide Data Analysis

March 16, 2023

How Assisted Suicide Laws Endanger People With Disabilities and Chronic Conditions

A disabled or chronically ill person who depends on life-sustaining treatment, even basic medications, would be able to qualify for assisted suicide if they lived where assisted suicide is legal. Oregon’s “Death With Dignity” law is the model for all U.S. states. As an Oregon official has clarified in writing, any person who becomes terminal because they do not receive treatment, for any reason, would qualify for assisted suicide under an Oregon type law.[1] If the reason they could not get treatment were an inability to afford insurance co-pays, they would be eligible for assisted suicide.

Anyone could ask for assisted suicide, but doctors are the gatekeepers with the power to decide who’s eligible. Since early 2020, the COVID pandemic has revealed that people with disabilities have been denied treatment for the virus due to their disabilities and pervasive healthcare provider biases about “quality of life.”

 

Assisted Suicide Laws Violate the Americans with Disabilities Act

By denying equal suicide prevention and other supports to people deemed “terminal”, assisted suicide laws are inherently discriminatory against older, ill and disabled people. The discrimination of state licensed health professionals denying equal suicide prevention and instead providing suicide assistance is a fundamental violation of the Americans with Disabilities Act.

 

The Oregon Assisted Suicide Data Substantiates Disability Concerns

Oregon’s assisted suicide law, the oldest in the U.S., is held up as the model for other states. One of the most frequently repeated claims by proponents of assisted suicide laws is that there is “no evidence or data” to support any claim that these laws are subject to abuse, and that there has not been “a single documented case of abuse or misuse” in the 25 reported years. Based on the Oregon state assisted suicide reports, these claims are demonstrably false.

Regarding documented cases, please refer to a description of individual cases and source materials compiled by the Disability Rights Education and Defense Fund entitled Oregon and Washington State Abuses and Complications.[2].[3]

The focus of the discussion below is the Oregon Public Health Division data.[4]

 

Non-Terminal Disabled Individuals Are Receiving Lethal Prescriptions In Oregon

The Oregon Public Health Division assisted suicide reports show that non-terminal people received lethal prescriptions every year except the first. Prior to the 2020 report, the online state reports did not reveal how many people outlived the 6-month or 180-day terminal prognosis. In 2019, at least one person lived 1503 days. The 2020 – 2022 reports revisit this “terminal” survival issue and state that 4 percent of individuals outlived their 6-month prognosis[5] in 2020, 3.8% in 2021[6] and 5.8% in 2022.[7] This does not take into account the individuals who took the drugs quickly but may have survived if they had waited longer. There is no requirement that the doctor consider the likely impact of medical treatment in terms of survival.

Oregon reports [show] that non-cancer conditions found eligible for assisted suicide have grown over the years. The addition of anorexia as a condition some physicians have viewed as warranting assisted suicide demonstrates how empty the law’s purported “safeguards” are.

 

The Only Certifiers of Non-Coercion And Capability Need Not Know the Person

Four people are required to certify that the person is not being coerced to sign the assisted suicide request form, and appears capable: the prescribing doctor, second-opinion doctor, and two witnesses.

In many cases over the years, the prescribing doctor is a doctor referred by assisted suicide proponent organizations. The Oregon state reports say that the median duration of the physician patient relationship was 5 weeks in 2021 and 2022, and 11 weeks over all years (2021 Report, page 13). Thus, lack of coercion is not usually determined by a physician with a longstanding relationship with the patient. This is significant in light of well-documented elder abuse-identification and reporting problems among professionals in a society where an estimated one in ten elders is abused, mostly by family and caregivers. (Lachs, et al., New England Journal of Medicine, Elder Abuse.[8])

The witnesses on the Oregon request form[9] need not know the person either. So neither doctors nor witnesses need know the person well enough to certify that they are not being coerced. What might be an example of coercion? Many elder and disabled people would say the threat of being put in a nursing home.

 

No Evidence of Consent or Self-Administration At Time of Death

In less than half the reported cases, the Oregon Public Health Division reports state that no health care provider was present at the time of ingestion of the lethal drugs or that it is “unknown” whether a provider was present (2022 Report, page 14). Without requiring an independent witness, there is no way to confirm whether the lethal dose was self-administered and consensual.

 

Pain Is Not the Issue, Unaddressed Disability Concerns Are

The top five reasons doctors give for their patients’ assisted suicide requests over all reported years are not pain or fear of future pain, but psycho-social issues that are well understood by the disability community: “losing autonomy” (90%), “less able to engage in activities” (90%), “loss of dignity” (72%), “burden on others” (48%) and “losing control of bodily functions” (44%) (2022 Report, page 14). These reasons for requesting assisted suicide pertain to disability and indicate that over 90% of the reported individuals, possibly as many as 100%, are disabled at the time of their assisted suicide request.

Three of these reasons (loss of autonomy, loss of dignity, feelings of being a burden) could be addressed by consumer-directed in-home long-term care services, but no disclosures about or provision of such services is required. Moreover, only 3% of patients who request assisted suicide were referred for a psychiatric or psychological evaluation (and only 3 patients in 2022), despite studies showing the prevalence of depression in such patients.

 

Conclusion

The Oregon assisted suicide data demonstrates that people who were not actually terminal received lethal prescriptions in all 25 reported years except the first, and that there is little or no substantive protection against coercion and abuse. Moreover, reasons for requesting assisted suicide that sound like a “cry for help” with disability-related concerns are apparently ignored. For all these reasons, assisted suicide laws should be rejected and repealed.

[For a slightly more detailed version of this analysis, go HERE.]

Endnotes:

[1] https://www.washingtontimes.com/news/2018/jan/11/diabetics-eligible-physician-assisted-suicide-oreg/;

https://drive.google.com/file/d/1xOZfLFrvuQcazZfFudEncpzp2b18NrUo/view

[2] https://dredf.org/wp-content/uploads/2015/04/Revised-OR-WA-Abuses.pdf

[3] https://dredf.org/wp-content/uploads/2012/08/Hendin-Foley-Michigan-Law-Review.pdf

[4] https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/ar-index.aspx

[5]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year23.pdf(page 11)

[6]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year24.pdf(page 12)

[7]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year25.pdf  (page 13)

[8] http://www.nejm.org/doi/full/10.1056/NEJMra1404688 ; See also, “New Report on Elder Abuse in Australia: Implications for Legalising Euthanasia” (Jan. 2022) https://www.australiancarealliance.org.au/new_report_on_elder_abuse_in_australia_implications_for_legalising_euthanasia

[9]http://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/pt-req.pdf

Press Release: Legislative Committee Does An End Run Around Disability Advocates

Contact: Deidre Hammon 775-544-9338

Legislative Committee Does An End Run Around Disability Advocates

March 14, 2023

A bill to legalize medically assisted suicide is being railroaded through the Nevada legislature in a manner that appears designed to exclude the voices of people with disabilities, people put most at risk if this bill passes.

The assisted suicide bill was added to today’s Senate Health and Human Services Committee hearing agenda at the last minute this morning.

“The legislature has just engaged in a blatant act of discrimination on the basis of disability for hearing the Physician Assisted Suicide bill (SB 239),” said Deidre Hammon with Nevada Not Dead Yet. “Less than 5 hours turn around for a hearing they know the Nevada Disabled Community including disabled veterans oppose. This demonstrates loudly and with malice aforethought that the Physician Assisted Suicide Bill is just codification of ‘Better off dead than disabled.’”

SB 239 was only introduced last Wednesday, March 8th. Disability advocates who have opposed these bills in prior years and were holding an advocacy day that same Wednesday, but had no prior notice of the bill’s planned introduction and only learned of it afterward.

The 2023 version of the bill would allow not only a physician but also a “physician assistant or advanced practice registered nurse to prescribe a medication that is designed to end the life of a patient….”

#

NDY’s Anita Cameron Featured in Media This Week

NDY’s Director of Minority Outreach, Anita Cameron, was featured in some important news pieces about medical bias against autistic people and proposed cuts to Medicaid. We applaud Anita for her incredible advocacy and we are so grateful to have her on Team NDY!

https://prescottenews.com/index.php/2023/03/07/above-all-else-believe-us-doctors-biased-behavior-toward-autistic-adults-taints-treatment-cronkite-news/

“For queer and gender-diverse autistic people, their gender or sexuality may have a larger impact than their autism on their medical treatment.

“It would literally be unsafe to disclose that I’m a lesbian,” said Anita Cameron, 57, a longtime disability activist and director of minority outreach at Not Dead Yet, a disability rights group.

“You literally get treated different…. It’s a little safer to be autistic than to be a lesbian, to be queer these days,” said Cameron, who lives in Rochester, New York. “Autistic people are six times more likely to be trans and non-binary.”

Cameron, who is Black, added that Black autistic people may be perceived as threats, due to others misinterpreting their behavior as dangerous. She notes the deaths of Black people with developmental disorders in encounters with police, making her careful of how she presents herself to health workers, even while living with chronic pain.

“If I go up in that emergency room crying and screaming … at the very least, I’ll get mocked,” Cameron said. “At the very worst, I will be escorted out of the emergency room or even arrested.” ”

https://spectrumlocalnews.com/nys/capital-region/politics/2023/03/08/advocates-want-medicaid-cuts-to-home-care-eligibility-blocked-in-budget#

“Anita Cameron, of Rochester, is visually impaired, and has issues related to autism and diabetes.

The 57-year-old currently qualifies for home care under the state’s Medicaid rules because she needs help with medications, house cleaning and bill payments, but would not qualify for one of the seven approved activities under the new law because she’s mobile.

Advocates worry the changes will force more people into nursing homes or adult-care facilities.

“Although I have mobility issues, I can transfer, I can maneuver — I can turn myself over in bed,” Cameron explained. “So under the proposed changes, I wouldn’t even get attendant services. I wouldn’t even be able to attempt to apply for services.”

Cameron, who works as a disability rights activist at events across the state, says the cuts will likely result in her being sent to an adult-care facility when she spends time in the hospital for medical care throughout the year.

“I have a job part-time, but I have a job,” Cameron added. “I wouldn’t be able to work from a nursing home.” “

New Vlog: Legislative Updates!

Video link: https://youtu.be/h9hOudlBKmI

This week, we’re taking a look at the assisted suicide bills currently being considered in states across the country. Learn what’s happening and how you can get involved. Want to get involved in activism around this issue? Fill out this quick form: https://secure.everyaction.com/8FDj6L…

Subscribe to our blog here: http://notdeadyet.org/subscribe-to-ou…

TRANSCRIPT:

Hello and welcome back to the NDY vlog! My name is Jules Good, I use they/them pronouns, and I’m the Assistant Director and Policy Analyst at Not Dead Yet. I’m a white person with short wavy brown hair wearing pink-rimmed round glasses, a blue blazer, and a cream colored shirt.

The legislative session is in full swing in states across the US, and it is jam-packed with assisted suicide legislation and related bills. The status of bills can change daily, but these updates are current as of 2/15. If anything important happens between when I record this and when I post it to the YouTube channel, I’ll make note of those changes in the video description below.

Let’s dive right in with the state that has FOUR bills this year: Connecticut! The first two, HB 5487 and SB 188 are companion bills, meaning they contain the exact same text but one is introduced in the House (or as it is called in Connecticut, the “General Assembly”) and the other is introduced in the Senate. Usually, legislators in the House and Senate team up on companion bills to promote simultaneous consideration in both chambers and to drum up more support for a particular piece of legislation. The House Bill currently has 28 legislators sponsoring or co-sponsoring it, all of whom are Democrats. The Senate bill has one lone sponsor. Unfortunately, neither bill has been fully drafted yet, so it is too soon to tell if they will be exactly in line with current assisted suicide legalization statutes or if they will contain any unique elements. All we have to go off of right now are the proposed bill summaries, which are pretty vague. There is also a second legalization bill coming through the House, HB 6530. Comparing its summary with that of HB 5487, there does not seem to be a huge difference. 6530 specifically mentions physicians and their role in the process, while 5487 does not, but both bills seem functionally the same at first glance. We shall see what differences arise between them once full drafts are published.

The fourth bill of interest in The Constitution State is HB 5486, which our colleagues have nicknamed the Death Certificate Accuracy Act. Shoutout to Stephen Mendelsohn at Second Thoughts Connecticut for his great work on this bill! This would ensure that if someone dies by assisted suicide, the cause of death on their death certificate reflects that. In many states where assisted suicide is legal, a person’s underlying illness is listed as the cause of death, not assisted suicide. This is mainly because of suicide clauses in life insurance policies, which withold payout of benefits to the deceased person’s beneficiaries for 1-3 years after the policy is purchased, depending on the insurer. These clauses are meant to dissuade someone from intentionally taking out a life insurance policy right before they plan to die by suicide, as a protective measure for insurers. Death certificate accuracy is particularly important in terms of stopping beneficiaries from coercing someone into pursuing assisted suicide to access their money. Here’s a real-life case of potentially coerced assisted suicide for economic gain, as reported by DREDF:

“Thomas Middleton was diagnosed with Lou Gehrig’s disease, moved into the home of Tami Sawyer in July 2008, and died by assisted suicide later that very month. Middleton had named Sawyer his estate trustee and put his home in her trust. Two days after Thomas Middleton died, Sawyer listed the property for sale and deposited $90,000 into her own account.[16] It took a federal investigation into real estate fraud to expose this abuse. Sawyer was indicted for first-degree criminal mistreatment and first-degree aggravated theft, partly over criminal mistreatment of Thomas Middleton. But the Oregon state agency responsible for the assisted suicide law never even noticed.”

If Middleton’s death certificate had accurately stated that he died by assisted suicide, Sawyer’s access to his assets may have been restricted, which could have dissuaded her from [allegedly] coercing Middleton to die prematurely. Hopefully, Connecticut won’t legalize assisted suicide so we don’t have to worry about how it’s reported on death certificates, but this is great backup legislation if CT joins The Dark Side.

Let’s move on up the coast to Massachusetts, which is considering assisted suicide legalization again this session with SD 265 after failing to pass it last year. MA’s process runs a little behind many other states, so it’s hard to predict when we might get a public hearing on this bill at the moment. Right off the bat, the bill has a clause that is not included in any currently codified law: “A patient shall not qualify if the patient has a guardian”. While guardianship is a whole other topic that deserves its own video, what you need to know for our purposes here is that guardians are typically appointed to make important legal and medical decisions for people deemed incapable of making those decisions for themselves. You may remember the recent guardianship controversy with Britney Spears, who was finally freed from her abusive guardian last year. In no other state is being under guardianship listed as an automatically disqualifying factor for pursuing assisted suicide, possibly because these bills purportedly require the person to be able to make healthcare decisions. This clause is likely meant as a safeguard to prevent abusive guardians from making decisions about their ward’s death, perhaps to emphasize the capacity requirement. The Massachusetts bill also requires that a patient’s physician must refer them to a psychological professional for an evaluation and receive a written go-ahead from that person in order to move forward with prescribing lethal medication. Referral for psych evaluation is recommended in many states, but not mandated. Aside from these two notable exceptions, SD 265 is pretty much a copy-and-paste of current assisted suicide statutes from other states.

Rhode Island is also considering an assisted suicide legalization bill this year after a failed bill last year. HB 5210, named the LILA MANFIELD SAPINSLEY COMPASSIONATE CARE ACT, is currently awaiting a hearing in the House Judiciary Committee.This bill is functionally identical to current assisted suicide legalization statues, but it does emphasize the point that physicians need to inform patients of alternative options such as palliative care more than many of its predecessors.

New York has a set of companion bills for assisted suicide legalization which are currently in the House and Senate Health committees, respectively. They are functionally in line with other bills, but contain one unique clause that reads: “(vi) an insurer shall not provide any information in communications made to a patient about the availability of medication under the article absent a request by the patient or by his or her attending physician upon the request of such patient, and any communication shall not include both the denial of coverage for treatment and information as to the availability of medication under the article”. Translation: insurers can’t mention assisted suicide to patients unless the patient asks about it. Insurers also cannot notify patients that coverage has been denied for treatment AND give information about assisted suicide in the same message. The idea behind this clause is one that disabled oppononets of assisted suicide have been bringing up for decades. If a patient is denied coverage for treatment, they may feel like their only option is to pursue assisted suicide, which is a form of financial coercion brought about by our broken healthcare system. While this safeguard sounds nice in theory, like so many others it is very difficult to enforce. Who is going to monitor communications between insurers and patients to be sure this type of communication doesn’t occur? How will patients know that it is illegal for an insurer to give them this information? Who would this even be reported to? These questions are intentionally left unanswered in the law– if they gave us a way to enforce this safeguard, it would be harder to reframe it as a barrier and rescind it later.

Next we have Indiana with HB 1011. It’s pretty run-of-the-mill and is currently awaiting a hearing in the House Committee on Public Health.

Maryland is considering SB 845, another copycat bill. It’s due for a hearing in early March.

Lastly (for now) is Arizona’s pair of companion bills, HB 2583 and SB 1646. Arizona proponents have been trying to pass assisted suicide legislation since 2003, and they have a better chance now than they ever have given the makeup of the legislature. These bills are also fairly unremarkable, although they are consistent with the trend of including a mechanism for overriding the 15 day waiting period for patients who are predicted to die before the waiting period ends.

A bright spot amid all of this bad legislation– Virginia introduced an assisted suicide legalization bill, SB 930, that quickly failed to pass through committee. One state down, 12 to go!

The other kinds of bills we’re tracking are those that expand access to assisted suicide by withdrawing safeguards and loosening requirements. Let’s take a look at these.

In Vermont, where assisted suicide has been legal since 2013, a bill to repeal the residency requirement in the law is being considered. As the law stands now, a patient must prove they are a Vermont resident as part of the process of determining their eligibility for assisted suicide. This bill, SB. 26, would remove that requirement so anyone from any state could pursue assisted suicide in Vermont. This is really problematic, because it essentially overrides the authority of other states that do not have legal assisted suicide.

Oregon is also entertaining a bill to remove its residency requirement, HB 2279. It had a public hearing on January 23rd, which NDY’s President and CEO Diane Coleman submitted testimony for. You can find it on our blog– I’ll put a link to it in the description.

Washington is considering a set of companion bills, HB 1281 and SB 5179, which would loosen requirements for the assisted suicide process. It would allow any “qualified medical professional”, rather than a physician only, to prescribe a lethal prescription. Any qualified medical provider who “has primary responsibility for the care of the patient and treatment of the
patient’s terminal disease” could write the prescription, opening it up to Advanced Practice Registered Nurses (APRNs) and physician assistants. If the attending professional is not a physician, they must consult with a physician. It also widens the scope of who can engage in counseling with a patient– it would no longer have to be a psychologist or psychiatrist. It could be “an independent clinical social worker, advanced social worker, mental health counselor, or psychiatric advanced registered nurse practitioner”. The bill strikes the current requirement that if a patient is living in a long term care facility, one witness to their request for a lethal prescription must be someone designated by that facility. It allows a lethal prescription to be delivered to a qualified patient by mail, which was previously prohibited. It shortens the waiting period between the first oral request and writing of the prescription from 15 days to 7 days, and provides that a patient can receive it sooner than 7 days if they are not expected to live that long. This bill would loosen requirements at almost every step of the process, inviting more room for clinical error and unnecessary death. It’s a great example of the trajectory of assisted suicide bills– they start out more restrictive, and then quietly expand over time. That’s why safeguards aren’t really safe– they can always be rolled back.

Last but not least: Hawaii. Hawaii’s companion bills, HB 650 and SB 899, would do many of the same things that Washington’s bills propose. APRNs and attending physicians could prescribe lethal medication, nurses with specialized training in psychology/psychiatry could provide counseling to patients, and the waiting period would be shortened from 20 days to 5 days. Hawaii’s bills would add a pathway to bypassing the waiting period for patients who are not expected to survive it, which its original bill did not have.

As you can see, we’ve got a doozy of a legislative session on our hands. Do you live in one of the states we talked about today? Do you want to learn more about assisted suicide legislation and what it means for your community? Please sign up for our action alerts! The link to sign up is in the description and it’s super easy– let us know who you are and what kind of advocacy you want to be involved in, and we’ll connect you with opportunities! Changing the conversation around assisted suicide and defeating these dangerous bills is going to take a critical mass of involved people. Please consider signing up– it doesn’t commit you to anything, it just lets us know that you’re interested. Together, we can protect our most vulnerable community members and affirm the value of disabled lives.

Thanks for watching! To learn more about us and what we do, please visit www.notdeadyet.org. And hey, if you want to stay updated on what we’re doing, consider subscribing to our blog. You’ll get an email when we post about an event, article, piece of legislation, etc. We promise not to spam your inbox– we generally post 1-2 times per week, max. Link to subscribe is in the video description below. See you next time!