George Exoo Free – Extradition Request Denied

assisted suicide, crime and punishment, george exoo, Our News & Commentary Blog

George Exoo, who fashioned his own form of “suicide tourism,” is a free man today. Irish authorities wanted to arrest and try Exoo on charges related to his role in the death of Rosemary Toole. NDY has been following Exoo’s case for quite awhile, as evidenced by this 2002 press release. It’s been a long watch, since Exoo wasn’t actually arrested until this summer, with an extradition hearing held in August. Those wanting more details on Exoo can also read our prior post from August, which describes the way in which he used his “compassionate” activities to finance his travels.

Because we’ve spoken out on the case, the Associated Press contacted us for the story it published today. The judge is quoted in one part of the story:

“While Mr. Exoo’s conduct may be viewed as wrong, and very highly improper by most if not all of us, it is generally not recognized as criminal here in the United States.”

That specific quote elicited the following from me:

Steven (sic) Drake, a spokesman for Not Dead Yet, a national group that opposes assisted suicide and euthanasia, said VanDervort’s comment on assisted suicide laws in the United States was overreaching.

“That’s awfully broad. There is certainly enough instances of people being prosecuted in various states,” Drake said.

“I think there are people in Ireland who would have wanted to see this played out in court,” he said. “But, on the other hand, it looks like the government gave it its best case.”

OK, they forgot to mention we’re a disability rights group, but the reporter I talked to wasn’t the one at that bureau who was familiar with us. My quotes are accurate.

I’m not a lawyer and don’t pretend to be anything close to an expert on laws governing extradition treaties. I do know that the government went to great lengths to document the number of states that criminalize suicide assistance through statute and common law. While that may not have been sufficient in terms of the extradition treaty (again, not a lawyer), it surely was enough to render the judge’s quote a rather incredible overstatement of where suicide “assistance” stands in regard to the law.

And, as I told the reporter, we’re disappointed here, but it looks like the court handled this seriously and thoroughly. And we respect the judicial process here – to a point. NDY is based in Illinois, which had an alarming number of innocent people on death row after the judicial system here dotted all its i’s and crossed all its t’s. So our respect is tempered by our sense of reality.

In the meantime, we’re wondering if Exoo will pick up with his old “Compassionate Chaplaincy” and European travel plan. We’ve got just the poster for him:


 The image above is a poster with the title “Join Reverend Exoo and the Compassionate Chaplaincy.” Below that is a drawn caricature of Exoo. Underneath the caricature are the words: “travel to exotic, distant lands; meet exciting, unusual people and help them kill themselves – all travel, lodging and recreational expenses reimbursed – cash up front.”
That’s all for now. More soon. –Stephen Drake

NY Times Blog: “When Doctors Steal Hope” (and more)

media coverage, Our News & Commentary Blog, professional accountability

I’m back in the office for at least today. Comments are caught up on the blog.

Catching up with email, an item from Monday, October 22nd caught my eye. It’s from the NY Times Health Blog. Columnist Tara Parker-Pope lays out a scenario that will be familiar to readers of this blog in “When Doctors Steal Hope“:

A 79-year-old woman I know suffered a stroke recently, and a doctor in the emergency room told her family there was nothing he could do. The family was devastated. The woman’s 24-year-old granddaughter ran to the parking lot and vomited, then spent the rest of the night at home with the family, sobbing with grief.

But the next day family members returned to the hospital room to see the woman sitting up, drinking a milkshake. The nurses even had her out of bed and walking to regain her strength. She clearly has a long recovery ahead of her, but three days after the doctor’s first grim prognosis she left the hospital for a rehabilitation facility. The family was whipsawed by the emotional events. Why, they wondered, hadn’t the doctor told them a recovery was even remotely possible?

The rest of the blog entry contains a discussion of the possible motivations of physicians in this type of scenario, which is treated as all-too-common. As part of her exploration, Parker-Pope solicits the input and expertise of Dr. Jerome Groopman, the author of several books, including “How Doctors Think.” Groopman was the author of the New Yorker article discussed on this blog recently. Here’s what Groopman had to say to Parker-Pope:

Dr. Groopman says he is troubled by stories like the one involving my friend, but he’s not entirely surprised, either. In the case of stroke, for instance, treatments are inexact and recovery largely depends on the body’s own ability to heal itself. “When the physician feels that he or she really can’t do anything active, they tend to take the most negative scenario as the likely one,’’ said Dr. Groopman.

And well-meaning doctors often see less harm in having been wrong when a person recovers than wrongly predicting a recovery that doesn’t happen, he explained. “In some ways it’s easier to give people the worst news, and then if something good comes about everyone is overjoyed,’’ he said.

Both Parker-Pope and Groopman are missing – or avoiding – another aspect of this behavior. When these individuals with stroke, brain injury, etc. are described as “hopeless” the next step is often a discussion of the removal of the ventilator or feeding tube that is being used in those first days and weeks post injury or illness. By avoiding this aspect, Groopman and Parker-Pope are avoiding the issue of the life-and-death consequences of these “rush to judgments,” as Diane Coleman recently called them.

And by avoiding that issue, Groopman is missing another possible motivation. At least some doctors might be motivated to nudge families toward removal of life-sustaining treatment, figuring the death of the individual is a better outcome than the stress the family would experience with the long rehabilitation and level of disability that their loved one may very well face. Referring once again to Diane Coleman’s blog entry on the topic, at least a couple of bioethicists have suggested that as a legitimate course of action for doctors.

The New Yorker article and this recent blog entry by Parker-Pope are welcome entries into new territory regarding the uncertainties facing people with neurological injuries. Let’s see if someone out there in the mainstream press can carry this discussion the rest of the way home. –Stephen Drake

Hastings Ctr Report: Article Claims Ashley X “Sacrificed for the disability rights agenda”

bioethics, Our News & Commentary Blog, reality check

This particular entry is difficult to write, since I’ll be referring to an article that is generally unavailable to the public. But it’s important enough to take a crack at it. I suspect that a number of readers of this blog will find a way to get the article one way or another. (smile)

For awhile now, the Hastings Center has been making a quiet outreach to the disability community. A few players from the Center are involved in an event that will take me away from my computer over the weekend. I’m dubious about the value of the event. Part of that is based on past experience. I’ve been involved in two such events before, involving “dialog” between bioethicists and disability advocates. Both were dead ends – no followup or follow-through. And some of the same people in this event were involved in those events.

Anyway, at the same time I’m preparing to have a polite exchange of ideas (or something like that) with some bioethicists, a colleague alerted me to a particularly nasty attack on the “disability rights agenda” published in the current issue of the Hastings Center Report. It makes me wonder if the author was inspired by social conservatives’ attack on the “Homosexual Agenda.” It certainly reads like it could be. (note: in my circles, that “agenda” is generally referred to as “gay rights” or simply “human rights.”)

The article in question, “Disability and Slippery Slopes” is the “perspective” piece in the current (Sep/Oct 2007) issue of the Hastings Center Report. I can’t share much of it or link to it. The journal editors have wisely left this piece unavailable as an online offering to the general public.

Anita J. Tarzian, the author of the piece, does some “interesting” things in the course of her essay. Focussing on the “Ashley X” debate, she challenges the question of the surgical alterations to the young girl in question as a “disability rights” issue. She selectively defines “disability rights” issues through the social model often applied to people with physical disabilities. She also refers to the Illinois People First website and makes the claim that the statements made about what people with disabilities need and want exclude people with the assumed intellectual impairments of “Ashley X.”

She pretty much suggests that the “Ashley X’s” of the world should be culled from the “disability herd.” It’s the old – “you can’t speak for them because they’re too disabled to be disabled” gambit. Guess she should tell organizations like The Arc and TASH that they’re wasting their time.

Never in this article does she actually quote actual activists in regard to “Ashley X” – she instead quotes a pediatrician from an excellent Salon article on the issue, although she disregards the questions raised about the ethics committee process in the same article.

Incredibly, she quotes Nancy Mairs, a writer and disability rights advocate to make a point:

People who act on principle are likely to sacrifice the individual for the agenda, which is frequently shaped by their own, often deeply buried, presuppositions about what constitutes an acceptable life.

Tarzian left out some important context. Mairs was referring to Jack Kevorkian in that quote – a person willing to sacrifice individuals to his agenda. It’s part of an even broader discussion about the interplay between personal beliefs about choice and the consequences of certain types of public policy – and how they can come into conflict.

Tarzian follows up the Mairs quote by saying that objecting to the ‘Ashley Treatment’ “sacrifices Ashley for the disability rights agenda.”

Say what? How was Ashley “sacrificed”? By the time anyone knew about this, she’d had the surgeries. If, like Tarzian, you thought the surgical alterations were ethical and acceptable, there is no reason to whine here. Is Tarzian complaining because Washington Protection & Advocacy had the bad manners to investigate and announce the hospital had broken the law?

Finally, Tarzian calls for “an informed and nuanced public debate about disability, quality of life, and health care resource allocation.” The implication, of course, is that somehow the “disability agenda” interfered with that.

Let’s get real. The public discussion was dominated by members of the ethics committee who sanctioned these surgeries, transhumanists (unidentified as such) talking about the esthetics of matching “mental age” to body size, and a host of ethicists supporting the so-called “Ashley Treatment.” Art Caplan stood out as the one ethicist with real time allotted in the media who criticized the procedures and the ethics committee.

Tarzian got one thing right. There wasn’t anything resembling an informed or nuanced debate in public about the so-called “Ashley treatment.” But disability rights advocates were barely present in the public discussion. Lay the blame where it belongs – at the feet of the ethics committee members, transhumanists and other talking heads who tried to make the issue as simple as possible for public consumption.

This also doesn’t exactly enhance my expectations for the upcoming meeting. This article is far below the standards one usually expects from the Hastings Center Report, even in the “perspectives” section. Disability rights activists and advocates can deal with criticism – but it’s reasonable to expect criticisms to be fairly constructed, based in reality, or at least rational. Tarzian’s article is none of those. –Stephen Drake

Sunday, Oct. 21 – Addendum: Wesley Smith has more to say about Tarzian’s article. Read it here.

There won’t be any posts on the blog for a few days due to a combination of professional and personal obligations. I’ll be on the road for the next couple of days. Look for new entries by (hopefully) Thursday, October 25th. I also beg the patience of those who post comments as they wait a few days for them to appear.

Montana – Compassion & Choices Pushes for Broad Constitutional Right to “Assisted Death”

assisted suicide, Montana, Our News & Commentary Blog

From the Associated Press:

HELENA – Two terminally ill men and four physicians, all from Montana, have filed a lawsuit against the state and Attorney General Mike McGrath aimed at decriminalizing assisted suicide.

The suit was brought by Robert Baxter, 75, a retired truck driver from Billings who suffers from lymphocytic leukemia; and Steven Stoelb, 53, a former logger and forest technician from

Livingston who has Ehlers-Danlos syndrome, a connective-tissue disease caused by a defect in the body’s ability to produce collagen.

Doctors on board

They were joined by four Missoula physicians who treat terminally ill patients – Stephen Speckart, C. Paul Loehnen, Lar Autio and George Risi Jr. – and a nonprofit patients’ rights organization.

That “patients’ rights organization” is Compassion & Choices, an organization which has as its primary mission is to promote assisted suicide legislation.

I also suspect that all parties in this case are using a rather broad definition of “terminal” in that I’d be surprised if either of the “terminal” conditions will result in their deaths within six months. That’s an interesting move and possibly a harbinger of a bolder move in Montana than we’ve seen elsewhere.

Why is that? The parties are arguing the Montana constitution guarantees their right “to control their own death by obtaining medications from their physician to enable the patient to achieve a peaceful death, if they so choose.” Nothing about terminal. For that matter, there’s nothing in the reasoning that limits “assistance” to providing drugs – this could well be a justification for active euthanasia.

I’ll be honest. I didn’t see this one coming. But it turns out that Wesley Smith predicted something like this would happen back in 2000. He writes about the court ruling that paved the way for this latest move in Montana.

Go read his blog entry on the Montana Assisted Suicide Case if you want to have a better understanding of the history and rationale behind this latest move by euthanasia enthusiasts. –Stephen Drake

Wisconsin trying to force elderly man into hospice over family objections

hospice, Our News & Commentary Blog, Surrogate Decisions & Guardianship

Apologies for the recent interruption in posts. We’ve had some computer issues which are now getting resolved, but we’ll have some scheduling pressures over the next couple of weeks which will reduce the volume here in the short-term. More about that tomorrow.

Right now, I wanted to share this article which came to NDY’s attention by way of Ron Panzer (bio on this page) at Hospice Patients Alliance.

(Alert: flexible and vague use of “end of life” in article)

Hospice care decision fought

By all accounts, 83-year-old Sam Webster is a very sick man.

He’s so sick that a doctor who specializes in end-of-life medical issues said he had less than six months to live and belonged in a hospice where he would be kept comfortable until his last breath.

But Webster’s lawyer and a nephew say Webster is not ready to die. They say he wants to be aggressively treated for what ails him and does not want to be sent to a hospice, where, the nephew and attorney say, he would be medicated only for pain.

The medical, ethical and legal questions surrounding Webster have landed in Milwaukee County Circuit Court, where Judge John DiMotto will have to decide some delicate issues that could become more common with technological advances that can extend life longer than most people had ever imagined.

Who should have the power to make Webster’s health decisions: the government or Webster’s family?

This is a very strange article for those familiar with “end of life” issues, competence, guardianship and other issues. It raises more questions than it answers. What little we do know is not comforting – the state moving in quickly to assume the decisionmaking role for an elderly man with no notice given to his family.

First, the issues facing Sam Webster have nothing to do with “technological advances.” He’s an elderly man with some degree of dementia. Allegedly, the dementia has affected his swallowing ability, leaving him at risk for aspiration pneumonia.

According to the article, both Webster’s lawyer and Webster’s nephew say that Webster doesn’t want to go to hospice. There are three lawyers involved now – one for the nephew, one for Webster and a court-appointed guardian. The nephew and Webster’s lawyer say that Webster wants a feeding tube and to go to a VA hospital instead of hospice.

Unanswered questions

Apparently, Sam Webster lived with a friend until very recently. Did he lose all capacity to make choices about his care in that time? Were other options explored and discussed regarding nutrition? Some people who have trouble swallowing do better with ground food and thickened liquids – was this explored as an alternative between starvation and a feeding tube?

Sam Webster’s voice is disturbingly absent in this article. It would be nice to know what he thinks. It’s hard to believe that the man has had a recline so rapid that he can’t communicate anything about where he wants to go and how he wants to be treated.

Or is it that when Wisconsin moved to have him declared him incompetent, they deprived him of any right to any opinion about his life at all? That was the case here in Illinois for a terminally ill man under guardianship – at least until legal advocates fought for his right to have a voice in his life and death.

Let’s hope this judge thinks it’s important to hear what Sam Webster wants. It would be nice to think that’s a given, but if it was, then guardianship would have been a more deliberative process than it looks like it was in this case. –Stephen Drake