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

Letter Asks Amer. Psych. Assoc. to Condemn Torture – Against People with Disabilities

advocacy, Our News & Commentary Blog, professional accountability, torture

In August, the American Psychological Association (APA) made some news when it passed a resolution affirming that its members shouldn’t be involved with “Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment” toward those termed “enemy combatants.” Many of us who are familiar with practices that are implicitly sanctioned by the APA took note of the narrowly-defined class of individuals who were affected by this document. So, a lot of us applaud the stand against aiding torture and cruel treatment of state prisoners, but aren’t surprised that the cautions aren’t applied to people with disabilities.

Recently, Mother Jones magazine became the latest member of the media to shine the spotlight on the cruel and inhumane treatment inflicted on students with disabilities at the infamous Judge Rotenberg Center in its feature story “School of Shock.” Here’s an excerpt of what goes on at the school, under “programs” that psychologists sign off on:

Employees shocked him for aggressive behavior, he says, but also for minor misdeeds, like yelling or cursing. Each shock lasts two seconds. “It hurts like hell,” Rob says. (The school’s staff claim it is no more painful than a bee sting; when I tried the shock, it felt like a horde of wasps attacking me all at once. Two seconds never felt so long.) On several occasions, Rob was tied facedown to a four-point restraint board and shocked over and over again by a person he couldn’t see. The constant threat of being zapped did persuade him to act less aggressively, but at a high cost. “I thought of killing myself a few times,” he says.

The reason we’re writing about this is that Derrick Jeffries has written a letter demanding that the prohibitions the APA extend the prohibition on participation in torture and cruel, degrading treatment to everyone, not just state prisoners. Derrick is a person with Asperger’s Syndrome, a parent of a child with Autism, and the brother of a sister with Autism.

His letter is posted in its entirety at disabledsoapbox blog and is titled “A Call for Ethical and Unprejudiced Leadership and Practice in the Field.” He invites organizations and individuals to sign on and provides contact info for those who prefer to contact the APA themselves.

Here is an excerpt:

Currently, children and young adults with autism, developmental differences, and mental health challenges are being treated in a manner that clearly meets the definition of Torture and Other Cruel, Inhuman, and Degrading Treatment or Punishment, as defined by the two previously mentioned APA documents. The Judge Rotenberg Educational Center (hereafter referred to as JRC) in Massachusetts has a long history of using electric shock, food deprivation and prolonged mechanical restraint, as well as other painful and dehumanizing aversive techniques.

Not Dead Yet has signed onto this letter and believe that individuals and organizations opposed to the abuse and mistreatment of people with disabilities should do the same.

Transhumanist Suggests Doctor’s Suicide Was “Wrought” by Disability Activists

activism, bioethics, Our News & Commentary Blog, unethical ethicists

This latest confirms my impression that transhumanists have an overrepresentation of bottom-feeders and generally sleazy characters. The latest blog posting of George Dvorsky brings even his performance to a new low.

Before I get into the latest post of his, a little history is in order. Dvorsky was the source of the quote about “Ashley X” aka the “Pillow Angel” that became really popular with the defenders of the radical surgical alteration of the young girl. One example of the quote can be found in the following news story:

George Dvorsky, a director of the Institute for Ethics and Emerging Technologies, countered: “If the concern has something to do with the girl’s dignity being violated, then I have to protest by arguing that the girl lacks the cognitive capacity to experience any sense of indignity.

“The estrogen treatment is not what is grotesque here. Rather, it is the prospect of having a full-grown and fertile woman endowed with the mind of a baby.” (emphasis added)


This mantra about matching “mental age” to body size became pretty popular and was even paraphrased by “don’t know squat about developmental disabilities but people will believe me because I’m a TV psychiatrist” Keith Ablow:

It is more appropriate, actually, for her to be in a physical body more the size to kind of match her intellectual abilities, which are so limited and that affords her a higher quality of life.

So what is Dvorky’s latest “contribution” to the “Ashley X” discourse? Unlike people close to Dr. Daniel Gunther, who are struggling to deal with his suicide, Dvorsky’s found a way to exploit the tragedy by throwing out a baseless accusation:

This is particularly upsetting for me, not just because I supported Gunther during the controversy, but because of the possibility that his suicide was wrought by undue pressure exacted on him by overzealous and vocal disability groups. (emphasis added)

As I noted yesterday in this blog, this accusation by Dvorsky would come as news to Gunther’s family who made a specific point of pointing to Gunther’s prolonged struggle with depression as the cause for his suicide – and specifically dismissed the idea that the controversy over “Ashley X” had anything to do with it.

I guess Dvorsky couldn’t resist an attempt to exploit this tragedy in an attempt to smear and possibly silence critics of the so-called “Ashley Treatment.” I guess it would be irresistible if you lack principles and any sense of shame. –Stephen Drake

Bob Kafka Replies to Robert Fine’s Defense of Texas “Futility”

activism, bioethics, futile care, Our News & Commentary Blog

The current issue of the New England Journal of Medicine features a letter from Robert L. Fine, M.D. in response to a harsh critique of the Texas Advance Directives Act by Robert T. Truog, M.D. Truog’s Tackling Medical Futility in Texas is freely available (although it might require free registration). Here is an excerpt from Truog’s critique:

On the other hand, the Texas law’s effectiveness as a mechanism for reaching closure in difficult cases is also what makes it most problematic. It relies on a due-process approach that is more illusory than real and that risks becoming a rubber-stamp mechanism for systematically overriding families’ requests that seem unreasonable to the clinicians involved. During a 2-year period at Baylor Health Care System, for example, the ethics committee agreed with the clinical team’s futility assessment in 43 of 47 cases.

This week, Fine, a major proponent of the “futility” statute in Texas, published his response:

These disputes occur not between physicians and patients but between physicians and families. Some families are trapped in normal psychological responses to bad news, and others are divided. Some have dubious motives, and some engage in magical thinking. Ultimately, physicians must choose between the easy path of acceding to the family’s medically inappropriate request and the hard path of undertaking further committee review and possible unilateral action. We should respect the family’s preference when possible, but we should never use a patient as a means to the family’s end if the patient does not benefit.

This problem will not go away, but after 8 years of practice, the Texas process remains the best approach when family requests conflict with professional obligations at the end of life.

As much as we appreciate Truog’s criticisms of the Texas Advance Directives Act, we thought it would be more interesting and useful to get the reaction of Bob Kafka, who has been leading efforts of disability advocates and activists in Texas to get the law in that state changed. Here’s what he said:

Dr Fine illustrates the arrogant “god like” attitude that unfortunately many in the medical community have about anyone or any consumer involved process that questions their decision to withdraw treatment that results in the death of the individual.

Though each individual case is different and presents many complicated medical issues the underlying reality is that the Texas law allows doctors to overide the stated wishes of the individual and/or the family. The ethics committee have no outside public member and is composed of the doctors peers who work at the hospital. All advocates were asking was to have adequate protections in the law. Dr Fine led the political juggernaut that killed legislation last Texas legislative session. The fact is when a person’s life is at stake there should be a presumption for survival. In Texas however you get more protections and appeals if you are on death row than you do under the Texas Futility Law.

Bob Kafka
NOT DEAD YET of Texas
Don’t Mourn – Organize!