Joan Cavanagh: State needs health care, not “death with dignity”

[Published in the CTPost on April 1, 2021, and New Haven Register April 3.]

State needs health care, not “death with dignity”

Anyone who has been with loved ones facing serious, painful illness will empathize deeply with the testimonies in Ed Stannard’s Sunday, March 21 article. I have. And I do.

But as an anti-war, anti-death penalty, pro-choice, human rights advocate who has been compelled to fight attempts by the medical system to restrict and withhold treatment, I also contend that there is a much larger picture to be considered. As a society, we must make decisions to protect the lives of the most vulnerable among us, not place them in further danger. The relevance of these considerations is repeatedly ignored or denied by the proponents of bills such as HB 6425, currently before the Connecticut state Legislature in another attempt to make it legal for doctors to prescribe lethal drugs for their patients.

Specific provisions of HB 6425 are problematic in themselves: among others, the mandate that doctors lie about the cause of the patient’s death, listing the underlying illness only, not the ingestion of the lethal cocktail; the removal of qualifying restrictions from previous bills regarding who can serve as witnesses to the patient’s written request; and the fact that the primary care physician and the “consulting” physician can now share a practice. But the bill must also be viewed in its larger context.

The New York Times Magazine reported on May 3, 2020, that the slogan of Compassion and Choices, which avidly promotes this legislation nationwide, found its way onto a sign at a “You Can’t Close America!” super-spreader event for Trump supporters last spring in Austin, Texas. The faulty premise of “My life, my death, my choice,” present at that rally and in this legislation, is that individual decisions are made in a vacuum without impact on the larger community. While it may offer “choice” for the few, medical assisted suicide is an existential threat to the many.

Medical practitioners already pronounce judgment on a patient’s “quality of life” based upon personal preferences and prejudices combined with institutional mandates and insurance company imperatives to slash costs. The underlying social Darwinist mentality is never acknowledged, but the telling phrase “death with dignity” is often used, suggesting that the care required by many who are disabled, elderly or seriously ill demeans them and burdens caregivers and society. This repudiation of our human connection and responsibility to each another lies at the core of these bills, which contain the seeds of abuse, neglect and coercion.

To deny this and to dismissively state that we are “fighting a battle we don’t need to fight” is insulting and belittles the lived experiences of those who have been forced to constantly struggle against the medical system to get needed care for ourselves or our loved ones. My mother was a Medicare/Medicaid patient who suffered from dementia in her later years. I was browbeaten and harassed by many of her providers and other medical personnel who wanted me to “let her die.” Along with their pious mantras about “quality of life” and “death with dignity,” I was also told point blank by hospital administrators that they could not “afford” to keep treating her.

The longstanding, ugly reality of health care rationing for certain populations was made publicly visible by the COVID crisis: poor, disabled, elderly, Black and brown people already face lethal discrimination. How can proponents of medical assisted suicide now possibly doubt that it would morph into the only option available to those for whom potentially life-saving treatment is pronounced “futile” or deemed too expensive for hospitals and insurance companies to sustain? As a now-elderly person whose only insurance is Medicare, I do not want my cost-effective death, couched in someone else’s view of my diminished “quality of life,” to become the preferred (or only) “treatment” I am offered. Would you?

People coping with the pain and stress caused by a serious illness or disability are too often also forced to fight the medical system to get the care they need, if they even feel empowered to do so. When you have experienced this or witnessed it, you know it is as searing, heartbreaking and terrifying as the experiences described in Stannard’s article.

It would be unconscionable to introduce medical assisted suicide into this environment.

Instead of debating the merits of a bill to allow our doctors to kill us, the state Legislature must craft legislation to provide equitable, comprehensive and full treatment for everyone who wants it, including much improved palliative care (when freely chosen and needed.) These measures — not poison cocktails — are the way to move forward.

Joan Cavanagh lives in New Haven.

 

Michael Hickson’s Widow Files Civil Case Against Guardian Agency That Consented To His Death

[Press Release from the law firm involved:]

FOR IMMEDIATE RELEASE March 16, 2021 Chicago, Illinois

ROBBINS, SALOMON & PATT, LTD. SEEKS JUSTICE FOR MICHAEL HICKSON, FILES LAWSUIT AGAINST GUARDIANSHIP PROGRAM

Robbins, Salomon & Patt, Ltd. (RSP) on March 10, 2021, filed a lawsuit against Family Eldercare, Inc., a Texas guardianship program and two of its employees, in the District Court of Travis County, 126th Judicial District in Texas. The employees were assigned as guardians for Mr. Michael Hickson, a 47-year-old man with multiple disabilities who died at St. David’s South Austin Medical Center (SDMC) in Austin, Texas in June 2020 after being deprived of all life-sustaining treatment including artificial nutrition and hydration for six days.

Admitted to SDMC on June 2, 2020, Mr. Hickson was fighting sepsis, a urinary tract infection, pneumonia, and suspected COVID–19, all conditions for which he was successfully treated at SDMC only three months prior. Almost immediately upon Mr. Hickson’s admission and without waiting to determine if antibiotics would be successful, SDMC physicians recommended he be placed on “Do Not Resuscitate” instructions. Mr. Hickson was a quadriplegic, had an anoxic brain injury, and cortical blindness all stemming from sudden cardiac arrest in 2017. All were stable conditions.

Despite identifying the specific organism that caused the bacterial infection and lab results indicating Mr. Hickson was responsive to administered antibiotics, on June 5, 2020, his physicians, with the obliging consent of Family Eldercare, abruptly withdrew all life-sustaining treatment including artificial nutrition and hydration and designated Mr. Hickson as Do Not Resuscitate. When pressed for an explanation as to why they would not treat him, in a legally recorded conversation, one of his physicians told his wife, Mrs. Melissa Hickson, “as of right now, his quality of life, he doesn’t have much of one.” The physician then distinguished Mr. Hickson from other of his patients who were being treated aggressively for COVID–19, “his quality of life is different than theirs. They were walking, talking.”

The lawsuit asserts multiple counts of gross negligence, wrongful death and intentional infliction of emotional distress against Family Eldercare and its two assigned guardians. Among other matters, the guardians expressly instructed an SDMC social worker to keep information away from Mrs. Hickson, assured Mrs. Hickson that Mr. Hickson was receiving artificial nutrition and hydration, and fatally, never questioned the physicians’ recommendation to withdraw all life- sustaining treatment including artificial nutrition and hydration. Those guardians then never informed Mrs. Hickson of her husband’s demise, and 22 days after their guardianship authority ended, granted SDMC authority to release certain of Mr. Hickson’s protected health information in a social media statement defending its actions and demeaning Mrs. Hickson. []

RSP’s litigation efforts are led by Jennifer M. Sender and Andrés J. Gallegos. RSP is co-counseling with Whitburn and Pevsner, PLLC.

Lisa Blumberg: It’s not end-of-of life care. It’s assisted suicide, and it needs to be stopped

It’s not end-of-of life care. It’s assisted suicide, and it needs to be stopped

Hartford Courant, March 16, 2021

Photo of Lisa Blumberg, head and shoulders shot of a smiling woman with short gray hair and a dark blue blouse seated with a desk of files and books in the background.
Lisa Blumberg

It defies imagination that Connecticut is contemplating legalizing assisted suicide when COVID-19 deaths have exceeded 500,000 nationwide. The virus has laid bare the inequities and prejudices of our health system. Low-income people and people of color are dying at disproportionately high rates. Connecticut has the highest COVID-19 nursing home death rate in the Northeast. There have been an appalling 91 nursing home deaths per 100,000 Connecticut residents. [1] Early in the crisis, members of the Harvard Medical School Center for Bioethics wrote chillingly that “typical medical options may soon not be available to everyone.”

Yet, as concerned health care providers said, “Guidelines that evaluate patients by age or ‘comorbid conditions [that] impact survival’ or ‘underlying medical diseases that may hinder recovery’ implicitly rely on value judgments about these patients’ quality of life and deny these patients justice in our health care system.”

The Connecticut assisted suicide bill would let a doctor write lethal prescriptions for people deemed to have a life expectancy of less than six months if they so request, and would grant broad legal immunity to everyone involved in their deaths. Terminology about an “end-of-life option” or “aid in dying,” confusing assisted suicide with palliative care, or soaring rhetoric about choice and self-determination belies the fact that the only course of action facilitated is death.

There is a sharp distinction between a patient deciding when not to have life-prolonging treatment — which a patient has every right to do — and a doctor actively and knowingly prescribing lethal drugs to directly cause the patient’s death. As Dr. Joseph Marine, professor at Johns Hopkins University School of Medicine, has stated, assisted suicide “is not medical care. It has no basis in medical science or medical tradition. … The drug concoctions used to end patients’ lives … come from the euthanasia movement and not from the medical profession or medical research.”

It is a misconception that people turn to assisted suicide due to uncontrollable pain. Oregon data indicate that among the leading reasons people request lethal prescriptions are psychosocial factors such as perceived lessening of autonomy or feeling they are a burden. An “end of life option” law forecloses options in a very basic sense. It arbitrarily uses health status to exempt people from the suicide prevention services others receive (while discounting the possibility of errors in diagnosis and prognosis as well as the potential for support services to address the person’s concerns).

Assisted suicide sends the wrong message to people with disabilities. It is telling that in Washington state, one of few states that, like Oregon, has legalized assisted suicide, just 4 percent of the people who have used the act were given mental health evaluations.

Although the law proposed for Connecticut would mandate that a person receive “counseling” to determine mental status before obtaining lethal drugs, that is just to determine if there is “impaired judgment.” The law also allows for licensed clinical social workers, in addition to psychologists or psychiatrists, to do the mental health consultation. There is also no requirement that a person be evaluated just prior to taking these drugs. Mood and outlook can fluctuate radically based on physical factors like oxygen level as well as situational factors such as dread of being isolated in a nursing home because of the lack of in-home support.

Disinterested parties need not be present to ensure the drugs are self-administered and taken freely. The difficulties created by the pandemic have caused domestic abuse to skyrocket. There are bound to be at least some cases in which a person is steered or coerced into taking the pills by someone whose life might be emotionally, practically or financially easier if he died sooner rather than later.

In this grim time, a Boston University study has found that COVID-19-related stressors have caused one out of three adults to be depressed. The lead author wrote eloquently, “We would hope that these findings promote creating a society where a robust safety net exists.”

Legalizing assisted suicide would do the opposite. It would increase the shredding of the social fabric. Now is not the time for the state to enact this type of law. If we are honest about the inherent dangers, there will never be such a time.

Lisa Blumberg is a Hartford-area lawyer, writer and disability rights activist.

[1] The online article incorrectly stated that there were 91 nursing home deaths per “100,000 nursing home residents” instead of per “100,000 state residents.” See https://www.journalinquirer.com/connecticut_and_region/connecticut-has-highest-northeast-virus-death-rate-in-nursing-homes-report-says/article_7258891e-e22d-11ea-9e7d-a3f9ec5de365.html

Joyce Bender, International Radio Host of Disability Matters, Interviewed Diane Coleman

I was honored this week to be interviewed by Joyce Bender, President and CEO of Bender Consulting Services and an internationally respected leader in the field of disability employment. Her bio reflects some highlights of her extensive work:

Joyce Bender has built her career on over 30 years of executive search experience, and has become an internationally recognized leader in disability employment, since founding Bender Consulting Services, Inc. in 1995.
Joyce began her career in 1979 as a search consultant, and in 1988, founded Bender and Associates International, Inc., an executive search firm specializing in technology and management search.  In 1985, Joyce had a life-threatening accident due to epilepsy that caused a cerebral hemorrhage that required subsequent brain surgery.  This accident left Joyce with a 60 percent hearing loss in one ear and a realization that she had epilepsy.  As a result of her personal experience, she developed a passion for helping people with disabilities secure employment.  Joyce has received numerous recognitions and been featured in various publications and broadcasts.  Those highlights can be found in the media section of this site.  Joyce is also the host of “Disability Matters with Joyce Bender,” a weekly internet talk radio show on voiceamerica.com.

Here is Joyce’s Disability Matters broadcast information for the segment, including the archived interview as well as accessibility options:

Joyce welcomes Diane Coleman, the president and founder of Not Dead Yet. This organization, is a national disability rights group, that gives a voice opposing assisted suicide and euthanasia. Diane will discuss the mission of this organization in depth, as well as her leadership and policies in place now. She is a well-known writer and speaker on assisted suicide and euthanasia.

»Listen

Diane Coleman – ecard

To see real-time captioning during the live show, please click here (N/A)

Show Links

» Transcript

 

Stephen Mendelsohn: Assisted suicide lobby spreads falsehoods to promote systemic ableism

Cartoon drawing of wheelchair user looking at stairs to a suicide prevention door while pointed to an access ramp to an assisted suicide door.
Assisted suicide lobby spreads falsehoods to promote systemic ableism

by Stephen Mendelsohn
March 8, 2021

Proponents of assisted suicide repeatedly spread falsehoods to promote their lethal and ableist agenda.  The February 8 op-ed, “Aid in dying is not assisted suicide” is no exception.

Suicide is defined as the act of taking one’s life intentionally.  The person who intentionally ingests a prescribed lethal overdose more closely fits the dictionary definition of suicide than the despondent person who jumps off a bridge.  The desire for suicide is a cry for help, even when redefined as a “medical treatment option.”

The Connecticut State Suicide Prevention Plan 2025 posits a clear intersection between assisted suicide and other suicide.  Connecticut has the only state suicide prevention plan that includes disabled people as a high-risk population.  To quote the relevant section (pp. 57-58):

Discussions about assisted suicide for those with terminal illness intersect in important ways with suicide prevention. The active disability community in Connecticut has been vocal on the need for suicide prevention services for people with disabilities… [William] Peace writes that “Many assume that disability is a fate worse than death. So we admire people with a disability who want to die, and we shake our collective heads in confusion when they want to live.”

Connecticut’s suicide prevention plan makes a number of important recommendations, including “Do not assume suicide is a ‘rational’ response to disability or chronic illness.”

In addition to attempting to redefine suicide, the assisted suicide lobby promotes other falsehoods.

Proponents claim assisted suicide is only available to people who will soon die.  Yet not only do many people far outlive “terminal” prognoses, including those who have received lethal prescriptions, but many disabled people are perceived as “terminally ill” by medical professionals.  Laws allow treatable medical conditions like diabetes to qualify as “terminal diseases,” and proponents have long sought to expand suicide assistance to those with non-terminal disabilities.

They claim that their legislation is only for people in “deep and dire pain,” yet nothing in HB 6425 requires those seeking lethal overdoses to be in pain.  Pain or the fear of it has never been in the top five reasons people give for seeking assisted suicide, according to Oregon’s annual reports.  The overwhelming reasons people ask for assisted suicide involve not wanting to live the way disabled people do.

Proponents claim that there have been no abuses in states that have legalized assisted suicide, when the Disability Rights Education and Defense Fund has documented a list of abuses and complications, including cases of prolonged and agonizing deaths.  Moreover, as the Oregon Department of Health and Human Services stated: “We are not given the resources to investigate [assisted suicide cases] and not only do we not have the resources to do it, but we do not have any legal authority to insert ourselves.”  The only reason more abuses have not been documented is that assisted suicide laws are designed to conceal them.

Advocates claim to be about patient choice, yet there have been instances when insurance companies would pay for assisted suicide but not curative care.  A Connecticut state senator and leading assisted suicide proponent authored an op-ed proposing a separate bill that would “require the completion of advanced directives in order to sign up for Medicare, Medicaid or private health insurance.”  He spoke of his proposal as a way of getting people to forgo curative care, thereby reducing healthcare costs.

Finally, proponents demand legislation that mandates the falsification of death certificates.  HB 6425 requires the underlying terminal illness be listed as the cause of death.  If Connecticut follows the lead of Oregon and Washington, this will forbid any mention of the lethal overdose. Connecticut’s Division of Criminal Justice has twice submitted testimony in opposition to death certificate falsification, stating:

Section 9(b) effectively mandates the falsification of death certificates under certain circumstances. It states: “The person signing the qualified patient’s death certificate shall list the underlying terminal illness as the cause of death.” This is simply not the case; the actual cause of death would be the medication taken by or given to the patient…  The practical problem for the criminal justice system and the courts will be confronting a potential Murder prosecution where the cause of death is not accurately reported on the death certificate.

Legislators and the public should not be fooled by a privileged lobby that seeks to sell suicide as a solution to their own disability-phobia.  We should follow the recommendations of the National Council on Disability’s report, The Danger of Assisted Suicide Laws, and reject codifying lethal and systemic disability discrimination into law.

Stephen Mendelsohn is a Research Analyst / Social Media Coordinator for Second Thoughts Connecticut.