Don’t Forget: Today is World Elder Abuse Awareness Day

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Today is World Elder Abuse Awareness Day. According to the National Council On Aging:

Approximately one in 10 Americans aged 60+ have experienced some form of elder abuse. Some estimates range as high as five million elders who are abused each year. One study estimated that only one in 24 cases of abuse are reported to authorities.

… In almost 60% of elder abuse and neglect incidents, the perpetrator is a family member. Two thirds of perpetrators are adult children or spouses.

Despite such a high prevalence, assisted suicide laws and their proponents rarely if ever address or bring up the topic. The fact that various forms of elder abuse – physical, emotional, financial – could cause an elder to want to die doesn’t seem to raise concerns. At best, they assign doctors the role of identifying coercion or abuse and, very rarely, referring the patient to psychological professionals to assess decisional capacity.

A few recent assisted suicide laws or bills also say that the doctor should meet with the patient alone to discuss potential coercion, pressure or abuse, but will that really work? How good are doctors at detecting abuse? According to an article in American Family Physician:

Despite [the] expected increased demand for expertise, physicians generally lack training, experience, education, and adequate guidelines for the assessment and management of abuse. Less than 2% of reports of elder abuse and neglect to state APS agencies come from physicians.

So purported protections against assisted suicide being granted in situations involving coercion and abuse are really just window dressing, form without substance. In practical terms, these laws only protect a prescriber who has little or no ability to protect the patient.

Boston Globe: “For assistance in dying, please press 1”

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Liz Carr’s documentary, “Better Off Dead?”, continues making a difference, serving as a wake up call about the dangers assisted suicide laws pose for people with disabilities. A Boston Globe columnist noted this week:

The most chilling detail in “Better Off Dead?” a new BBC documentary by the English actress and comedian Liz Carr, is an automated telephone message. …

 “Thank you for calling. The Ontario Medical Assistance in Dying Care Coordination Service is designed to provide information about end of life options in Ontario and referrals for Medical Assistance in Dying. If you would like to speak with an adviser to access the service or get more information, please press 1.”

As the Globe column points out, proponents are advocating for passage of assisted suicide laws in the United Kingdom and Massachusetts (as well as other U.S. states). They argue that eligibility is strictly limited to people whose conditions are terminal. However, since eligibility is based on a doctor’s prognosis (currently in the U.S., six months till death), it can be incorrect and the Oregon data from people who wait past 6 months to take the lethal drugs shows that it is incorrect sometimes.

Line in the sand vs shifting sands…

The Globe column describes a conversation between Liz Carr and one of the leading proponents of assisted suicide in the UK House of Lords:

In her documentary, Carr interviews one of those advocates, Lord Charles Falconer, who dismisses concerns that the criteria for assisted dying will inevitably be expanded. “Once a legislature decides it’s going to be terminal illness only, it will stick at that,” he says firmly. “The line in the sand for me is terminal illness. It goes no further than that.”

But the thing about sand, as Carr observes tartly, is that it shifts.

It certainly shifted in Canada. When MAID took effect in 2016, its boundaries were clear: Only mentally competent adults dying of a terminal condition could be approved for euthanasia. …

Yet soon the law was expanded to include anyone with a “grievous and irremediable medical condition,” whether fatal or not.

Expansion of assisted suicide laws – often called the “slippery slope” or “incrementalism” – has happened in the U.S. (e.g., waiting periods reduced or eliminated, new types of lethal drug prescribers allowed) but more slowly than in some countries. Unlike countries which legalized assisted suicide nationwide, proponents in the U.S. were essentially forced by the Supreme Court to enact bills state-by-state following the Glucksberg decision. Proponents are likely hoping that the number of states with assisted suicide laws will reach “critical mass” soon, but judging by their hesitation to support the outrageous California expansion bill SB 1196 earlier this year, they don’t think they are “there” yet.

The Globe column also gave credit to disability activists’ opposition to these bills.

Among the most eloquent opponents of assisted-suicide laws are disabled activists who fear that once people are allowed to seek a doctor’s help in ending their life, many will be coerced into doing so. That coercion might come from family members unwilling to bear the strain of long-term medical care when assisted suicide is a cheap alternative. It might come from insurance companies refusing to reimburse the cost of lifesaving treatments once legalization lets them offer aid in dying as a covered benefit instead. It may come from physicians, many of whom, recent research shows, underestimate the quality of life of individuals with significant disabilities.

The Globe has had over ten years to observe the successful advocacy of John Kelly and Second Thoughts MA which is based in Boston. Hopefully more news outlets will take notice of the important work disability advocates are doing in many states and nationally on this issue. Medically assisted suicide is not part of healthcare and is not a progressive social cause. Give this issue the Second Thoughts it deserves.

Second Thoughts MA protest gains important news coverage

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Second Thoughts Massachusetts led a peaceful counter demonstration at a gathering of assisted suicide proponents held at the Massachusetts State House on Wednesday, June 5th.

A group photo of six people in purple Second Thoughts t-shirts, three wheelchair users and three standing behind them in a large hall.
Seated: John Kelly, Randi Shea, Brian Shea
Standing: Chip Guiney, Glacier Gray, Ashlinn Parnell

In addition to those featured in the photo above, others who participated included Ian McIntosh and Jessica Rodgers of the Patients Rights Action Fund, Harry Weissman, Director of Advocacy for Disability Policy Consortium, as well as Gabriell Paye, Jon Ball, John Robinson and Dr. Rich Florentine.

The State House News Service (SHNS) provided unusually balanced coverage of the disability led demonstration against the assisted suicide bill currently before the Massachusetts legislature.

While it is all too common to see only a brief paragraph or sentence about opponents near the end of a lengthy article favoring physician assisted suicide laws, SHNS started with and frequently returned to Second Thoughts Massachusetts member Pamela Daly for her perspective. Below are some excellent excerpts from the article, Shifting views color Aid In Dying debate:

BOSTON, Mass. (SHNS)–When Pamela Daly first heard about the proposed legislation to give certain terminally ill patients the legal option to end their lives with a doctor’s prescription, she thought it was great that people could have a choice about how and when to die. …

But on Wednesday, … at the back of Nurses Hall, Daly and other advocates from Second Thoughts Massachusetts were holding signs and demonstrating against the controversial, long-discussed policy.

…Daly said she realized as she learned more about the proposal that it could be “extremely difficult and dangerous for many populations … just marginalized people in general.”

“They have a very simple argument, those people. Easy, who’s going to disagree with them? Who wants to suffer?,” she said after supporters talked about the pain of watching their loved ones suffer in their final days. “We have a much harder argument.”

The issue of physician-assisted death has lingered around Beacon Hill for years, with advocates claiming steps of progress as the Massachusetts Medical Society voted to drop its longstanding opposition and instead adopt a position of neutral engagement, and then as aid-in-dying legislation got a favorable report from the Public Health Committee after at least five straight sessions of being sent to study.

…But despite the talk of progress, … Daly and other opponents said they don’t sense the same kind of momentum for the legislation as supporters do. She said the feedback she hears from lawmakers suggests there is little appetite among elected officials to wade into the touchy topic.

“I don’t think it’s as close as they seem to think it is. There are a lot of politicians who don’t like to speak about this bill because it’s so controversial … and they feel that it’s such a big quagmire,” Daly said. She added, “It affects so many people in so many different ways.”

…Opponents like Daly contend that authorizing the policy could expose patients to coercion and abuse. Disability advocacy groups warn of a slippery slope — arguing that authorizing assisted death for terminally-ill patients is “just another incremental step to make non-terminal disabled people eligible for this as has happened in Canada and much of Europe,” John Kelly of Second Thoughts Massachusetts said.

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Great work by Second Thoughts MA in ensuring that legitimate concerns about a public policy of assisted suicide were heard in the ongoing debate.

Advisory: Disability Rights Advocates Opposing Assisted Suicide Available for Interviews

Our News & Commentary Blog

MEDIA ADVISORY                                                                  CONTACT

June 3, 2024                                                                           John Kelly 617-952-3302

                                                                                                       Pamela Daly 617-543-7868

Disability Rights Advocates Opposing Assisted Suicide Available for Interviews

WHAT:       Press availability of disability rights activists and allies in opposition to the assisted suicide bill S.1331, the “End of Life Options Act,” now before Senate Committee on Ways and Means.

WHERE:     The Massachusetts Statehouse, Nurses Hall; 2nd floor.

WHEN:     Wednesday June 5, 2024; starting at 10:30 am

WHO:       Second Thoughts Massachusetts and allies (look for purple t-shirts and signs)

Compassion & Choices (formerly the Hemlock Society) will also be hosting an event starting at 11 AM.

Second Thoughts Director John B. Kelly says, “Legalized assisted suicide is less about pain and more about fear of increasing disability and dependence on others. We support equal suicide prevention services, and yet individual suicide isn’t illegal. Our bottom line: keep your assisted suicide away from vulnerable people and our unequal and broken healthcare system.” John is commonly referred to as “paralyzed from the neck down,” which makes him eligible, in Canada and elsewhere, for lethal injection.

Second Thoughts member Pamela Daly says, “Bills like S.1331 have the potential to cause great harm to marginalized people like me and must not pass. Its safeguards are ridiculously easy to get around, and in other states that passed these bills, proponents soon got busy weakening them.”

Colin Killick, Executive Director of the Disability Policy Consortium (DPC), says: “Until we live in a world where free, high-quality health care and personal care assistants (PCA) services are available to everyone, where ableist stigma didn’t tell people with disabilities that their lives don’t have value, we must not pass this law.”

DPC Director of Advocacy Harry Weissman will attend and be available to speak with the media.

Kelly notes that all the leading national disability groups that have taken a position on assisted suicide, have come out against it.

In May, BBC One aired actor Liz Carr’s documentary, “Better off Dead?, which at last presents a disability perspective on assisted suicide. Just watch the first 7 minutes for a glimpse of the threats we face. Or search for “Liz Carr YouTube Better off Dead?”

Second Thoughts is a grassroots group of disability rights advocates from Massachusetts and the region which opposes the legalization of assisted suicide as a deadly form of discrimination against disabled people. We demand social justice against laws, policies, and media messages fueled by social bias. We organized in 2012 to help defeat assisted suicide Ballot Question 2. Since then, we have helped defeat 5 more bills in the legislature.

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The New York Bar Assn. and Medical Society Ignore Dangers of Legalized Assisted Suicide

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Lisa Blumberg

By Lisa Blumberg

The New York State Bar Association (NYSBA) adopted a resolution in 2023 that supports the provisions of the assisted suicide bill before the legislature. This position is based on a report by its Task Force on Medical Aid in Dying. The report is extensive but seems more of defense of assisted suicide rather than a balanced inquiry into the myriad issues raised by its legalization.

During the summer last year, Not Dead Yet had learned of the NYSBA Task Force and requested an opportunity to speak to which the chair replied, “I’ll be in touch a little later to settle on date for you to visit.” Sometime later, NDY inadvertently learned that David Leven, a leader in End of Life Choices New York, made a presentation to the Task Force. Rather than scheduling a comparable opportunity for opponents, the Task Force scheduled an open forum in November with a limited number of slots and did not notify the NY Alliance Against Assisted Suicide, a coalition of doctors, disability advocates and other opponents of assisted suicide laws. By the time word reached the Alliance, only three speaking slots remained available, the rest (over 20) taken by proponents. Later in December, another panel of prominent assisted suicide advocates presented to the Task Force but, once again, no expert panel from the opposition.

In the resulting Task Force report, assisted suicide and palliative care are jumbled together as end-of-life care. Portions of the report read like a planning document for the implementation of assisted suicide if the bill is enacted. For example, it encourages lawmakers to mandate that insurers offer coverage for assisted suicide. (pp. 32-36)

The slant of the report is evident right from the beginning of the introduction which states:

“To address the experience of some terminally ill people who suffer at the end of life, even with the support of hospice and palliative care, lawmakers have sought for more than 9 years to change the law in New York to allow these people to access an end-of-life option known as ‘medical aid in dying.’ Medical aid in dying is a medical practice that has now been adopted in 11 U.S. jurisdictions that allow a terminally ill, mentally capable adult with a prognosis of six months or less to live to request from their doctor a prescription for medication they can decide to self-ingest to die peacefully in their sleep.” (Italics mine for emphasis.)

With such value laden and highly debatable statements in the report, it is little wonder that the association decided as it did. However, they did not set a very good example for the Medical Society of the State of New York (MSSNY).

In April at its annual House of Delegates meeting, the MSSNY voted in a policy change that states “MSSNY supports legislation such as the medical aid in dying act and supports physicians’ choice to opt-in or decline to engage in the processes and procedures as outlined in any proposed medical aid in dying legislation.” While the medical societies of several states have taken a stance of so-calledengaged neutrality in regard to assisted suicide, no other state medical society has come out in affirmative support of its legalization.

There seems to be nothing on the MSSNY website which provides a rationale for its position. In fact, due to sloppy drafting of the resolution, its position is unclear. The phrase “legislation such as the medical aid in dying act” can be interpreted in various ways. Does the MSSNY just support the assisted suicide bill that is currently before the New York legislature or does it support any “medical aid in dying” bill that New York might consider in the future, including one that would allow voluntary euthanasia? (Proponents are increasingly using “aid in dying” as an umbrella term to refer to assisted suicide and euthanasia.) Or would it support a bill that openly includes chronic conditions and disabilities as eligible? Most doctors are not lawyers! Despite the ambiguity though, the New York Bar Association has commended the MSSNY for its position.

The MSSNY policy change does indicate that a doctor can opt-out, i.e., decline to engage in whatever it is the legislature legalizes as “aid in dying”. However, doctors can always decide what is beyond their realm. My dermatologist simply won’t give me advice on how to handle a cold. The fact that the MSSNY explicitly recognizes an opt-out right implies that there is something about assisted suicide that is professionally problematic, something outside of what doctors would ordinarily be doing. Regardless, the doctors who opt out are protected, but that does nothing to protect patients from mistakes, coercion and abuse.

It was New York’s highest court in 2017 which, by listening to all sides in regard to a proposed constitutional right to assisted suicide, drew the distinctions that should be made. They got it right when they stated, the “potential danger[s] of this dramatic change in public policy would outweigh any benefit that might be achieved.”

The MSSNY and the New York Bar Association should have taken their cues from them.