At last month’s GSA meeting, I attended several sessions on successful aging and disability. I was particularly interested in exploring the intersection of aging and disability because I was preparing for a class debate on assisted suicide at the time.
What is successful aging?
In the influential MacArthur Foundation Study of Aging in America
Yet, the minority view of disability challenges any implication that disability is a negative outcome. In addition, this successful aging definition has been criticized for assuming individual autonomy/control and lifestyle choices, without considering subjective/cultural perceptions and broader socio-economic conditions facing older adults that may limit their options in life. In Outliers: The Story of Success, Malcolm Gladwell emphasizes opportunity and legacy—no one ever makes it alone.
Yet, the minority view of disability challenges any implication that disability is a negative outcome. In addition, this successful aging definition has been criticized for assuming individual autonomy/control and lifestyle choices, without considering subjective/cultural perceptions and broader socio-economic conditions facing older adults that may limit their options in life. In Outliers: The Story of Success, Malcolm Gladwell emphasizes opportunity and legacy—no one ever makes it alone.
Clearly, there is a need to revise this definition of successful aging to be more inclusive and to encompass factors such as resilience and adaptation to aging processes (Baltes’ selective optimization with compensation, Kahana’s preventive and corrective proactivity). To join the lively conversation, the presenters in Public Health Implications of Healthy and Successful Aging (BSS) symposium posted their presentations online at http://healthyandsuccessfulaging.wordpress.com/.
Next year’s GSA annual meeting theme is Optimal Aging Through Research (http://www.geron.org/images/pressreleases/2012/rubenstein.pdf)
What’s new about disability?
New Investigations of Aging with Disability (BSS) symposium featured data from National Institute on Disability and Rehabilitation Research (http://www2.ed.gov/about/offices/list/osers/nidrr/index.html). While persons with disabilities are living longer due to advances in medicine, rehabilitation, public health and technology, they are experiencing an earlier onset of age-related conditions (osteoporosis, diabetes, obesity). About 12 million Americans with disabilities acquired in early or mid-life are over age 50, thus aging with disability.
Ivan Molton (http://agerrtc.washington.edu/) noted that secondary health conditions are frequently described as more significantly disabling than the original condition itself; for example, a person diagnosed with multiple sclerosis often copes with secondary conditions like chronic neuropathic pain, spasticity, gait/balance problems with greater fall risk, cognitive impairment, higher risk of infection, hypertension, accelerated arthritis, etc. Middle-age is “lousy” for individuals aging with long-standing disability conditions because this is when highest demands meet new limitations; fatigue and pain are the most frequently reported and impairing; and falls are prevalent and injurious. These secondary health conditions can be addressed with multidisciplinary pain treatments; interventions for fatigue and cognitive impairment; and falls prevention.
New Investigations of Aging with Disability (BSS) symposium featured data from National Institute on Disability and Rehabilitation Research (http://www2.ed.gov/about/offices/list/osers/nidrr/index.html). While persons with disabilities are living longer due to advances in medicine, rehabilitation, public health and technology, they are experiencing an earlier onset of age-related conditions (osteoporosis, diabetes, obesity). About 12 million Americans with disabilities acquired in early or mid-life are over age 50, thus aging with disability.
Ivan Molton (http://agerrtc.washington.edu/) noted that secondary health conditions are frequently described as more significantly disabling than the original condition itself; for example, a person diagnosed with multiple sclerosis often copes with secondary conditions like chronic neuropathic pain, spasticity, gait/balance problems with greater fall risk, cognitive impairment, higher risk of infection, hypertension, accelerated arthritis, etc. Middle-age is “lousy” for individuals aging with long-standing disability conditions because this is when highest demands meet new limitations; fatigue and pain are the most frequently reported and impairing; and falls are prevalent and injurious. These secondary health conditions can be addressed with multidisciplinary pain treatments; interventions for fatigue and cognitive impairment; and falls prevention.
Tamara Heller (http://www.ihrp.uic.edu/researcher/tamar-heller-phd) created these word clouds for Aging and Disability, highlighting the prominence of health, exercise and program as common themes in health promotion interventions. Disability can learn from aging’s greater focus on interventions for specific diseases/conditions and use of peer leaders delivering health promotion interventions. Aging can learn from disability’s programming for people with cognitive impairments, adherence to principles of self-determination and adaptation of equipment for people who have physical disabilities.
Assisted suicide: autonomy or aging & disability risk?
For my Aging in Multidimensional Context class, I was assigned to a debate team opposing the legalization of assisted suicide. Our major arguments were based on traditional morality that prohibits killing innocent human lives, the sanctity of a physician’s Hippocratic oath, the slippery slope effect that foresees the gradual devaluation of human life with risk to vulnerable groups, and alternatives available (hospice/palliative care for comfort and pain management, psycho-social counseling for depression/fear of losing control/adapting to impairments, etc.) to address an individual’s reasons for even considering assisted suicide.
Here’s what I had to say about assisted suicide’s risks to vulnerable groups like the elderly and persons with disabilities:
On a micro level, assisted suicide impacts the patient-physician relationship and vulnerable patients who can be manipulated into assisted suicide that’s not really their own choice. A 1998 study by Georgetown University's
Proponents argue assisted suicide is about autonomy, that doctors should respect a competent and informed patient’s wishes and choices. They attempt to draft laws to provide safeguards so assisted suicide is available to persons who are competent and informed. Yet, one’s ability to make rational decisions is compromised by experiences of pain, isolation, depression, fears of disability/dependency and losing control, worry about being an undue financial and caregiving burden, prognoses about terminal illness and estimates of remaining life expectancy that can be unreliable. When emotions are raw and continually evolving, one’s judgment is understandably impaired. If a rational person is determined to commit suicide, it’s possible without legalizing assisted suicide to involve a physician.
On a mezzo level, assisted suicide impacts the following groups: patient’s family and friends who are concerned about a patient’s time left to live; elderly and persons with disabilities who see themselves as targets in assisted suicide laws that apply to terminally ill and/or those suffering incurable diseases and painful conditions; and the poor who become easy targets when assisted suicide is used as a form of medical cost containment in decisions on whether to prolong or shorten their lives.
As we have seen in European countries, legalizing assisted suicide sets the stage for the beginning of a slippery slope that expands to active euthanasia, as well as extending assisted suicide beyond the terminally ill to devaluing the lives of the elderly, infirm, disabled and other vulnerable groups who would be denied access to life under assisted suicide. Since 1942, Switzerland Netherlands Belgium followed the Netherlands Luxembourg
Those who support assisted suicide are primarily white people who are accustomed to power and privilege in their lives, and they want autonomy/control over how to die. During Oregon
States, which represent society’s rights for the common good, should not legalize assisted suicide to benefit the rights of individuals in this elite group. Doing so is dangerous because we live in a society of growing socio-economic inequality and prejudice in which the delivery of health care in a profit-driven system already creates disparities in treatment and pain control. If vulnerable groups aren’t even getting health care they need while living, it’s doubtful they’d get more sensitive treatment when they’re dying. It is unconscionable to talk about legalizing assisted suicide when low-income persons do not have access to comprehensive medical care including pain management and hospice care. Putting the lives of so many vulnerable people at risk for the possible benefit of an elite group is unacceptable.
Individual patient autonomy/choice is an illusion. In reality, assisted suicide is open to abuse by doctors and health insurance companies under financial pressure to contain costs of caring for the terminally ill. In 2008, reports surfaced that the state-run Oregon Health Plan doesn't cover life-prolonging treatment like chemotherapy unless there is a better than 5% chance it will help the patients live for five more years; but it covers life-terminating assisted suicide, defining it as a means of “therapeutic treatment” or providing comfort, no different from hospice care or pain medication. In its denials, Oregon Health Department informs patients about the availability of physician-assisted suicide; cancer drugs cost $3K-$6K per month versus lethal meds cost $35-$50 for one-time use (assuming no complications like vomiting)(http://abcnews.go.com/Health/story?id=5517492). Under these pressured circumstances, can a patient truly exercise autonomy when given a “choice” between an offer of fully-paid assisted suicide and alternative of no affordable medical treatment?
Further, this loss of autonomy justification for assisted suicide is disturbing, especially to persons with disabilities. The late SFSU Professor Paul Longmore wrote about his outrage over a state’s refusal to fund independent living for persons with disabilities, yet its willingness to support their assisted suicide (http://www.raggededgemagazine.com/archive/p13story.htm). Where are our priorities when a state supports so-called Death with Dignity, but not Life with Dignity and compassion for all persons?
Longmore provided this testimony against assisted suicide before the California Assembly, suggesting that tolerance of death for persons who live years with disabilities stem from fear and societal prejudice, and the need to reframe what autonomy and dignity means to replace any shame of needing help (http://www.independentliving.org/docs5/longmore1592.html):
“Fear of disability typically underlies assisted suicide. All but one Oregonian who died under that state's law feared, not pain, but losing autonomy or control of bodily functions. The advocates play upon that horror of ‘dependency.’ Said one, ‘Pain is not the main reason we want to die. It's the indignity. It's the inability to get out of bed or get onto the toilet....’ [People]...say, 'I can't stand my mother - my husband - wiping my butt.' That's why everybody in the movement talks about dignity. If needing help is undignified and death is better than dependency, there is no reason to deny assisted suicide to people who will have to put up with it for 6 or 16 years, rather than just 6 months. Not that we favor assisted suicide if it is limited to terminally ill people. We simply want to ask, has this country gotten to the point that we will abet suicides because people can't wipe their own behinds?”
Many people fear the three 3 D’s—Disease, Disability, Death—which has an upside of causing us to develop humility over these common experiences, forcing us to face the Big Questions about the meaning and value of life. If this makes us live with more purpose and intention, then maybe this unlocks the key to successful aging.
A Life-or-Death Situation
ReplyDeleteBy ROBIN MARANTZ HENIG
As a bioethicist, Peggy Battin fought for the right of people to end their own lives. After her husband's cycling accident, her field of study turned unbearably personal.
http://www.nytimes.com/2013/07/21/magazine/a-life-or-death-situation.html
‘Aid in Dying’ Movement Takes Hold in Some States
ReplyDeleteBy ERIK ECKHOLM
FEB. 7, 2014
DENVER — Helping the terminally ill end their lives, condemned for decades as immoral, is gaining traction. Banned everywhere but Oregon until 2008, it is now legal in five states. Its advocates, who have learned to shun the term “assisted suicide,” believe that as baby boomers watch frail parents suffer, support for what they call the “aid in dying” movement will grow further.
In January, a district court in New Mexico authorized doctors to provide lethal prescriptions and declared a constitutional right for “a competent, terminally ill patient to choose aid in dying.” Last May, the Vermont Legislature passed a law permitting it, joining Montana, Oregon and Washington. . . .
Opponents say that actively ending a life, no matter how frail a person is, is a moral violation and that patients might be pushed to die early for the convenience of others. . . .
There is a quiet, constant demand all over the country for a right to die on one’s own terms, said Barbara Coombs Lee, president of Compassion & Choices, and that demand is likely to grow, she said, as the baby boomers age.
Her group counsels people who call for advice, Ms. Lee said, describing options but not encouraging them to end their lives or providing direct help.
Callers who seem to be mentally disturbed and suicidal, she said, are referred to a suicide hotline. If they are facing imminent suffering and death and seek some control, the group urges them first to arrange for palliative or hospice care as they consider their next steps.
“People should get the best care, but also have a choice to accelerate the time of death if the very best care cannot make their remaining days acceptable,” she said.
One method for some is to simply halt vital treatments, such as dialysis or insulin. Another is to turn off a pacemaker or, like Mr. Mitton, refuse an unwanted new treatment. An increasingly popular choice, she said — “for patients who are truly, emotionally and spiritually ready to die” — is to stop eating and drinking.
But it makes a tremendous difference, Ms. Lee said, to live where the law permits assisted dying. Too often people seek alternatives in shame and secrecy, sometimes making frantic international trips for lethal drugs or using more violent means to kill themselves.
Research in Oregon indicates that for many patients, just knowing the option is there has proved a great comfort, she noted. Of the 122 patients who obtained lethal drugs in 2013, only 71 used them, the rest dying naturally with the pills in a drawer.
http://www.nytimes.com/2014/02/08/us/easing-terminal-patients-path-to-death-legally.html
The option of “rational suicide,” as Davis calls it, is based on wanting to avoid becoming dependent and on wanting to spare family the burden of caregiving, as well as the potential loss of an inheritance. The diabolical nature of dementia is that if you wait until you are a burden, until you can no longer do any of the things that once gave meaning to your life, then you will most likely have reached a stage where you have also lost the ability to take your own life or even to remember that you ever wanted to end your life if you developed advanced dementia. And those countries (such as Switzerland, Belgium, and the Netherlands) and those American states (Montana, Oregon, Washington, and Vermont) where Physician Assisted Suicide (PAS) is legal all require that the patient be of sound mind at the time the request is made and that she have a prognosis of not more than 6 months. So PAS is not generally an option for people with dementia. . . .
ReplyDeleteThe way to proceed, I believe, is for former Jane Doe to identify the goal of carefor her future self. Plausible goals are the prolongation of life, maximization of quality of life, or promotion of comfort. Death, parenthetically, is not a goal; it is a means to an end. Only rarely is it the only or the best means to achieving a legitimate goal. Most people, I suspect, would choose comfort as the goal in advanced dementia and maximizing quality of life as the goal in moderate dementia. All the physician needs to do is to translate that goal into practice. For an acute medical problem such as pneumonia, for example, comfort means using Tylenol to keep fever at bay and oxygen to ameliorate shortness of breath. Maximizing quality of life may mean using oral antibiotics—but not hospitalization in an intensive care unit with a ventilator for breathing.
We will never entirely be able to prevent people from committing suicide upon learning they are at substantial risk, if they live long enough, of developing clinical Alzheimer’s. After all, people can kill themselves when diagnosed with a disease such as metastatic cancer, even before they develop intolerable symptoms, though few do so. They could kill themselves prophylactically at age 65 or 70 to assure they will never get any awful disease, though most people do not choose this route. Our responsibility, however, as clinicians, ethicists, and lawyers is to try to make sure that every individual can live as good a life as possible, whatever cards she has been dealt. That’s what a good society does.
http://blog.drmurielgillick.com/2014/07/kicking-bucket.html
Advocates of assisted dying seek clarity on state’s law
ReplyDeleteBy Melody Gutierrez
Saturday, November 22, 2014
…East Bay cancer patient Brittany Maynard sparked a national debate on right-to-die laws after she spoke frankly of her decision to hasten her death by moving to Oregon, where it’s legal for doctors to prescribe lethal medicine to the terminally ill…
But, in truth, assisted dying happens in California…
Without right-to-die laws in California, friends and family can be thrust into a legal gray area when a dying loved one wants help dying…
The issue has prompted at least one California city to take action. On Monday, the West Hollywood City Council passed a resolution urging the Los Angeles County district attorney not to prosecute doctors and family members who provide lethal medication to mentally competent, terminally ill adults requesting it…
State lawmakers met with aid-in-dying advocates from Compassion & Choices last week to discuss potential legislation in California. The group anticipates lawmakers in 12 states will introduce bills during the coming year. Five states already have right-to-die laws for terminally ill people…
Any efforts are being met by longtime opponents, who argue that assisted dying puts the elderly and disabled at risk. Opponents point to the potential for abuse of an assisted suicide law, such as greedy relatives looking to cash in on an estate or the potential for cost of care to dictate decisions. In two high-profile examples in Oregon, which has had the aid-in-dying law for two decades, the state’s Medicaid program for the poor denied chemotherapy to two late-stage cancer patients. The plan, however, agreed to pay for physician-assisted death.
Opponents also worry that right-to-die laws essentially normalize suicide, particularly because some groups don’t help just those near death but also those with “irreversible” illnesses. It’s a slippery slope when defining the threshold for quality of life, opponents argue…
The helium tanks can be purchased at toy stores, often with a few balloons thrown in so as to not raise suspicions. The other supplies can be found at a corner store. Cobbled together, it’s called an “exit bag.”
It’s the recommended assisted-dying method for the Final Exit Network, a nonprofit that provides step-by-step instructions to terminal and irreversibly ill patients who want to die sooner than their illness will take them. Final Exit Network and Compassion & Choices were formerly the same group, called the Hemlock Society, before splitting.
In the past 14 months, 90 people have asked the Final Exit Network to help them die. Frank Kavanaugh, a board member of the Final Exit Network, said 82 applications were approved after medical records were reviewed by a team of physicians and the person was determined to be mentally competent and suffering with a terminal or irreversible illness.
Almost 20 of the total applications were from California.
“We give information on how to end your life quickly,” said Kavanaugh, 80, a retired health law professor in Florida. “If you want us to be there when you do it — because we don’t think anyone should die alone — we will be there. All we are providing is information.”
Kavanaugh said the Final Exit Network is well versed on assisted-dying laws in all states and knows how to work within their limits.
In California, the law is as short as it is vague: “Every person who deliberately aids, or advises, or encourages another to commit suicide, is guilty of a felony.”
A similarly worded law in Minnesota was struck down this year in a case against Final Exit Network after the state’s Supreme Court ruled that making it illegal to advise or encourage a suicide was an unconstitutional restriction on free speech.
Many prosecutors and assisted-dying advocates have interpreted state law to mean “physical assistance” is illegal…
http://www.sfgate.com/politics/article/Advocates-of-assisted-dying-seek-clarity-on-5911733.php
Dying Dutch: Euthanasia Spreads Across Europe
ReplyDeleteBY WINSTON ROSS / FEBRUARY 12, 2015
Give Me Liberty, Give Me Death
…doctor-assisted euthanasia, which is booming in the Netherlands. In 2013, according to the latest data, 4,829 people across the country chose to have a doctor end their lives. That’s one in every 28 deaths in the Netherlands, and triple the number of people who died this way in 2002. The Dutch don’t require proof of a terminal illness to allow doctors to “help” patients die. Here, people can choose euthanasia if they can convince two physicians they endure “unbearable” suffering, a definition that expands each year... The Dutch can now choose death if they’re tired of living.
That act is technically illegal in the Netherlands. Those who aid in euthanasia can face up to four and a half years in prison. But since the early 1970s, the Dutch government has treated assisted suicide much the same way it handles cannabis users: by looking the other way, honoring the public’s overwhelming view that people in the Netherlands should have the right to die. Since 2002, euthanasia has officially been decriminalized here, so long as certain criteria are met…
The march toward euthanasia mirrors a trend spanning continents today: a growing number of countries are placing more value on individual freedom. This worries religious leaders, ethicists and disability advocates. Assisted suicide may ease suffering, they say, but it threatens our most vulnerable citizens—the elderly and the disabled, who already struggle to justify their lives. “I like autonomy very much,” says Theo Boer, a professor of ethics at the Theological University Kampen in the Netherlands. “But it seems to have overruled other values, like solidarity, patience, making the best of things. The risk now is that people no longer search for a way to endure their suffering. Killing yourself is the end of autonomy.”…
Doubts and Double Suicides
…There are great risks associated with allowing doctors to help people check out early, they say. Paramount among them, says Wesley J. Smith, a California lawyer and consultant for the International Task Force on Euthanasia and Assisted Suicide, is that people have forgotten the meaning of suffering. “There is a new view of suffering, that it’s the worst of all possible experiences…and that the role of society is to prevent it, as opposed to mitigating it.”….
In light of the Dutch experiment, critics say there is no way to legalize assisted suicide without accepting the risk that vulnerable people will be pushed to their deaths—by the health care system, by their own guilt or by abusive family members or caregivers. “We don’t think any set of safeguards is sufficient,” Coleman says. “We need to respond to the desire to die with the message, ‘No, how can we help you? How can we be with you?’ That’s the real compassion people deserve.”
As for euthanasia, Gawande is torn… American doctors rightly allow people to refuse food, water, medication and treatments (and therefore end their lives). But the Dutch model is “a measure of failure,” he writes, because it forgets that the ultimate goal should be “not a good death but a good life to the very end. The Dutch have been slower than others to develop palliative care programs that might provide for it. One reason, perhaps, is that their system of assisted death may have reinforced beliefs that reducing suffering and improving lives through other means is not feasible when one becomes debilitated or seriously ill.”
Instead of suicide assistance, Coleman argues, doctors should offer better suicide prevention. When asked why they want to end their lives, people invariably check the same boxes: They’ve lost autonomy, or don’t want to be a burden on friends and family. But allowing physicians to help patients commit suicide is a cheap out, she says. What they should do instead is to help people make their lives livable, even if that’s just for the last few weeks.
http://www.newsweek.com/2015/02/20/choosing-die-netherlands-euthanasia-debate-306223.html
California Medical Association drops opposition to doctor-assisted suicide
ReplyDeleteLOS ANGELES | BY DAN WHITCOMB
Wed May 20, 2015 6:55pm EDT
The California Medical Association on Wednesday dropped its three-decade opposition to physician-assisted suicide, possibly paving the way for already-introduced legislation that would make the practice legal for terminally ill patients in the state.
The CMA said its change to neutral on the issue marked the first by a state medical association. It comes amid renewed debate over doctor-assisted suicide following the death of brain cancer patient Brittany Maynard last fall.
The American Medical Association remains opposed to doctors participating in assisted suicide, saying in a policy statement on its website that doing so was fundamentally incompatible with a doctor's role as a healer, would be difficult to control and posed "serious societal risks."
After Maynard was diagnosed as terminally ill at 29, she moved from California to Oregon, where physician-assisted suicide is legal, and died there because California forbids the practice. The Oregon Medical Association has never opposed physician-assisted suicide.
Two California lawmakers in January introduced SB-128, the End of Life Option Act, to legalize assisted suicide in the most populous U.S. state. That legislation has since passed a key panel in the state senate.
California Medical Association spokeswoman Molly Weedn said a "shift in the conversation" on the issue by both the American public and doctors prompted a debate within the organization.
The neutral position the CMA took "allows physicians to determine between themselves and patients whether they want to participate in the End of Life Option Act" and also gave the group input into the legislation, she said
For example, Weedn said, it was key for the CMA that doctors not be required to participate in assisted suicide or refer patients to a colleague who does.
Critics of the California legislature's bill said they remained "steadfast in opposition" despite CMA's shift.
"Our coalition continues to oppose this deeply flawed legislation because of the dangers it poses to those living with disabilities or in vulnerable circumstances, particularly in a state as ethnically and economically diverse as California," said Catherine Campisi, former director of the California Department of Rehabilitation and supporter of Californians Against Assisted Suicide, in a statement.
"Assisted suicide is inherently dangerous to those who are expensive to care for or who lack access to proper medical care, and rather than open up that Pandora's box, we ought to be exploring how to expand hospice and palliative care to address the needs of those terminally ill," she said.
(Reporting by Dan Whitcomb; Editing by Lisa Lambert)
http://www.reuters.com/article/2015/05/20/us-usa-assistedsuicide-california-idUSKBN0O52TI20150520
California becomes fifth state to allow physician-assisted suicide
ReplyDeleteBy Valerie Richardson - The Washington Times - Monday, October 5, 2015
California’s wrenching yearlong legislative debate over the right to die culminated Monday with Gov. Jerry Brown signing into law a bill making California the fifth state to permit physician-assisted suicide for the terminally ill…
“In the end, I was left to reflect on what I would want in the face of my own death,” Mr. Brown said in his signing statement. “I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others.”
Groups like Not Dead Yet and Californians Against Assisted Suicide had joined the Catholic Church in opposing the legislation, arguing that it would place pressure on the ill and disabled to end their lives rather than run up large health insurance bills.
“This is a dark day for California and for the Brown legacy,” said Californians Against Assisted Suicide spokesman Tim Rosales in a statement.
“As someone of wealth and access to the world’s best medical care and doctors, the governor’s background is very different than that of millions of Californians living in health care poverty without that same access — these are the people and families potentially hurt by giving doctors the power to prescribe lethal overdoses to patients,” Mr. Rosales said.
Oregon became the first state to legalize assisted suicide for terminally ill, mentally competent adults in 1994, followed by Washington and Vermont. The Montana Supreme Court has ruled that physicians may prescribe lethal drugs to the competent terminally ill.
The was thrust back in the limelight this year after the highly publicized case of 29-year-old Brittany Maynard, who moved from California to Oregon to end her life after being diagnosed with terminal brain cancer.
“The crux of the matter is whether the State of California should continue to make it a crime for a dying person to end his life, no matter how great his pain or suffering,” Mr. Brown said in his statement…
Foes of the legislation argued that state Democrats gamed the process by introducing the bill during a special session designed to deal with Medi-Cal funding, rather than during the regular legislative session, when the matter would have received a more thorough hearing.
In fact, a nearly identical bill died earlier this year after stalling in the Assembly Health Committee and under enormous public opposition from religious and disabled rights groups, despite strong Democratic support in the state Assembly and Senate.
Democratic state Sen. Lois Wolk, a supporter of Assembly Bill 2x-15, posted a message shortly after the bill-signing saying, “Thank you Governor Brown for providing all Californians the right to a peaceful death. History was made today.”
Supporters of right-to-die legislation predicted that the California bill would have a ripple effect in other state legislatures…
The newly signed law takes effect 90 days after the end of the special legislative session, which could extend until after the start of the year.
Mr. Rosales said the coalition opposing assisted suicide is “reviewing all of its options,” which could include a statewide ballot measure to repeal the law.
http://www.washingtontimes.com/news/2015/oct/5/california-fifth-state-to-allow-physician-assisted/
California Assisted Suicide Law Is Denounced by DREDF
ReplyDeleteAnnounces watchdog website for reporting abuses and other problems
Berkeley, CA – June 17, 2016 – The Disability Rights Education and Defense Fund, a leading national disability rights law and policy center based in Berkeley, California, denounces the enactment of California's End of Life Option Act, which went into effect on June 9.
DREDF is pleased to announce, along with our coalition partners in Californians Against Assisted Suicide, that this week, the national organization Patients Rights Action Fund will launch a new watchdog website (http://patientsrightsaction.org/stories/) where concerned individuals, family members, and friends can report potential abuses, problems, and complications associated with assisted suicide laws.
California's assisted suicide law, which is modeled on Oregon's law, is marked by extraordinarily weak safeguards and oversight, posing great danger to many Californians with disabilities as well as people with chronic and terminal illnesses, lower–income Californians, and to the general public.
DREDF and all our coalition partners, including the many California disability organizations that opposed this law, remain gravely concerned about it. The End of Life Option Act:
• creates a deadly mix with our broken, profit-driven healthcare system,
• is conducive to elder abuse,
• has very weak safeguards, allowing families to shop for other doctors to provide lethal drugs if the first physician says no, and endangering patients who receive terminal diagnoses that are often mistaken,
• puts people with depression at risk, and does not require patients requesting lethal drugs to receive a mental health evaluation,
• provides for no investigation of abuse, and
• requires no neutral witness to be present when the lethal drugs are taken.
See more about the DREDF opposition, particularly B.1. Some Oregon and Washington State Assisted Suicide Abuses and Complications and A.1. Why Assisted Suicide Must Not Be Legalized.
Because the dangers are so significant, many national disability organizations, plus the American Medical Association (AMA), also oppose the legalization of assisted suicide.
DREDF is part of the Californians Against Assisted Suicide coalition, which has worked against assisted suicide laws since 2005. The new California law allowing doctor-prescribed suicide received significant Democrat and Republican opposition in the California Legislature, particularly in the State Assembly. It stalled in the Democrat-controlled Assembly Health Committee because of a significant failure to receive adequate support. The bill was later passed only through the use of an unusual legislative maneuver that placed the bill into a Special Legislative Session on healthcare funding that bypassed many established legislative protections.
Recent attempts to pass similar assisted suicide laws in at least fourteen other states, including Colorado, Nevada, New Jersey, Minnesota, Wisconsin, Maryland, Connecticut, Delaware, Maine, and New Hampshire, have failed.
About Disability Rights Education and Defense Fund (DREDF)
Founded in 1979, by people with disabilities and parents of children with disabilities, the Disability Rights Education and Defense Fund (DREDF) is a national law and policy center, based in Berkeley, CA, dedicated to protecting and advancing the civil rights of people with disabilities.
Maine becomes 8th state to legalize assisted suicide
ReplyDeleteMarina Villeneuve, Associated Press
Wednesday, June 12, 2019
AUGUSTA, Maine (AP) — Maine legalized medically assisted suicide on Wednesday, becoming the eighth state to allow terminally ill people to end their lives with prescribed medication.
Democratic Gov. Janet Mills,…"It is my hope that this law, while respecting the right to personal liberty, will be used sparingly," said Mills.
Oregon was the first state to legalize such assistance, in 1997, and it took over a decade for the next state, Washington, to follow suit. While still controversial, assisted suicide legislation is winning increasing acceptance in the United States, and this year at least 18 states considered such measures.
Maine's measure will allow doctors to prescribe a fatal dose of medication to terminally ill people. It declares that obtaining or administering life-ending medication is not suicide under state law, thereby legalizing the practice often called medically assisted suicide.
The proposal had failed once in a statewide referendum and at least seven previous times in the Legislature. The current measure passed by just one vote in the House and a slim margin in the Senate.
…Maine joins seven other states and Washington, D.C., that have similar laws, according to the Death With Dignity National Center and the Death With Dignity Political Fund. The states are: California, Colorado, Hawaii, Oregon, Vermont, Washington, and New Jersey, whose governor signed the legislation earlier this year.
Montana doesn't have a specific law on the books, but the state Supreme Court ruled in 2009 that doctors could use a patient's request for life-ending medication as a defense against criminal charges.
Maine's population has the oldest median age, and, as in other states, the proposal has exposed divisions that defied party lines.
Supporters, including Democrats and a small group of Republicans who say the legislation is in line with the rugged state's tradition of individualism, say the terminally ill should have the right to choose how their lives end.
The governor said she believes the law should protect such rights, while also spelling out protections for those "unable to articulate their informed choices."
She issued an executive order Wednesday calling for the state to swiftly put the law's protections into place and analyze the law's impact.
Opponents, meanwhile, have said any assisted suicide legislation puts the terminally ill and individuals with disabilities in danger of abuse, coercion and mistakes. Such groups argue that doctors can be wrong and that government is devaluing life by "turning suicide into a medical option."
"Do you think the insurance companies will do the right thing or the cheap thing?" said Teresa McCann-Tumidajski, executive director of the Maine Right to Life Committee. "The so-called safeguards are there for the physicians, insurance carriers and lawyers. Not the patient."
As more states slowly pass similar laws, critics nationwide argue that government should simply never wade into such issues.
"Assisted suicide is a dangerous public policy that puts the most vulnerable people in society at risk for abuse, coercion and mistakes," said Matt Valliere, Executive Director of Patients Rights Action Fund, an advocacy group. "It also provides profit-driven insurance companies perverse incentives to offer a quick death, rather than costly continuing quality care."…
https://www.sfgate.com/news/medical/article/Maine-becomes-8th-state-to-legalize-assisted-13973819.php