End of Life Option Act Lacks Accountability

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Though California’s assisted suicide bill has gone into effect, pro-life attorneys are preparing for another court date to halt the measure.

The End of Life Option Act legalizes doctor-assisted suicide, although questions remain about its legality and ethics on the part of lawmakers in how it was passed.

Read more about Life Legal’s challenge to the End of Life Option Act from OneNewsNow.

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Stephanie’s Journey

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“I can’t sit and watch that happen without having something to say about it, I can see solutions. It’s not easy, but life isn’t meant to be easy.”

Stephanie Packer, a 32-year old mother of four, diagnosed in 2012 with a terminal diagnosis, shares her reasons for opposing assisted suicide. Featuring Dr. Aaron Kheriaty.

When Stephanie Packer, a 32-year-old wife and mother of four, was told in 2012 that she had three years to live, the news didn’t sink in right away. It took a month for her to acknowledge that her days were numbered, and during that time many of her friends were unable to deal with the prognosis and deserted her.

Packer said she often feels alone, unwilling to burden her husband and family with her fears. “When you’re sick and dying, everyone around you is going through it, too,” she noted. “It’s a ripple effect that touches everyone around you, but you can’t let it consume you.”

She was diagnosed with scleroderma, a chronic connective tissue disease. Scleroderma affects each person differently; in her case, the disease has caused scar tissue to form in her lungs making it difficult for her to breathe. For the past month, she has taken all nutrients (TPN) through a PICC line because scar tissue from the disease has paralyzed her gastrointestinal tract, prohibiting anything by mouth except tiny sips of water.

Yet far from letting the terminal diagnosis define or defeat her, Packer has found new purpose in leading and participating in support groups for fellow scleroderma patients who are dealing with symptoms and effects of the difficult-to-diagnose disease. A former church youth minister, Packer also is actively working to combat California’s proposed End of Life Option Act, SB 128, introduced to the state legislature on Jan. 21. She speaks on media panels and at ethics conferences and tries to advocate for other dying patients.

Based on Oregon’s successfully enforced assisted-suicide law, the California legislation would permit physician-assisted suicide for terminal patients with 6 months or less to live. “Terminally ill people need to know they’re valuable and worthwhile,” Packer said.

“They think they will add value to their lives by taking their own lives, that ending their lives sooner is more dignified. But if they really value their lives and the lives of the people around them, they could entrust their doctors to care for them properly and treat their pain.”

Read more at stephaniesjourney.org

How One Woman Chose Assisted Suicide…Then Survived

In 1994, Jeannette Hall, a resident of King City, Ore., voted in favor of Ballot Measure 16, which for the first time in the United States, would allow terminally ill patients to end their own lives through physician-assisted suicide.

“I thought, hey, I wouldn’t want anyone to suffer,” Hall told The Daily Signal. “So I checked it. Then it became legal.”

That day at the ballot box, Hall never could have predicted that six years later, she would be diagnosed with inoperable colon cancer.

“She was terminal because she was refusing treatment,” Dr. Kenneth Stevens, one of Hall’s two cancer doctors, told The Daily Signal. “It’s like a person could be considered terminal if they’re not taking [their] insulin or [other] medications.”

Read Jeannette’s story here.

(Video: The Daily Signal and Patchbay Media)

 

 

Life Legal Files Lawsuit to Stop Assisted Suicide Law

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The Life Legal Defense Foundation filed a lawsuit today challenging California’s physician-assisted suicide law, the “End of Life Option Act.” The lawsuit was filed in the California Superior Court in Riverside County.

The civil rights lawsuit alleges Equal Protection violations of individuals labeled terminally ill and was filed by five physicians in southern California and by the American Academy of Medical Ethics (AAME), which represents more than 600 California doctors and over 2 million patients. AAME has 15,000 physician members nationwide. The individual physicians include two oncologists, a neurologist, as well as palliative care and hospice physicians, all seeking to protect the rights of their patients.

The Act decriminalizes physician-assisted suicide and instantly removes criminal law, elder abuse, and mental-health legal protections from any individual deemed terminally ill, despite the inherent uncertainty and frequently inaccurate nature of such a prognosis.  In contrast, all non-terminally ill Californians enjoy Penal Code § 401 protection, which makes it a felony to aid, advise, or encourage another to commit suicide. They also enjoy other legal protections against suicide, including being placed on 72-hour (to 30-day) mental-health holds to protect them from self harm.

California’s assisted suicide law does not require labeled individuals seeking a lethal prescription to undergo a psychiatric evaluation, so patients with untreated depression and suicidal ideation can be prescribed lethal drugs. A large body of psychiatric research has demonstrated that 80-90% of all suicides are associated with depression or other treatable mental disorders. The California Department of Public Health Care Services assumes that only two percent of Medi-Cal patients likely to request the lethal drugs will be referred for psychiatric counseling and set the state budget accordingly.

“We are asking the court to uphold civil and criminal laws that should apply equally to all Californians, including laws that protect people from self-harm and elder abuse laws. The End of Life Option Act is irreparably flawed as it removes crucial protections from individuals who are most susceptible to depression, abuse, and coercion,” said Alexandra Snyder, Executive Director of the Life Legal Defense Foundation. “The Act provides virtually no safeguards for labeled individuals who may suffer from untreated mental illness or mood disorders and grants full immunity for doctors to participate in the killing of their most vulnerable patients.”

The End of Life Option Act also incentivizes the creation of Kevorkian-like suicide pipelines. Doctors who prescribe the drugs do not have to have a prior relationship with patients and are thus free to prey on vulnerable patients—including those who are mentally ill—as they would be immune from nearly all civil and criminal liability under the Act.

Under the Act, “terminal illness” includes any condition that, if left untreated, would cause death within six months. This encompasses many types of illnesses—even those that can be successfully treated—if the patient decides to forego treatment. Moreover, predicting life expectancy is crude and fraught with subjective judgment.  Physicians’ predictions for life-expectancy are frequently wrong.

To read the complaint, click here: End of Life Option Act Conformed Complaint

 

How Has Assisted Suicide Worked in Oregon?

  1. In Oregon, fewer than 6% of individuals who have died by assisted suicide were ever referred for psychiatric consultation to rule out the most common causes of suicidal thinking. This lack of basic psychological evaluation and treatment constitutes medical negligence.
  2. The first woman to die by assisted suicide in Oregon was initially refused a prescription for aid-in-dying drugs by her physician and a second consulting doctor because she suffered from untreated clinical depression. Compassion in Choices, an organization that actively encourages assisted suicide, referred her to a doctor who prescribed the lethal drug.
  3. In Oregon, a small number of physicians, fewer than 200 out of over 10,000 physicians statewide, write a disproportionately large number of the prescriptions, creating a marginalized cottage industry.
  4. The number of deaths from assisted suicide in Oregon was 37% percent higher in October than the 2014 average. After Brittany Maynard’s death on November 1, 2014, deaths from assisted suicide spiked in November, rising 71.4% above the 2014 average.
  5. The overall suicide rate in Oregon has risen dramatically following the legalization of assisted suicide there. As of 2010, suicide rates were 35% higher in Oregon than the national average.
  6. Proponents of assisted suicide claim that “physician aid in dying” is not really suicide because taking a deadly drug is allegedly peaceful. Data from Oregon reveals numerous cases where patients have experienced severe physical and emotional symptoms from the drugs, including feelings of terror, confusion, and vomiting. In some cases, patients fall into a coma for several weeks before they die.

5 Problems with the End of Life Option Act

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  1. California’s End of Life Option Act does not require a psychological evaluation prior to receiving a prescription for aid-in-dying drugs. This lack of basic psychological evaluation and treatment constitutes medical negligence.
  2. The Act puts vulnerable individuals at risk. We can’t ignore the economic factors at work in medicine. For example, patients in Oregon have been refused life-extending chemotherapy by their insurance companies, who instead opt to pay for aid-in-dying drugs. There are forces at work that will pressure individuals and narrow their options, rather than expand their range of options.
  3. The Act communicates the message that under especially difficult circumstances, some lives are not worth living. This message will be heard by not only those with a terminal illness but also any person struggling with the temptation to end his or her life.
  4. The Act abandons vulnerable patients to lethal drugs. To abandon suicidal individuals in the midst of a crisis under the guise of respecting their autonomy is socially irresponsible. It undermines sound medical ethics and erodes social solidarity.
  5. The Act will undermine the ability of patients to get adequate medical care. Patients with a terminal illness are exquisitely vulnerable to any suggestion from their physicians, their health care team, and their insurers that they are becoming too expensive to care for, or too burdensome.

Do Assisted Suicide Laws Promote Suicide?

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  1. Assisted suicide laws communicate the message that under especially difficult circumstances, some lives are not worth living. This message will be heard by not only those with a terminal illness but also any person struggling with the temptation to end his or her life.
  2. Suicide rates constitute a public health crisis. According to the Centers for Disease Control, suicide is currently the third leading cause of death among adolescents and young adults and the tenth leading cause of death overall for individuals over the age of ten. Legalizing assisted suicide will worsen this crisis. It sends a message to teens and young adults that suicide is an appropriate response to difficult life circumstances.
  3. In October 2015, a study was published in the Southern Medical Journal showing that legalizing physician assisted suicide was associated with a 6.3% increase in total suicides, including assisted suicides.[1] The increase in total suicides among individuals 65 years and older was 14.5%. This is contrary to the assertions of Judge Richard Posner of the U.S. Court of Appeals for the Seventh Circuit, who suggested that legalizing assisted suicide “might actually reduce the number of suicides and postpone the suicides that occur.”[2]
  4. The “Werther Effect,” which refers to the increase in clusters of suicides after publicized cases of suicide, is well validated. The U.S. Centers for Disease Control and Prevention, the World Health Organization and the U.S. Surgeon General have published strict journalistic guidelines for reporting on suicides to minimize this effect. Unfortunately, these guidelines were ignored in the case of Brittany Maynard, whose suicide was portrayed in the media as inspiring and even heroic.
  5. The number of deaths from assisted suicide in Oregon was 37% percent higher in October than the 2014 average. After Maynard’s death on November 1, 2014, deaths from assisted suicide spiked in November, rising 71.4% above the 2014 average.
  6. The overall suicide rate in Oregon has risen dramatically following the legalization of assisted suicide there. As of 2010, suicide rates were 35% higher in Oregon than the national average.
  7. Studies show that when an individual receives intervention during a crisis—for example, during the months of difficult adjustment after a new diagnosis of a serious or terminal disease—his or her risk of suicide is substantially decreased.
  8. Belgium and Switzerland, where assisted suicide is practiced, have the highest and second-highest suicide rates in Western Europe.
  9. In contrast to the “Werther Effect,” the publication of cases that convey a message of hope and perseverance in the face of adversity is associated with decreased suicide rates. This is known as the “Papageno Effect.”
  10. In the midst of suffering and decline we can still find courage, hope and even beauty. True compassion and mercy involve walking this difficult journey with our loved ones — a journey in which there simply are no shortcuts.

[1] Jones, DA and Paton, D. How Does Legalization of Physician-Assisted Suicide Affect Raters of Suicide? South Med J. 2015; 108(10):599-604.

[2] Posner, RA. Aging and Old Age. Chicago: University of Chicago Press, 1997.