To the Montana Board of Medical Examiners:
Not Dead Yet is a national disability rights group with members in Montana. This letter is to urge you to rescind the position statement that the Board of Medical Examiners formulated entitled "Physician Aid in Dying" (Position 20).
First, it is incorrect to state that the Baxter decision will "...shield a physician from liability for acting in accordance with a patient's end-of-life wishes if an adult, mentally competent terminally ill patient consents to the physician's aid-in-dying." The Montana Supreme Court merely stated that if the physician can show that he/she acted in accordance with a person's wishes and consent, then such consent can be raised as a defense to a charge of homicide against the physician. Once raised, a judge or jury may or may not find the defense valid after considering all the facts and circumstances of the case.
For example, a judge or jury could reasonably expect a doctor who assists in a patient’s suicide to take practical steps to ensure that the patient’s request to die is voluntary and not coerced by others who might benefit from the death financially or by being relieved of care giving responsibilities. The potential for coercion is fraught with risks for physicians.
It is estimated that there are 21,265 cases of elder abuse annually in Montana, reported and unreported. http://www.eadaily.com/15/elder-abuse-statistics/ Statistically, 90% of elder abusers are a family member or trusted other. Similarly, people with disabilities are up to four times more likely to be abused than their same-age nondisabled peers.
A relative who is willing to abuse an elder or disabled person might be equally willing to bring up assisted suicide as an option for an ill relative. An abuser might take their relative to visit the doctor to request assisted suicide. An abuser might pick up the lethal prescription at the pharmacy. Even if the abuser went so far as to administer the drugs without the person’s actual consent at the time of death, who would know?
It is simply naïve to suggest that assisted suicide can be added to the array of medical treatment options, on a par with palliative care, without taking into account the harsh realities of elder abuse and the related potential for coercion. The Montana Supreme Court overlooked the public policy implications of elder abuse in its analysis, but in individual cases this issue is likely to become a factor that physicians could only ignore at their peril.
In stating that physicians have a shield against liability for assisted suicide when either a judge or a jury may view a case very differently, the Board is both misleading physicians and endangering patients.
We urge the Board to reconsider and rescind its position on assisted suicide.
Diane Coleman, JD, MBA
Not Dead Yet