Monday, December 31, 2012

"Assisted suicide in Washington and Oregon is a recipe for elder abuse and cloaked in secrecy"

By, Margaret Dore, Esq.
Supporting documentation follows letter, below.

I disagree with Susan Hancock’s description of how the Washington and Oregon assisted suicide laws work.   (Dec. 20, guest column)  I disagree that assisted suicide cannot be forced upon an unwilling person.

The Oregon and Washington assisted suicide acts have a formal application process. The acts allow an heir, who will benefit from the patient’s death, to actively participate in this process.

Once the lethal dose is issued by the pharmacy, there is no oversight. For example, there is no witness required at the death. Without disinterested witnesses, the opportunity is created for an heir, or for another person who will benefit from the patient’s death, to administer the lethal dose to the patient without his consent. One method would be by injection when the patient is sleeping. The drugs used in Oregon and Washington are water soluble and therefore injectable. If the patient woke up and struggled, who would know?

The Washington and Oregon acts require the state health departments to collect statistical information for the purpose of annual reports. According to these reports, users of assisted-suicide are overwhelmingly white and generally well-educated. Many have private insurance. Most are age 65 and older. Typically persons with these attributes are seniors with money, which would be the middle class and above, a group disproportionately at risk of financial abuse and exploitation.

The forms used to collect the statistical information do not ask about abuse. Moreover, not even law enforcement is allowed to access information about a particular case. Alicia Parkman a mortality research analyst at the Center for Health Statistics, Oregon Health Authority, wrote me: “We have been contacted by law enforcement and legal representatives in the past, but have not provided identifying information of any type.“

Assisted suicide in Washington and Oregon is a recipe for elder abuse and cloaked in secrecy. Don’t make our mistake.

Supporting documentation below.

Margaret Dore, Esq.
Seattle, Wash.

Friday, December 21, 2012

MAAS files New Lawsuit Against Board

On Monday, December 17, 2012, MAAS filed a new lawsuit against the Montana Board of Medical Examiners.

The lawsuit is a response to the Board's order entered on November 16, 2012 refusing to vacate Position Statement No. 20.   The lawsuit's claims include that the statement is invalid because it was adopted "without statutory authorization, . . . outside the Board's subject matter jurisdiction and/or because it is an infringement on the role of the Legislature." 

The petition for the lawsuit can be viewed by clicking here.  The attachments to that petition can be viewed by clicking here and here.

Wednesday, December 19, 2012

Gazette opinion: Time to update Montana elder abuse law

The Montana Elder and Persons with Developmental Disabilities Act was intended to protect especially vulnerable citizens. But the statute isn’t used as often as it should be in criminal cases.

"Compassion & Choices is a successor organization to the Hemlock Society"


I am a lawyer in Washington State where assisted-suicide is legal. 

Your readers should know that Compassion & Choices is a successor organization to the Hemlock Society, originally formed by Derek Humphry. In 2011, Humphry was the keynote speaker at Compassion & Choices’ annual meeting here in Washington State. In 2011, he was also in the news as a promoter of mail-order suicide kits from a company now shut down by the FBI. This was after a 29 year old man used one of the kits to commit suicide.

In 2007, Compassion & Choices was a plaintiff in Montana’s assisted-suicide case. Compassion & Choices requested legalization of assisted-suicide for “terminally ill adult patients.” The definition of this phrase was broad enough to include an otherwise healthy 18 year old who is insulin dependent or a young adult with stable HIV/AIDS. Such persons can live for decades with appropriate medical treatment.

Once someone is labeled “terminal,” an easy justification can be made that their treatment should be denied in favor of someone more deserving. Those who believe that legalizing assisted-suicide will promote free choice may discover that it does anything but.

Supporting authority not included in the published letter, below:

1.  This is a link to Compassion & Choices' newsletter announcing that Humphry would be the keynote speaker at its annual meeting in Washington State on October 22, 2012:

2.  This is an excerpt from Oregon's Register-Guard newspaper:
"A spotlight was cast on the mail-order suicide kit business after a 29-year-old Eugene man committed suicide in December using a helium hood kit.  The Register-Guard traced the $60 kit to [the company, which] has no website and does no advertising; clients find [the] address through the writings of Humphry."

3.  Here is a link to my opinion letter with Richard Wonderly MD  analyzing Compassion & Choices' definition of "terminally ill adult patient."

Monday, December 17, 2012

Time to strengthen assisted suicide law

December 13, 2012, Independent Record

I have several concerns about the practice of assisted suicide, which has been rejected by most states and is currently legal in only two states (Washington and Oregon). 1) The potential for elder abuse is very real. Patients in Oregon with a “terminally ill” diagnosis have been refused treatment and steered toward assisted suicide. Patients can be pressured by a relative, who can even administer the dose. 2) A “terminally ill” diagnosis can be wrong. Some patients recover with treatment and may live a long time. 3) Montana already has a high suicide rate and state policy is directed at lowering that rate. The suicide rate in Oregon has increased since their law was passed.

Please tell your legislators to clarify and strengthen our law against assisted suicide.

Ruth Plesner

Monday, December 10, 2012

Liberal Massachusetts Defeated Assisted Suicide

Support withered for assisted-suicide question

By Chris Camire

In late September, polls showed a ballot initiative that would make physician-assisted suicide legal for terminally ill patients had support from 68 percent of Massachusetts voters.

Over the next month, that support steadily eroded, and on Election Day the measure failed by a razor-thin 51-49 percent margin.

How did a proposal that seemed sure to pass just five weeks before the election come up short?

Joseph Baerlein, president of Rasky Baerlein Strategic Communications, who handled public relations for the Committee Against Physician Assisted Suicide, said the measure's opponents had to convince voters who supported the idea of assisted suicide that the bill before them was flawed.

"We focused our campaign strategy on looking at those weaknesses," said Baerlein.

Sunday, December 9, 2012

Recipe for Elder Abuse

December 04, 2012 7:45 am

Brad Williams (letter, Nov. 28) is correct, assisted suicide is not legal in Montana (Associated Press, Nov. 16). The Montana Supreme Court decision, Baxter v. State, merely gives doctors a potential defense to prosecution for homicide.

In the 2011 legislative session, Sen. Anders Blewett and I introduced competing bills in response to Baxter, neither of which passed. His bill sought to legalize assisted suicide; mine sought to eliminate the defense.

During the hearing on Blewett's bill, he conceded that assisted suicide was not legal under Baxter. He said: "under the current law ... there's nothing to protect the doctor from prosecution."

Similar statements were made by others. For example, Dr. Stephen Speckart testified: "most physicians feel significant disease with the limited safeguards and possible risk of criminal prosecution after the Baxter decision."

To view a transcript, see:

Legal assisted suicide is, regardless, a recipe for elder abuse in which heirs are empowered to pressure and abuse older people to cut short their lives.

Assisted suicide is not legal in Montana. The potential defense to prosecution is, however, a "toe in the door," which could lead to legalization in the future. Tell your legislators that you support reversing the defense to keep assisted suicide out of Montana.

Sen. Greg Hinkle, Thompson Falls

Saturday, December 8, 2012

“Dr. Stevens, you saved my life!”

Doctor helped patient with cancer choose life over assisted suicide
November 27, 2012 6:15
I am a doctor in Oregon, one of two states where assisted suicide is legal. This letter responds to your article about the controversy over this practice in Montana. (AP article re: Medical Examiners Board, Nov. 16). I write to clarify that legalizing assisted suicide would allow non-dying persons to be steered to suicide.

Oregon’s assisted-suicide law applies to patients predicted to have less than six months to live. In 2000, I had a cancer patient named Jeanette Hall. Another doctor had given her a terminal diagnosis of six months to a year to live. This was based on her not being treated for cancer.

At our first meeting, Jeanette told me that she did not want to be treated, and that she wanted to opt for what our law allowed – to kill herself with a lethal dose of barbiturates.

I did not and do not believe in assisted suicide. I informed her that her cancer was treatable and that her prospects were good. But she wanted “the pills.” She had made up her mind, but she continued to see me.

On the third or fourth visit, I asked her about her family and learned that she had a son. I asked her how he would feel if she went through with her plan. Shortly after that, she agreed to be treated, and her cancer was cured.

Five years later she saw me in a restaurant and said, “Dr. Stevens, you saved my life!”

For her, the mere presence of legal assisted suicide had steered her to suicide.

I understand that assisted suicide will be an issue in your upcoming legislative session. I urge you to encourage your legislators to clarify your law to keep assisted suicide out of Montana.

Kenneth Stevens,
Sherwood, Oregon

Friday, December 7, 2012

Assisted suicide leaves no room for doctors' errors or erroneous prognostications

Jeanette Hall's letter ( "Assisted suicide prompts some terminally ill patients to give up on life prematurely"), about how she would have died from assisted suicide if her doctor hadn't talked her out of it, hit a nerve. Her stated motivation was that she had been diagnosed with cancer and given six months to a year to live. That was 12 years ago.
Doctors do not know the future. They are often wrong. Indeed, this has happened twice in my family.
The first time was with my father. At age 66, he collapsed as he was leaving a doctor's appointment in the hospital at Glasgow. A week or so later his doctor recommended that we "pull the plug." I instead moved my father to another hospital. He fully recovered and lived nine more years. The doctor was wrong.
The second time was with me. When I was 62 years old, I was paralyzed due to a disease and put on a respirator. After four months, my doctors offered to take me off the respirator. They said that there was no chance of recovery. They said that if I lived, I would always be respirator dependent and a quadriplegic. Instead, I eventually lost my paralysis and even went back to work. My doctors, excellent doctors with years of experience, were wrong. It is now 14 years later.
Proponents of assisted suicide sometimes claim that assisted suicide is no different than pulling the plug. This is untrue. When you pull the plug, the patient doesn't necessarily die. If the patient does die, he or she dies due to his or her illness, not a lethal overdose.
I hope that we can keep assisted suicide out of Montana.
Jerry and Dora Lou Jacobson,

Assisted suicide: Idea is repugnant

I was glad to see the letter in your publication by Brad Williams  (Nov. 28). Assisted suicide is an important topic for Montana, where proponents are wrongly claiming that the practice is legal and the majority of the population are senior citizens (over 50 years of age).
I retired from the Motion Picture Pension and Health Plans in Studio City, Calif., as the chief financial officer. One reason that I retired to Montana was that I had the perception that it was senior-citizen friendly, i.e., unlike Oregon and Washington, which have adopted laws allowing doctors and family members to assist people in killing themselves. That was repugnant to me.
The proposed legalization is for terminally ill persons. "Terminally ill" is a term that I am all too familiar with. In my previous employment, one would need to be terminally ill to qualify for a pension if they had not reached a specified age. Many, many times doctors deemed someone terminally ill and they wound up outliving their caregivers; not really, but they lived many years. If these persons had instead been applying for a lethal dose and used it, they would have been dead before their time.
Ted Friesen, Bigfork 

Tuesday, December 4, 2012

National disability rights group concerned Montana could legalize assisted suicide

December 02, 2012

Not Dead Yet is a national disability rights group with members in Montana, some of whom are seniors. On behalf of our members, I write to say that we are extremely concerned that assisted suicide, sometimes euphemistically called "aid in dying," could be legalized in Montana.

It is estimated that there are 21,265 cases of elder abuse annually in Montana, reported and unreported (

Statistically, 90 percent 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.

In Oregon and Washington, legal assisted suicide has opened new paths of abuse against persons who "qualify" to use these laws. A more obvious problem is a complete lack of oversight when the lethal drug is administered. If an abuser were to administer the drug without the person's consent, who would know?

It is simply naive to suggest that assisted suicide can be added to the array of medical treatment options, without taking into account the harsh realities of elder abuse and the related potential for coercion.

For more information about problems with legalization of assisted suicide, please see and Coleman,
Not Dead Yet,
Rochester, New York

Also published in the Ravalli Republic at

Efforts to legalize assisted suicide may be one cause for high suicide rates

Dec. 4, 2012

Your article, “Cowboy culture’ factor in Montana’s high suicide rate” (Nov. 25-27), discusses possible reasons for that high rate. A reason I did not see discussed is the active and ongoing push to legalize physician-assisted suicide in Montana.

I am a doctor in Oregon, where physician-assisted suicide is legal. In Oregon, physician-assisted suicide means that a physician facilitates a patient’s suicide by providing a lethal prescription. In Oregon, our law also allows family members to participate in the suicide, for example, by helping with the lethal dose request process and by picking up the lethal dose at the pharmacy. Physician-assisted suicide is sometimes called “aid in dying.“

Oregon’s overall suicide rate, which excludes suicide under our assisted suicide act, is 35 percent above the national average. This rate has been “increasing significantly” since 2000. Just three years prior, in 1997, Oregon legalized physician-assisted suicide. This statistical correlation is consistent with a suicide contagion in which the normalization of one type of suicide encouraged other suicides.

In 2011, a bill similar to Oregon’s law was proposed and defeated in the Montana Legislature. I understand that another bill will be proposed this coming legislative session. With this active promotion of physician-assisted suicide, there is the possibility of a normalization process similar to what appears to have taken place in Oregon. If so, this is another factor in Montana’s high rate of suicide.

I hope that you will encourage your legislators to keep assisted suicide out of Montana. Don’t make our mistake.

William L. Toffler,
Professor of family medicine,
Oregon Health & Science University,
National director and board member,
Physicians for Compassionate Care Education Foundation,
Portland, Ore.

Montana has not legalized assisted suicide

December 02, 2012 12:00 am
A recent AP article which appeared Nov. 16 in most major newspapers in our state incorrectly stated that Montana is the third state to allow assisted suicide, along with Washington and Oregon. Attorneys Greg Jackson and Matt Bowman did an extensive analysis of the case and concluded it "did not legalize assisted suicide and it continues to carry both criminal and civil liability for any doctor, institution, or lay person involved." The Montana Lawyer, the official publication of the Montana State Bar concluded the issue is open to argument, confirming that the Legislature needs to clarify the issue this coming session.

Your readership needs to know that there are problems inherent in passing a law that would allow a physician to kill their patient. People need to understand that we are talking about a physician writing a prescription for the express purpose of one taking their own life. The very oath that physicians take in stepping into this profession states that they "shall do no harm." Their purpose is to cure, to heal, to provide comfort and care at the end of life, but not to aid in facilitating the end of that life through active means. Physicians are fallible human beings and often are wrong in their prognosis concerning how long a patient will survive their illness. Often, it is depression that prompts one to think that life is not worth living or perhaps the feeling that because of their illness they are a burden to their family. The whole matter is a recipe for elder abuse.

I appreciate the opportunity to set the record straight and hope that The Gazette will continue to report on this vital topic.

David W Hafer, DDS, MS

Sunday, December 2, 2012

Assisted suicide may not bring peace to either terminally ill or their families

November 30, 2012 6:15 am  
This letter is a follow up to your recent (Nov. 16) article on assisted suicide and the Montana Medical Board.
A study was recently released in Switzerland, where assisted suicide is legal (“Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2012) 542-546, available at The study found that 1 out of 5 family members or friends present at an assisted suicide were traumatized. These persons “experienced full or sub-threshold (Post Traumatic Stress Disorder) related to the loss of a close person through assisted suicide.”

This study is consistent with what I have observed with my law practice clients whose parents participated in the Washington/Oregon death with dignity acts (assisted suicide). With one client, one branch of the family wanted the parent to use the lethal dose, while the other did not. The parent spent much of his final days traumatized and struggling over the decision of whether or not to kill himself. This was instead of making the best of the time that he had left. My client was also traumatized. In that case, the parent did not use assisted suicide and died a natural death.

With another case, it’s unclear that the parent’s assisted-suicide death was voluntary. My client lives with that memory.

Legal assisted suicide is sold as a peaceful and loving death. It may be anything but.

Margaret Dore, Seattle WA

Saturday, December 1, 2012

Senator Jim Shockley: Assisted suicide not legal

Brad Williams is correct that assisted-suicide is not legal in Montana. (Legalization could lead to abuse). The Montana Supreme Court's assisted-suicide case, Baxter v. State, limited its holding to giving doctors who assist a suicide a potential defense if those doctors are charged with homicide for the death of their patients. There are several steps that the doctor must demonstrate to perfect the defense.

Baxter did not invalidate our homicide statutes. Baxter did not overrule our case law allowing family members to sue an attending physician for negligence, malpractice, or wrongful death.

As an attorney in private practice, I did my share of wills, probates and estates. I observed that some heirs did not care as much for the elderly as they did for the elderly person's assets.

With the legalization of assisted-suicide, heirs would be encouraged to suggest, cajole or coerce older people to kill themselves, i.e., before such persons are able to change their wills, give their money to charity or simply spend it. Legal assisted suicide is a recipe for elder abuse.

Jim Shockley
Senate District 45