Hawaii’s ill-chosen legalization of assisted suicide

by Matt Valliere, Patients Rights Action Fund, April 5, 2018

Hawaii just made the mistake of becoming the eighth jurisdiction in the United States to allow assisted suicide.

We can learn a lot about the folly of this path if we look to other places here and abroad where assisted suicide already is legal. A quick survey turns up countless instances of the failures of these laws to safeguard the most vulnerable.

From Europe, there seems to be a constant stream of documented cases related to the practice of assisted suicide and euthanasia, which would give anyone pause.

In the Netherlands, the number of people with experience of mental illness being euthanized is rising by the day. There are known cases of such people being abused or coerced into death by people they should be able to trust. A whistle-blowing doctor in Belgium went to the Associated Press with the details of a dementia patient’s death by euthanasia – the patient had never formally asked to die.

A column in the Washington Post recounts another sad story of one case gone very wrong. In 2016, an otherwise healthy elderly woman with dementia, having made an ambiguous advanced directive to end her life “when the time was right,” was euthanized against her will at the request of her husband by a nursing home doctor whose assessment was that the patient’s suffering was “unbearable and incurable.” She prepared the lethal injection.  The physician tried silencing the patient’s protests by slipping a sedative into her coffee. When the sedative failed, this doctor had the family of the patient restrain her so that she could administer the lethal injection.

The columnist rightly asks, “How many botched cases would it take to end euthanasia of the vulnerable?”

In January, a physically healthy 29-year-old suffering from depression was euthanized. The Daily Mail reported that in Holland in 2013, “a total of 42 people with ‘severe psychiatric problems’ were killed by lethal injection compared to 14 in 2012 and 13 in 2011.”

Are these abuses confined to Europe or are they the inevitable fruits of what is everywhere bad public policy?  There is evidence for the latter.

In Oregon, Michael Freeland, who had a 40-year history of acute depression and suicidal ideation, not only received the lethal prescription but also was allowed to keep the drugs even when all other means of his taking his own life had been removed from his home.

Another Oregonian, Kate Cheney, who had been diagnosed with dementia, was first referred for the non-required psychiatric evaluation and denied the lethal dose. Her family shopped for a doctor until they found one who would sign off; the doctor’s report stated that her “choices may be influenced by her family’s wishes and her daughter, Erika, may be somewhat coercive.”

In fact, just this legislative session, there was a bill before the Delaware General Assembly that would sanction the assisted suicides of people with intellectual and developmental disabilities. This flies in the face of the central concerns of the disability rights community: Nothing in the proposed Delaware bill ensures that people actually have access to the pain relief, palliative care and home-based and community-based personal care services they need.

Moreover, just like all of the proposed bills and assisted suicide laws, the Delaware bill utterly fails to prevent coercion. Coercion to request lethal drugs, like any form of abuse, occurs behind closed doors.

Let’s all note how legalizing assisted suicide and euthanasia has led to the tragic death of vulnerable people. Whether in Europe, Canada, or even here in the U.S., this public policy push is unsuccessful at instituting any structures that would protect those who are most vulnerable from abuse and coercion.

We can avoid making the same mistake here by rejecting such laws and proposals altogether.

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Matt Valliere is executive director of Patients Rights Action Fund, a national organization that opposes assisted suicide.

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18,000 Sign Petition against aid in dying -- presented to Gov. Ige

KHON: The governor is set to sign a bill legalizing medical aid in dying. Not everyone is happy about it.

Over 18,000 people signed a petition to try to deter him from signing the bill, which he said he would do Thursday.

"Our concern has been with the wider community," said Eva Andrade of the Hawaii Family Forum.  "Whether it's elderly kupuna or youth. Suicide is not what the people of Hawaii really want."

Gov. Ige thanked everyone for coming to share their feelings on the issue.

He's still slated to sign the bill Thursday morning.

read … Petition against aid in dying presented to Gov. Ige

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GOVERNOR SIGNS OUR CARE, OUR CHOICE ACT, ALLOWING END OF LIFE CHOICES FOR TERMINALLY ILL

News Release from Office of the Governor, Apr 5, 2018

HONOLULU – Gov. David Ige today signed HB 2739 — the Our Choice, Our Care Act. The bill gives mentally capable, terminally ill people with six months or less to live – the option to take prescription medication that enables them to die peacefully in their sleep.

HB 2739 is modeled after Oregon’s Death with Dignity Act, which has been in practice for 20 years. The Hawaiʻi bill establishes a regulatory process under which the terminally ill patient may choose to obtain a prescription for medication to end the patient’s life.

The bill includes strict eligibility criteria and safeguards that ensure a safe, compassionate and patient-centered end-of-life practice. In addition, there are additional regulatory requirements to address opponents’ concerns about misuse.

Among the safeguards: the patient is required to take the medication on his/her own; two doctors must confirm the terminal illness and six-month prognosis; patients are not eligible for medical aid in dying based on age or disability; the attending physician must inform the requesting patient about all end-of-life care options, including pain and symptom management, hospice and palliative care; the patient’s mental capacity must be confirmed by a mental health professional; two separate requests for medication must be made, with a 20-day waiting period between the first and second request; a written request overseen by two witnesses is also required, with one witnesses prohibited from being a beneficiary of the patient’s estate.

The measure also makes it a criminal offense to tamper with a patient’s request for a prescription or to coerce a patient to request a prescription.

“I believe that we have clear safeguards in place. It is time for terminally ill, mentally competent Hawai‘i residents who are suffering to make their own end-of-life choices with dignity, grace and peace. I am honored to sign HB 2739 into law, in hopes of giving these patients and their families choices and peace of mind,” said Gov. Ige.

With Gov. Ige’s signature, the Department of Health will form an Advisory Committee to help facilitate the implementation of the new law.

Act 2 becomes law on Jan. 1, 2019.

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Senate News Release:  “OUR CARE, OUR CHOICE ACT” SIGNED INTO LAW​.