Testimony of Kenneth Stevens MD Opposing Assisted Suicide

Testimony of Kenneth Stevens MD Opposing Assisted Suicide

To view testimony as a pdf, click here.

1.  I strongly urge you to Vote No on HB 264, which seeks to legalize physician assisted suicide in Utah

Photo of me and my patient Jeanette Hall, 15 years after
I talked her out of assisted suicide in Oregon

I am a cancer doctor in Oregon, where physician-assisted suicide is legal. I was also raised in Logan, graduated from USU, and received my MD from the University of Utah Medical School 50 years ago. I am Professor Emeritus and former chair of the Department of Radiation Oncology at Oregon Health and Science University. I regularly visit Utah. I continue to practice in my cancer medical specialty.

Problems with H.B. 391

By Margaret Dore, Esq., MBA

H.B. 391 seeks to legalize physician-assisted suicide in Utah.  I am a lawyer in Washington State where we have a similar law.  Our law is based on a law in Oregon.  

Problems include:

1.  HB 391, if enacted, will encourage people with years to live to throw away their lives.

HB 391 seeks to legalize assisted suicide for persons with a "terminal disease," which is defined as having less than six months to live.  In Oregon's law, which uses the same definition, young adults with chronic conditions, such as diabetes, are "eligible" for assisted suicide.  Such persons can have years, even decades, to live.  See https://choiceisanillusion.files.wordpress.com/2014/12/a-2270-3r-memo-12-02-14.pdf   "Eligible" patients can also have years to live because doctors can be wrong.  See https://choiceisanillusion.files.wordpress.com/2013/10/terminal-uncertainty.pdf and https://choiceisanillusion.files.wordpress.com/2014/08/signed-john-norton-affidavit_001.pdf

2.  HB 391, if enacted, will allow health care providers/institutions to use coverage incentives to steer patients to suicide.

In Oregon, that state's Medicaid Plan steers patients to suicide through coverage incentives.  If HB 391 is enacted, Utah health care providers/institutions will be able to do the same thing.  For more information about Oregon's situation, see the affidavit of Kenneth Stevens, MD, at this link:  https://maasdocuments.files.wordpress.com/2014/08/dr-stevens-affidavit_001.pdf 

3.  Legalization is a recipe for elder abuse. 

HB 391, like Washington's law, has no oversight at the death.  No doctor is required to be present. Not even a witness is required.  This situation creates the opportunity for an heir, or another person who will benefit from the patient's death, to administer the lethal dose to the patient without his consent. Even if he struggled, who would know?

4.  Increased suicide

In Oregon, other suicides have increased with the legalization of physician-assisted suicide.  See http://www.choiceillusion.org/2014/03/the-high-financial-cost-of-regular.html Legalization, regardless, sends the wrong message to young people that suicide is an acceptable solution to life's problems. Utah already has one of the highest suicide rates in the nation.  See http://www.standard.net/Health/2014/05/22/Utah-suicide-rate-soars

5.  Washington's similar law.

For a short article about Washington's similar law, please go here (non-lawyers tell me they like it):  https://www.kcba.org/newsevents/barbulletin/BView.aspx?Month=05&Year=2009&AID=article5.htm

New England Journal of Medicine Article Misleading

Dear Editor:

I am a lawyer in Washington State, one of two states where assisted-suicide is legal.  The other state is Oregon, which has a similar law.  Lisa Lehmann's article, "Redefining Physicians' Role in Assisted Dying," is misleading regarding how these laws work.

First, the Oregon and Washington laws are not limited to people in their "final months" of life.[1,2]  Consider for example, Jeanette Hall, who in 2000 was persuaded by her doctor to be treated rather than use Oregon's law.  She is alive today, twelve years later.[3]

Second, these laws are not "safe" for patients.[4][5]  For example, neither law requires a witness at the death.  Without disinterested witnesses, the opportunity is created for the patient's heir, or someone else who will benefit from the patient's death, to administer the lethal dose to the patient without his consent.  Even if he struggled, who would know?  

Third, the fact that persons using Oregon's law are "more financially secure" than the general population is consistent with elder financial abuse, not patient safety.  Do not be deceived. 

* * *

[1]  Margaret K. Dore, "Aid in Dying: Not Legal in Idaho; Not About Choice," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 18-20, September 2010, available at http://www.margaretdore.com/pdf/Not_Legal_in_Idaho.pdf.
[2]  Kenneth Stevens, MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 16-17, September 2010, available athttp://www.margaretdore.com/info/September_Letters.pdf 
[3]  Ms. Hall corresponded with me on July 13, 2012.
[4]  See article at note 1.  See also Margaret Dore, "Death with Dignity": A Recipe for Elder Abuse and Homicide (Albeit Not by Name)," at 11 Marquette Elder's Advisor 387 (Spring 2010), original and updated version available at http://www.choiceillusion.org/p/the-oregon-washington-assisted-suicide.html 
[5]  Blum, B. and Eth, S.  "Forensic Issues: Geriatric Psychiatry." InKaplan and Sadock's Comprehensive Textbook of Psychiatry, Seventh Edition, B. Sadock and V. Sadock editors.  Baltimore, MD: Lippincott, Williams and Wilkins, pp. 3150-3158, 2000. 

What People Mean When They Say They Want to Die

(originally published as a Statement for the BBC)

For a print version, click here.  

by William Toffler, MD

______________________________________________

There has been a profound shift in attitude in my state since the voters of Oregon narrowly embraced assisted suicide 11 years ago.  A shift that, I believe, has been detrimental to our patients, degraded the quality of medical care, and compromised the integrity of my profession. 

Since assisted suicide has become an option, I have had at least a dozen patients discuss this option with me in my practice.  Most of the patients who have broached this issue weren't even terminal. 

One of my first encounters with this kind of request came from a patient with a progressive form of multiple sclerosis.  He was in a wheelchair yet lived a very active life. In fact, he was a general contractor and quite productive.  While I was seeing him, I asked him about how it affected his life.  He acknowledged that multiple sclerosis was a major challenge and told me that if he got too much worse, he might want to “just end it.” “ It sounds like you are telling me this because you might ultimately want assistance with your own assisted suicide- if things got a worse,” I said.  He nodded affirmatively, and seemed relieved that I seemed to really understand.

I told him that I could readily understand his fear and his frustration and even his belief that assisted suicide might be a good option for him. At the same time, I told him that should he become sicker or weaker, I would work to give him the best care and support available. I told him that no matter how debilitated he might become, that, at least to me, his life was, and would always be, inherently valuable. As such, I would not recommend, nor could I participate in his assisted-suicide.  He simply said, "Thank you."

The truth is that we are not islands.  How physicians respond to the patient’s request has a profound effect, not only on a patient's choices, but also on their view of themselves and their inherent worth.

When a patient says, "I want to die"; it may simply mean, "I feel useless."

When a patient says, "I don't want to be a burden"; it may really be a question, "Am I a burden?"

When a patient says, "I've lived a long life already"; they may really be saying, "I'm tired.  I'm afraid I can't keep going."

And, finally, when a patient says, "I might as well be dead"; they may really be saying, "No one cares about me."

Many studies show that assisted suicide requests are almost always for psychological or social reasons.  In Oregon there has never been any documented case of assisted suicide used because there was actual untreatable pain.[6]  As such, assisted suicide has been totally unnecessary in Oregon. 

Sadly, the legislation passed in Oregon does not require that the patient have unbearable suffering, or any suffering for that matter.  The actual Oregon experience has been a far cry from the televised images and advertisements that seduced the public to embrace assisted suicide.  In statewide television ads in 1994, a woman named Patty Rosen claimed to have killed her daughter with an overdose of barbiturates because of intractable cancer pain.  This claim was later challenged and shown to be false.  Yet, even if it had been true, it would be an indication of inadequate medical care- not an indication for assisted suicide.

Astonishingly, there is not even inquiry about the potential gain to family members of the so-called "suicide" of a "loved one." This could be in the form of an inheritance, a life insurance policy, or, perhaps even simple freedom from previous care responsibilities.

Most problematic for me has been the change in attitude within the healthcare system itself. People with serious illnesses are sometimes fearful of the motives of doctors or consultants.  Last year, a patient with bladder cancer contacted me.  She was concerned that an oncologist might be one of the "death doctors."  She questioned his motives—particularly when she obtained a second opinion from another oncologist which was more sanguine about her prognosis and treatment options.  Whether one or the other consultant is correct or not, such fears were never an issue before assisted suicide was legalized. 

In Oregon, I regularly receive notices that many important services and drugs for my patients-even some pain medications-won't be paid for by the State health plan.  At the same time, assisted suicide is fully covered and sanctioned by the State of Oregon and by our collective tax dollars.

I urge UK leaders to reject the seductive siren of assisted suicide.  Oregon has tasted the bitter pill of barbiturate overdoses and many now know that our legislation is hopelessly flawed.  I believe Great Britain, the birthplace of Dame Cicely Saunders, and the Hospice movement, and a model to the rest of the world, deserves better.

On May 12, 2006

"I was afraid to leave my husband alone"

Letter from Oregon resident, Kathryn Judson, Published in the Hawaii Free Press, February 15, 2011.  To view the original letter, click here and scroll down towards the bottom of the page.   

Dear Editor,

Hello from Oregon.

When my husband was seriously ill several years ago, I collapsed in a half-exhausted heap in a chair once I got him into the doctor's office, relieved that we were going to get badly needed help (or so I thought).

To my surprise and horror, during the exam I overheard the doctor giving my husband a sales pitch for assisted suicide. 'Think of what it will spare your wife, we need to think of her' he said, as a clincher.

Now, if the doctor had wanted to say 'I don't see any way I can help you, knowing what I know, and having the skills I have' that would have been one thing. If he'd wanted to opine that certain treatments weren't worth it as far as he could see, that would be one thing. But he was tempting my husband to commit suicide. And that is something different.

I was indignant that the doctor was not only trying to decide what was best for David, but also what was supposedly best for me (without even consulting me, no less).

We got a different doctor, and David lived another five years or so. But after that nightmare in the first doctor's office, and encounters with a 'death with dignity' inclined nurse, I was afraid to leave my husband alone again with doctors and nurses, for fear they'd morph from care providers to enemies, with no one around to stop them.

It's not a good thing, wondering who you can trust in a hospital or clinic. I hope you are spared this in Hawaii.

Sincerely,

Kathryn Judson, Oregon