Update 81, Vol. 30, Number 4 (2016-4)

Colorado’s doctor-prescribed suicide initiative up for a vote in November

A measure to allow doctors to prescribe lethal drugs to adult patients with six months or less to live has qualified for Colorado’s November ballot. Using paid signature gatherers, the proponents of Prop 106 (the End-of-Life Options Act) were able to garner approximately 108,000 valid signatures to put the measure before Colorado voters. [Denver Post, 8/5/16]

Assisted-suicide advocates opted to go the initiative route after the legislature failed to pass bills to legalize the practice in 1995, 1996, 2015, and 2016. They essentially took the bill that failed this year—also titled the End-of-Life Options Act—and turned it into a ballot measure.

Prop 106 would amend the Colorado Revised Statutes to transform the current crime of assisted suicide into a medical treatment. Physicians licensed by the state would be allowed to provide lethal drugs (barbiturate overdoses) to competent, terminally ill, adult state residents who request the drugs so they can end their lives.

The Yes on Colorado End-of-Life Options group has raised $4.47 million in the hope of convincing voters to pass its initiative. Four million ($4 million) of that war chest came from the national group Compassion & Choices (C&C) Network, formerly the National Hemlock Society.

The opponents of the measure, No Assisted Suicide Colorado, have, so far, raised only $1.23 million. [Coloradoan, 9/8/16]

The initiative battle has posed a serious semantic dilemma for the state’s news outlets trying to report on the campaign. Should they call the issue before voters “assisted suicide” or should they use euphemistic terms created by C&C to make the issue seem less abhorrent to the public, terms like “medical aid in dying” and “end-of-life option”?

KUSA 9News political reporter Brandon Rittman discussed the problem. “Supporters of that law have asked 9News not to call it assisted ‘suicide.’ They’d rather we call it ‘medical aid in dying.’” He went on to say why the TV station decided not to grant that request.

“Supporters of this proposal want to change the dictionary definition of suicide,” he said. “But it’s not our job in the news business to change the dictionary. It’s our job to use plain language that’s current and accurate.…” He explained that the Oxford Dictionary—among others—defines “suicide” as “killing oneself intentionally,” which is exactly what the initiative allows with a doctor’s assistance. [KUSA, 8/17/16]
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Canada’s euthanasia body count mounts in just 2 months

Less than two months after Canada enacted its “medical assistance in dying” (MAID) law on June 17, the number of euthanasia and assisted-suicide deaths soared to approximately 120 people. But that’s not an official figure because the government hasn’t yet set reporting guidelines or started tracking the number of MAID deaths in the country’s 13 provinces and territories.

The approximate 120 figure is the result of the Canadian Broadcast Company news department calling all the provinces to get the number of reported deaths in each. The combined totals for Ontario, British Columbia, Alberta, and Manitoba came to 118. Saskatchewan said there were fewer than 5. Quebec, The Yukon, New Brunswick, and Nova Scotia  refused to give out the number of deaths for privacy reasons, and Nunavut, Northwest Territories, Prince Edward Island, and Newfoundland and Labrador said there were no reported deaths during the two-month time span.

CBC News said the actual number of deaths will be significantly higher since some provinces and territories did not provide their MAID-death count. The 120 death figure “likely represents only one tenth of those who made ’serious requests’ for medically assisted death.” [CBC News, 9/2/16]

Apparently, the Canadian Bar Association (CBA) is not concerned about the alarmingly high death toll after the MAID law was enacted. At its annual meeting in August, the CBA’s council unanimously passed three resolutions urging the government to expand the law to allow euthanasia and prescribed-suicide deaths for more than the terminally ill—specifically those with psychiatric conditions, people with dementia who sign an advance euthanasia request, and mature minors. [The Record, 8/12/16; Canadian Press, 8/12/16]

Regarding mature minors, CBA’s Alberta Chapter President Wayne Barkauskas said, “Canada is a signatory to a number of treaties and documents involving the rights of a child and, if you follow those documents, it would indicate that a child should have the right [to die] as well.” [CHED (AM 630), 8/14/16]

The CBA’s law expansion efforts support a lawsuit filed within days of the MAID law’s enactment by the British Columbia Civil Liberties Association (BCCLA) that claims that the law is unconstitutional because it restricts MAID to only the terminally ill and denies the assisted-death right to the same categories of patients listed in the CBA’s three resolutions. The BCCLA’s case is pending.  (For more on the lawsuit, see Update, 2016, No. 3, p.5]

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Washington State’s 2015 report shows significant increases in assisted-suicide deaths and doctor participation

The Washington State Department of Health (WSDH) recently released its 2015 annual assisted-suicide report. The statistical report indicates that, between January 1, 2015 and December 31, 2015, 213 patients were prescribed lethal drugs by 142 individual doctors, and 166 of those patients ingested the drugs and died.

Those figures represent a significant increase over the statistics reported just one year ago: a 21% rise in the number of patients given lethal drug prescriptions, a 30% jump in the number of different doctors who wrote those prescriptions for patients, and a 32% leap in the number of patients who died as a result of those prescriptions.

Of the 213 patients prescribed lethal drugs, 202 died in 2015—but not all those deaths were caused by the lethal drug overdoses. In addition to the 166 patients who died as a result of the drugs, 24 died without ingesting them. For the remaining 12 patients who died, the WSDH has no clue if they took the drugs or not. The state also doesn’t know if an additional 11 patients are even alive or dead.

Washington State’s assisted-suicide reports, like Oregon’s official reports, are riddled with a significant amount of “unknown” data, which raises questions concerning the credibility of each state’s reports. (For more on Oregon’s reports, see Update, 2016, No. 2, p. 3]

Of the 202 deaths that the WSDH knows about, 72% had cancer, 8% had a neuro-degenerative disease like ALS, and 20% had respiratory disease, heart disease, and “other illnesses.” Those other illnesses are not listed.

Oregon’s 2015 report does list the specific other illnesses in a footnote. Included among those illnesses was diabetes. [Oregon Death with Dignity Act: 2015 Data Summary, Footnote 2, p. 7]

The 202 Washington patients who died in 2015 ranged in age from 20 to 97 years-old. The vast majority (95%) lived west of the Cascade mountains. Of the 213 patients who were prescribed lethal drugs, only 8 (4%) were referred for a psychiatric or psychological evaluation.  [WSDH, 2016 Death with Dignity Act Report, 8/16]

End of Life WA (formerly Compassion & Choices of WA) assisted 93% of those opting for death in 2015. [EOLWA, Newsletter, Summer/16.]

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News briefs from home & abroad

United States:

Status of state assisted-suicide measures – In 2016, the following states defeated bills to legalize doctor-prescribed suicide: Alaska, Arizona, Colorado, Hawaii, Iowa, Kansas, Maryland, Massachusetts, Minnesota, Missouri, Nebraska, New Jersey, New York, North Carolina, Oklahoma, Rhode Island, Tennessee, Utah, and Wisconsin.

Recently, a prescribed-suicide bill was introduced in Michigan—the home state of the late “Dr. Death,” Jack Kevorkian. Also, while New Jersey rejected a bill earlier this year, the measure’s sponsors quickly reintroduced it, so it’s still an active bill. Other states with pending assisted-suicide measures are Delaware, District of Columbia (DC), and Pennsylvania. The DC Council is scheduled to hear its bill on October 5.  A Council vote will likely follow.

Colorado Medical Society – One of the contributing factors that enabled legislators to pass California’s doctor-prescribed suicide law in 2015—after years of repeatedly rejecting similar measures—was the California Medical Association’s (CMA) decision to change its traditional stand of opposition to such bills to one of neutrality. On September 16, 2016, the Colorado Medical Society (CMS) followed the CMA’s lead and voted to take a neutral stand on Prop 106, the November ballot measure to legalize doctor-assisted suicide in Colorado. [CMS website, Breaking News, 9/16/16]

…Depressed patients slipping through the cracks –  According to a report released by the Agency for Healthcare Research & Quality (AHRQ), nearly three in four adult Americans who would meet the clinical criteria for a diagnosis of depression are not even being tested for it. Researchers screened 46,417 adults for depression. Of those surveyed, 8.4% screened positive for the condition. Yet, while 78.5% of those had seen a medical provider during the year, only 28.7% received any kind of treatment for depression. The National Institute of Mental Health and the Centers for Disease Control estimate that more than 15 million Americans live with depression, an illness that claims more than 41,000 lives per year. A study recently published in Health Affairs found that “US primary care practices are not well equipped to manage depression as a chronic illness.” [ABC, 8/29/16; Health Affairs, 3/16]

Belgium:
An unnamed, terminally ill youngster in the Flemish region of Belgium was the first reported child to be euthanized since the country legalized the practice for minors of any age in 2014.Details regarding the child’s age, sex, and terminal illness were not disclosed—although multiple news sources reported that the minor was 17 years-old. News of the death was announced by the euthanasia pioneer Dr. WimDistelmans, who heads the country’s Federal Control & Evaluation Committee. He told the Flemish newspaperHet Nieuwsbladthat the death was reported to the committee by a local doctor the week before Distelmans’ September 17 announcement. In order to terminate the life of a minor, the law requires that the child be able to rationally make decisions and the parents must give their permission for the lethal injection. [Het Nieuwsblad, 9/17/16; Bioedge, 9/17/16] So as not to be outdone by Belgium, Dutch pediatrician Eduard Verhagen predicted that a center for euthanizing children would open in the Netherlands next year. [nltimes.com, 9/19/16] Currently, Dutch law doesn’t allow minors aged 1-11 to be euthanized.

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