True or False Fact Sheet

TRUE or FALSE FACT SHEET

 This fact sheet is intended to provide information about the false claims made by assisted-suicide advocates and the truth about those claims.  Because all laws and proposed laws basically rely on Oregon’s “Death with Dignity Act” which was the first law permitting assisted suicide in the United States, much of the information centers on that law. Differences with that law go in one direction ‒ expansion of the law ‒ making assisted suicide more accessible.  

The terminology for the practice of providing prescriptions for a lethal overdose of drugs differs from state to state, including such labels as “death with dignity.” “aid in dying,” etc.  However, in this fact sheet, that practice will generally be referred to as “assisted suicide.” 

Recent proposals based on Oregon’s law refer to the “safeguards” as “barriers.”

Claim:
An expansion of the existing California “End of Life Option Act” bill is necessary because the current law is too restrictive and the Oregon law on which it was based has been free of abuse. 

Senator Susan Eggman authored the existing “End of Life Option Act” when she was in the California Assembly.  The California law was modeled on Oregon’s “Death with Dignity Act.”  Eggman is the coauthor of the proposed expansion to the law.  She stated that “There’s been over 30 years of data from the state of Oregon that says there’s been no abuses.”[1]

Reality:
Here is what the data from Oregon shows:
“Safeguards” are disregarded and no one has been disciplined.

Referring to Oregon’s assisted-suicide cases that were in violation of the law, Dr. Katrina Hedberg who was the lead author of many of Oregon’s official reports said, “[T]here have been a number over the years.”[2]   Asked if complications are investigated or reported, Hedberg replied, “[W]e are not given the resources to investigate….[N]ot only do we not have the resources to do it, but we do not have any legal authority to insert ourselves.”[3]

David Hopkins, Data Analyst for Oregon’s Center for Health Statistics, said, “We do not report to the Board of Medical Examiners if complications occur; no, it is not required by the law and it is not part of our duty.”[4]

Data for reports is based on self-reporting by doctors who prescribe lethal drugs. Asked if there is any systematic way of finding out and recording complications, Hedberg replied, “Not other than asking physicians.”[5] Furthermore, Hedberg said, “After we issue the annual report, we destroy the records.”[6]

There are no penalties for non-reporting or for inaccurate or incomplete reporting.  Oregon officials say that the state has no authority and no funding to examine the accuracy of the reports.[7]

The state department charged with formulating Oregon’s official reports admitted:
“For that matter the entire account [received from prescribing doctors] could have been a cock-and-bull story.  We assume, however, that physicians were being their careful accurate selves.”[8]

The lack of sufficient information is still evident in even the most recent official Oregon report. Although the official reports indicate that complications are to be reported, complications are reported as “unknown” in 57% of deaths in the official report issued in February 2021.[9]

Once a doctor-prescribed suicide bill becomes law, there is no way to determine what really happens after the prescription for the lethal drugs is filled. 

Claim:
Patients must undergo a careful in-person process of being diagnosed by an attending physician followed by a second diagnosis by a consulting physician and a written request before being eligible to receive a prescription for a medically assisted death.

Reality:
It had been assumed that in the other states all of the diagnoses and requests were being made in person.  However, that is not true. 

As of the end March 2021, 10 jurisdictions[10] had legalized assisted suicide.  Of those, only Vermont requires that the physician determine the patient has a terminal condition, based on the physician’s physical examination and that the patient made two oral requests to the physician in the physician’s physical presence.[11]

In 2021, a Vermont bill (S. 74) would have amended its law removing the requirement of in-person diagnoses and requests for assisted suicide. The bill failed to make it out of committee but advocates say they will take it up again next year.

Until recently, few people were aware that drugs for assisted suicide were being prescribed without in-person examinations.  However, during the pandemic, medical appointments have gone virtual, using telemedicine and zoom calls.  And assisted suicide deaths are increasingly taking place online, from the initial doctor’s visits through the patient’s death.

In fact, the American Clinicians Academy on Medical Aid in Dying has a committee that has established telemedicine policy recommendations for the purpose of guiding physicians through the process.[12]

Among those involved in the Americans Clinicians Academy is Dr. Lonny Shavelson of California who ran the End of Life Options clinic in the Bay Area[13] and Dr. Carol Parrot, a retired Washington State anesthesiologist who has assisted over 300 patients in ending their lives.[14]

Claim:
Care is taken by the physician to make sure that the oral requests are made to the physician before they prescribe the drugs.

Reality:
The doctor who prescribes the drugs does not need to be the physician who diagnosed the patient or who received the oral requests.

Dr. Lonny Shavelson’s End of Life Options in the Bay Area has been referred to as “a sort of one-stop shop for assisted death.”[15]  Shavelson explained that he often received calls from other doctors who refused to perform assisted death or who were forbidden to do them by the hospitals or hospices where they worked.[16]

A book titled “The Inevitable: Dispatches on the Right to Die,” described how Shavelson referred to himself when talking to his 90th assisted-suicide patient on the day of his death:  “Let me help you a little bit.  Do you remember that I’m the doctor who is here to help you die.”[17]

Claim:
Aid in Dying is about patient choice. 

Reality:
Once assisted suicide becomes just one more medical option, it can become the only option that insurance companies will pay for.

This can cause emotional and financial pressure on patients.  It gives insurance programs the opportunity to cut costs since they can deny payment for treatments that patients need and want while approving payment for the far less costly prescription for a lethal drug overdose.

This has happened in states that permit doctor-prescribed suicide.

Referring to payment for assisted suicide, the Oregon Department of Human Services explains, “Individual insurers determine whether the procedure is covered under their policies, (just as they do any other medical procedure).“[18]

There is documented information about terminally ill patients in Oregon and California who were denied coverage for treatment by insurance providers and, instead, were told that doctor-prescribed suicide would be covered.[19]

In California, after finding that her insurance company would not cover the chemotherapy her doctor had prescribed, a woman asked if assisted suicide was covered under her plan.  She was told, “Yes, we do provide that to our patients, and you would only have to pay $1.20 for the medication.“[20]

California pays for assisted-suicide drugs obtained by Medi-Cal patients under the state’s doctor-prescribed suicide law.[21]
………………
Note:
A recent Los Angeles Times investigation described how for-profit hospices are sending out recruiters to build up their businesses.  There are not many qualifications for starting or running a hospice other than having a clean felony record, getting licensed by the state and being certified by Medicare that entails paying only a few thousand dollars.

To qualify for these hospices is a very simple process.  “Patient must be certified by their attending physicians, if they have them, and by a hospice doctor.”

It was found that many of those who were signed up for hospice services were not dying.[22]

Yet, those patients, having been diagnosed as terminally ill, would be eligible for assisted suicide in California.
……………………………………………………………………………………………………………………………….

[1] “CA Bill Would Expand Access to Aid-in-Dying Law,” Public News Service, February 12, 2021.  Available at: https://www.publicnewsservice.org/2021-02-12/health/ca-bill-would-expand-access-to-aid-in-dying-law/a73145-1. (Last accessed 3/13/21.)

[2] The testimony was published in: House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill, “Assisted Dying for the Terminally Ill Bill [HL]” Volume II: Evidence. Apr. 4, 2005.  (Hereafter referred to as HL) Pg. 257, Q. 555.

Available at: http://www.publications.parliament.uk/pa/ld200405/ldselect/ldasdy/86/86ii.pdf (Last accessed 4/18/16.)

[3]  Hedberg, HL, p. 266, Q. 615.

[4]  Hopkins, HL, p. 259-260, Q. 568.

[5]  Hedberg, HL, p. 263, Q. 597.

[6]  Hedberg, HL, p. 262, Q. 592.

[7]  Hedberg, HL, pp. 259, 262 and 266.

[8]  Oregon Health Division, CD Summary, vol. 48, no. 6 (March 16, 1999) pg. 2.  Available at: https://www.oregon.gov/oha/ph/DiseasesConditions/CommunicableDisease/CDSummaryNewsletter/Documents/1999/ohd4806.pdf (Last accessed 5/10/21.)

[9]  Official report for 2020 deaths under Oregon’s Death with Dignity Act, Oregon Public Health Division, “Oregon’s Death with Dignity Act – 2020 Data Summary,” pg. 12. Available at: https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year23.pdf. Pg. 12. (Last accessed 3/13/21.)

[10] Jurisdictions where assisted suicide is legal as of March 30, 2021: California, Colorado, District of Columbia, Hawaii, Maine, New Jersey, New Mexico, Oregon, Vermont, Washington.

[11] 18 V.S.A. § 5283 (1), (2) and (5).

[12] American Clinicians Academy of Medical Aid in Dying, March 25, 2020, Available at: https://www.acamaid.org/telemedicine.  (Last accessed 4/28/21.)

[13]  Katie Engelhart, “I’m the Doctor Who Is Here to Help You Die,” The Atlantic, March 1, 2021.  Available at: https://www.theatlantic.com/health/archive/2021/03/aid-dying-lonny-shavelson/618139.  (Last accessed 3/15/21.)

[14]  Anita Hannig, “The Complicated Science of a Medically Assisted Death,” Quillette, March 18, 2020, Available at: https://quillette.com/2020/03/18/the-complicated-science-of-a-medically-assisted-death. (Last accessed 4/29/21.)

[15]  Terry Gross, “Engelhart’s Inside the Fight for the Right to Die: Logistical and Ethical Challenges,” transcript NPR, March 9, 2021.  Available at: https://www.npr.org/sections/health-shots/2021/03/09/975175847/inside-the-fight-for-the-right-to-die-logistical-and-ethical-challenges.  (Last accessed 3/15/21.)

[16]  Katie Engelhart, “I’m the Doctor Who Is Here to Help You Die,” The Atlantic, March 1, 2021.  Available at: https://www.theatlantic.com/health/archive/2021/03/aid-dying-lonny-shavelson/618139.  (Last accessed 3/15/21.)

[17]  Katie Engelhart, “I’m the Doctor Who Is Here to Help You Die,” The Atlantic, March 1, 2021.  Available at: https://www.theatlantic.com/health/archive/2021/03/aid-dying-lonny-shavelson/618139.  (Last accessed 3/15/21.)

[18] Oregon Dept. of Human Services, “FAQs about the Death with Dignity Act,” pg. 4. Available at: http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/faqs.pdf.  (Last accessed 3/6/21.)

[19]  There is documented information about terminally ill patients in Oregon and California who were denied coverage for treatment by insurance providers and, instead, were told that doctor-prescribed suicide would be covered.

[20] See, for example:  Bradford Richardson, “Assisted-suicide law prompts insurance company to deny coverage to terminally ill California woman,” Washington Times, October 20, 2016.  Available at: http://www.washingtontimes.com/news/2016/oct/20/assisted-suicide-law-prompts-insurance-company-den. (Last accessed 2/19/21.)
Also see: Susan Donaldson James, “Death Drugs Cause Uproar in Oregon,” ABC News, August 6, 2008.  Available at:  http://abcnews.go.com/Health/story?id=5517492&page=1. (Last accessed 3/6/21.)

[21] Kimberly Leonard, “Californians Can Choose to Die – With the Help of Taxpayers,” U.S. News & World Report, March 21, 2016.  Available at: https://www.usnews.com/news/articles/2016-03-21/in-california-government-to-pick-up-the-tab-for-death-with-dignity.  (Last accessed 3/6/21.)

[22]  Kim Christensen, “New reform measures target fraud, kickbacks in California’s end-of-life care industry,” Los Angeles Times, April 30, 2021.  Available at: https://www.latimes.com/california/story/2021-04-30/reform-hospice-end-of-life-fraud-kickbacks-abuses. (Last accessed 5/7/21.)

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