Update 006: Volume 10, Number 6 (December 1996)

Special Report: Veterinary euthanasia drug may be intended for human use

Questions which were first raised in 1994 by European Patent Office (EPO) examiners now swirl around a “euthanasia composition” developed at Michigan State University (MSU) and threaten to derail MSU’s patent for the drug that could eventually be marketed as a human euthanasia agent. The “composition” contains the anesthetic gamma-hydroxybutramide and chloroquine, an anti-malarial drug that can stop the heart when injected. It was created by researchers at MSU’s College of Veterinary Medicine, using $353,046 in grants received from three divisions of the German drug company Hoechst AG (Hoechst-Roussel, Hoechst-Celanese and Hoechst-Roussell AgriVet) between 1987 and 1990. [Declaration of Donald C. Sawyer to the U.S. Patent and Trademark Office, 4/1/90, pp. 6-8.]

On April 10, 1996, MSU was granted a temporary patent by the EPO for the euthanasia composition, with a permanent patent automatically scheduled to go into effect on January 10, 1997, barring formal opposition. Opposition to a patent application, outside of the technical realm, is rare, and there is generally little or no discussion of pending applications. However, questions raised in 1994 by an official examiner from the EPO and the responses to those questions by MSU have led to a public debate on both sides of the Atlantic.

  • Potential human use acknowledged

While the composition may have been intended initially for animal euthanasia, its potential for human use was acknowledged by MSU in 1994 when an EPO examiner noted that the patent application’s claims would encompass human use:

“The Examining Division notices that the subject matter of the claims is not limited to the provision of euthanasia in lower mammals. The attention of the Applicant is drawn to the fact that humans are mammalian species, and that as a result of the wording of the claims, the Applicant is seeking protection for an agent for committing euthanasia on humans as well…. The Applicant is asked for an explicit statement to this effect, or to limit the claims of the present application.” [Correspondence from EPO examiner to Grünecker, Kinkeldey, Stockmair & Partner, the German law firm representing MSU, dated 3/1/94, file copy 2/24/94, pp. 1-2, Problem/Solution #4. Emphasis added.]

At that point MSU could have limited its claims to non-human use of the euthanasia composition. However, through its attorney in Munich, MSU responded:

“There is no intent to violate the laws of any country in reference to use in humans. Nevertheless, if it should ever become legal to use the compositions in human beings, the patent claims should encompass the use of the compositions of the present invention for this purpose.”

The university, through its attorney, further noted that if human use of the composition were prohibited in one or more states (member countries), it could still be used in others:

“‘…a product could still be manufactured under a European patent for export to states in which its use is not prohibited.'” [Response for 7/1/94 by K. Goldbach of Grünecker, Kinkeldey, Stockmair & Partner, representing MSU, to EPO, pp. 2-3, “As to Item 4.” Emphasis added.]

After the public controversy over the MSU patent erupted in late 1996, MSU was asked repeatedly for assurances that the composition would not be used on humans. However, as late as November, the university remained unwilling to do so. At that time, Frederic H. Erbisch, director of MSU’s Office of Intellectual Properties, stated in writing that the university had not formulated any statement that there would be no use of these compositions in human beings. [Erbisch letter of 11/26/96 to IAETF] This stance shifted in late December when MSU officials told Newsday that they have no intention of allowing anyone to use the drugs for humans. “We at the university aren’t looking to do anything with controlling populations of humans,” said Erbisch. [Tom Maier, “Euthanasia Drug/European patent would allow human use,” Newsday, 12/22/96:A7]

While the December statement seems to indicate a change, MSU has not yet taken any steps to limit the actual patent claims. (If the listed claims are not changed to specifically restrict the composition’s use to lower mammals, the patent continues to cover human use.) In the absence of formally limiting the claims so that all human use of the composition is excluded, other concerns and questions remain.

  • No use of controlled substances

Chloroquine, which is the major ingredient of the euthanasia composition, has been discussed at length by right-to-die advocates as a means to carry out assisted suicide or euthanasia. [“Chloroquine: Pro and Con,” Last Rights (newsletter of the Right to Die Society of Canada), Issue No. 8, 2-3/93:12-13; “Beyond Final Exit: The Chloroquine Controversy, Part 2,” Last Rights, Issue No. 9, 4-5/93:19-22]

Chloroquine is not a controlled substance, thus the compound would be subject to very little regulatory oversight. This caused an EPO examiner to ask if MSU’s intent was to offer the product to the public. The examiner further stated that, in view of the documented suicide risks related to veterinary euthanasia drugs, such laxity in control would be irresponsible. [Correspondence from EPO examiner to Grünecker, Kinkeldey, Stockmair & Partner, dated 3/1/94, file copy 2/24/94, pp 2-3, Problem/Solution #7.]

MSU’s attorney responded that, without controlled substances in the euthanasia composition, it would be less apt to be used by people who are addicted to drugs and, further, the absence of controlled substances would permit the composition to be legally carried around and stored without the type of safeguards required for controlled substances.

“The issue of this compound not being a controlled substance means that its contents would not be used by drug addicts and used for their pleasure (addiction). This should not be confused with anyone using this drug to commit murder or suicide. It simply means that because it is dangerous and lethal, this drug will not attract drug addicts… it can legally be carried in a vehicle where euthanasia can be performed on site….” [Response of 7/1/94, K. Goldbach of Grünecker, Kinkeldey, Stockmair & Partner (representing MSU), to European Patent Office, p. 6, “As to Item 7.”]

While this may be the case, it would also be true that, if the compositions were used for human euthanasia or assisted suicide, it would be very easy to circumvent reporting requirements. Purchase in large quantities would not be subject to any type of investigation or oversight.

  • Market for euthanasia drugs

Currently, there are only three euthanasia agents for veterinary purposes listed in Veterinary Pharmaceuticals and Biologicals (the reference book most often used by U.S. and foreign veterinarians). None of these agents is protected by a patent, perhaps due to the relatively small market for this type of product. This raises questions about the reason for the large sums of money spent by MSU in seeking patent protection for its euthanasia composition. The product, if used for animal purposes, would be unlikely to produce enough revenue to even pay the costs incurred to obtain the patent.

But, since it takes years to develop drug compositions for human use, European patent protection obtained now could give an edge to MSU if euthanasia were ever legalized. Also, the firms with which MSU holds licensing agreements would effectively have marketing exclusivity over human euthanasia products for quite some time. The market price for such a product could justify the significant costs of developing the product and obtaining the patent.

The euthanasia drug’s sales potential has been recognized by Faye Girsh, executive director of the Hemlock Society USA, who said, “If the Supreme Court says there’s a constitutional right to physician-assisted dying, it’s conceivable there could be a market for this.” [Maier, Newsday, 12/22/96:A7]

  • Already marketable?

The permissive legal atmosphere surrounding assisted suicide in some countries may indicate that a market already exists for the euthanasia composition. In the Netherlands, which is an EPO “member state,” euthanasia and assisted suicide are widely practiced, but technically illegal. However, right-to-die advocates have stated that Norway, Germany, and Switzerland have no laws against assisted suicide. [World Right-to-Die Newsletter, Issue No. 29, 11/96:2] The EPO patent which MSU has applied for would cover Germany and Switzerland, since both are EPO “member states.” Norway is not a member state, but MSU has specifically applied for patent protection in that country as well.

It is possible that the MSU euthanasia composition could be manufactured for sale in those countries. The composition’s self-administration could be easily accomplished with a primitive “machine” such as that used by Jack Kevorkian or by means of the computerized death program developed in Australia. (See Update, 10-11/96:13.)

Euthanasia advocates often point out that it is permissible to euthanize pets, and ask that the same practice be available for human beings. MSU’s “euthanasia composition” presents the potential for doing just that.

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Australian Parliament’s lower house passes bill to overturn NT euthanasia law

On 12/10/96, Australia’s federal House of Representatives overwhelmingly passed a bill to repeal the Northern Territory’s (NT) law which legalized euthanasia and assisted suicide. The bill, entitled “The Euthanasia Laws Bill,” was passed 88 to 35 in a free conscience vote. Introduced by Kevin Andrews, the bill prohibits the passage of euthanasia or assisted suicide laws in Australia’s three territories. NT’s euthanasia law, called “The Rights of the Terminally Ill Act,” took effect on 7/1/95, but its implementation has been slowed by attempts to overturn it on both the local and federal levels. On 9/22/96, Bob Dent, a 66-year-old carpenter with prostate cancer, became the euthanasia law’s first casualty when he used a lap top computer and a software program developed by NT physician Dr. Philip Nitschke to administer a lethal drug intravenously.

Andrews’ bill to repeal the euthanasia law had been the subject of heated debate prior to the House’s final vote. While the federal government has constitutional power over territories, but not states, those opposed to Andrew’s bill argued that the issue was really federalism, with the federal Parliament acting against the rights of NT citizens. Those in favor of overturning NT’s law argued that euthanasia is illegal everywhere in Australia except in the remote Northern Territory, and the national parliament has a compelling interest in such an important issue. Australian Prime Minister John Howard, who opposes the NT law, explained, “After all, that kind of issue does go very directly to the kind of society we are, and inevitably if it happens in one part of Australia, it can have an influence on another part.” “Surely, if the national parliament is worthy of its name,” he added, “it ought to be able to express a view and pass a law about such an issue.” [Australian AP, 12/11/96; see also Updates, 5-6/96:12, 10-11/96:13.)

Andrews’ repeal bill must now go before Parliament’s upper house, the Senate, where it could face a tougher battle. Pro-euthanasia advocates have said that they plan to wage a public campaign to put pressure on Senate members to reject the Andrews’ bill. The measure is currently in a Senate committee where its constitutional implications are being studied. That committee is scheduled to issue its findings by 2/24/97. A full Senate vote is expected by the end of March. [Reuters, 12/10/96; The Age, 12/10/96; Australian AP, 12//10/96]
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Dutch put a rosy spin on new euthanasia studies

The data from two new studies — commissioned in 1995 by the Dutch government to evaluate euthanasia practice and reporting — reveal that the number of euthanasia deaths have increased significantly since 1990 and that, while more doctors are reporting these deaths to the authorities, the majority of physicians are still not complying with the reporting requirements. While euthanasia and assisted suicide are technically illegal in the Netherlands, both are widely practiced. Doctors are assured that they will not be prosecuted if they follow established guidelines and notify authorities about all induced deaths.

Reports on the new Dutch studies were published in the 11/28/96 issue of The New England Journal of Medicine (NEJM). One report compared the practices of euthanasia and physician-assisted suicide in 1995 with those documented in the 1990 Dutch study popularly known as the Remmelink Report. The purpose was to see whether, within that five-year period, medical practice — as it relates to end-of-life care and decision-making — had significantly dropped down a slippery slope. Interviews were conducted with 405 selected doctors, and questionnaires were mailed to the attending physicians listed on 6,060 death certificates. [van der Maas et al., “Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995,” NEJM, 11/28/96:1699]

In the NEJM report, the authors of the 1995 Dutch studies concluded that the “data do not support the idea that physicians in the Netherlands are moving down a slippery slope.” [p. 1705] That opinion was shared by NEJM editor Marcia Angell, M.D., in her accompanying editorial. According to Angell, a physician-assisted suicide advocate, the Dutch do not appear to be on the down-side of a slippery slope. “It would be very hard to construe these findings as a descent into depravity,” Angell wrote. “As far as we can tell, Dutch physicians continue to practice physician-assisted dying only reluctantly and under compelling circumstances.” [Editorial, “Euthanasia in the Netherlands — Good News or Bad?” NEJM, 11/28/96:1676]

A review of the data and other facts, however, does not support the researchers’ or Angell’s assessment. Moreover, certain statistical conclusions contained in the reports are somewhat misleading.

For example, the report states that in 1990 voluntary euthanasia and assisted suicide accounted for between 1.9% to 2.2% of all deaths in the Netherlands, while in 1995 between 2.6% to 2.7% of all deaths resulted from voluntary euthanasia and assisted suicide. [NEJM, Table 1, p. 1701] Stated this way, the increased number of induced deaths between 1990 and 1995 appears minimal — less than 1%. But, if the numbers of just the euthanasia and assisted suicide deaths in 1990 and 1995 are compared, rather than the percentages of all deaths, the increase is far more revealing. Deaths from voluntary euthanasia and assisted suicide actually increased during that five-year period by a minimum of 29.2% (from 2,447 to 3,524 deaths) to a maximum of 44% (from 2,883 to 3,660 deaths).

The authors also noted that cases of involuntary euthanasia (not called “euthanasia” by the Dutch, but referred to as “ending life without the explicit request of the patient”) had decreased slightly from 1990, accounting for 0.7% of all deaths in 1995. The authors, however, also reported that 55% of the physicians interviewed in 1995 indicated that “they had ended a patient’s life without his or her explicit request,” or “they had never done so but that they could conceive of a situation in which they would.” [p. 1701]

In a companion report on physician compliance with a 1994 law requiring doctors to report assisted deaths to the coroner, the authors concluded, “Substantial progress in the oversight of physician-assisted death has been achieved in the Netherlands.” [van der Wal et al., “Evaluation of the Notification Procedure for Physician-Assisted Death in the Netherlands,” NEJM, 11/28/96:1706] The basis for that optimistic conclusion is the finding that the reporting rate increased from approximately 18% in 1990 to 41% in 1995. But that still leaves the majority of Dutch doctors (59%) who are not reporting voluntary euthanasia and assisted-suicide deaths. The authors further acknowledged, “Cases of physician-assisted death without the patient’s explicit request [involuntary euthanasia] were rarely reported: two cases were reported in 1990, and three in 1995.” [p. 1707]

In spite of those facts, the authors wrote:

“We believe that cautious optimism is warranted. There seems to be only a small increase in the number of cases of euthanasia, there are indications that decision making has improved, the number of reported cases has greatly increased, and options for further improvement in public oversight have been identified.” [p. 1710]

Herbert Hendin, M.D., executive director of the American Suicide Foundation and author of a new book on Dutch euthanasia practice entitled, Seduced by Death: Doctors, Patients and the Dutch Cure, criticized the new studies as “attempting to give a favorable spin” on euthanasia practices “by claiming they haven’t gotten worse.” Hendin was also critical of the way the authors counted, or more specifically failed to count, the involuntary euthanasia deaths in both studies. According to Hendin, under the category “ending life without the patient’s request,” the authors did not include almost 2,000 cases in which Dutch doctors had intentionally administered large doses of pain medication for the primary purpose of ending patients’ lives. [D. Gianelli, “Dutch data indicate physician-assisted death on rise,” American Medical News, 1/13/97:6]

Comment:It should be noted that the new Dutch reports neglected to mention two specific cases which reflect just how far down the slippery slope Dutch medical practice has gone. Both cases occurred between 1990 and 1995, the time span covered by the new studies. Neither case fits the typical euthanasia patient profile — terminally-ill adult, most often suffering from late-stage cancer — described in both NEJM reports.

The first case is that of 50-year-old Hilly Bosscher, a physically healthy, yet clinically depressed patient who said she wanted to die after the deaths of her two sons. One son had died of cancer in May 1991; the other had committed suicide several years earlier. Psychiatrist Boudewijn Chabot, after seeing Hilly as a patient for a little over one month, provided her with drugs to end her life in September 1991. Chabot was prosecuted, since it appeared that he had not followed established euthanasia guidelines by helping a physically healthy woman to die. But on 4/21/93, in a landmark decision, a Dutch court found that Chabot was medically justified and followed established euthanasia guidelines in assisting in Hilly’s death. In 1994, the Dutch Supreme Court essentially upheld that lower court ruling. [New York Times, 6/22/94:A5; AP, 6/22/94] The legal precedent was now firmly established: euthanasia and assisted suicide were medically justified for mental suffering as well as physical suffering. The so-called strict euthanasia practice guidelines were stretched once again to accommodate yet another category of patient.

The second landmark case involved Rianne Quirine Kunst, a disabled newborn referred to as “Baby Maartje.” She was only days old in March 1993 when gynecologist Dr. Henk Prins intentionally injected her with a muscle-paralyzing drug to stop her breathing. Rianne had been born with hydrocephalus, spina bifida, and leg deformities. Reportedly, her parents were saddened by the prospect of having a disabled child. Prins was quoted in a Dutch newspaper admitting that there were treatment options available which would have allowed the baby to live possibly for years and would have relieved the pressure in her head. A Dutch court found Prins guilty of murder, but refused to punish him for the crime. According to the court, Prins “made a choice which — given the special circumstances of the case — can reasonably be considered as justifiable.” The court further expanded the limits of the accepted euthanasia guidelines, allowing babies to be killed if the child is said to be in unbearable pain which is not being controlled and the parents repeatedly ask that the baby’s life be ended. [Reuters, 4/27/95; AP, 4/27/95; De Telegraaf, 7/9/94] But the legal precedent set in this case went beyond the killing of babies. Now it was permissible in the Netherlands to terminate the lives of incompetent patients of any age, including the mentally retarded, the cognitively disabled, or those simply physically unable to communicate.

To get the best possible perspective on whether Dutch medical practice has been on a slippery slope, one should look beyond the short five-year span between 1990 and 1995 which was the focus of the new Dutch studies. Go back 50 years or so, and the answer becomes very clear.

During World War II, the Netherlands was the only occupied country whose doctors refused to go along with the German euthanasia program. At great risk to themselves, Dutch physicians openly defied their German conquerors and never recommended or participated in even one euthanasia death. Commenting on this fact in light of modern day Dutch euthanasia policy, the late British journalist Malcolm Muggeridge observed that it took only a few decades “to transform a war crime into an act of compassion.” [Time Magazine, 3/19/90:67]

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Numerous briefs opposing assisted suicide reach U.S. Supreme CourtIAETF submits brief to high court

The IAETF has submitted an amicus curiae brief to the U.S. Supreme Court asking the high court to overturn both the Ninth and the Second Circuit Court of Appeals rulings which struck down state laws banning assisted suicide. The IAETF argued that, if physician-assisted suicide ever became legal, the practice “would not be implemented in a vacuum,” but rather practiced within a health care system increasingly dominated by for-profit managed care and HMO programs bent on cutting costs. Given the inherent conflict facing such programs between profit margins and costly patient care, state laws banning assisted suicide serve the compelling interest states have in protecting the lives of vulnerable patients. The following are a few excerpts from the brief:

  • The “medical practice” of assisted suicide would not be implemented in a vacuum. There is nothing to indicate that a judicially created transformation of assisted suicide from a crime into a legitimate form of medical treatment would cause the health care delivery system to become more responsible to patient needs, nor would it afford a compassionate means for patients to have their suffering alleviated. If anything, the availability of assisted suicide would likely result in a decreased amount of time and attention given to treating and alleviating significant medical problems, such as pain, particularly when assisted suicide would be far less time-consuming and less costly than interventions which alleviate pain while not taking the patient’s life. This latter point is especially pertinent in a health care system dominated by managed care.It is within the context of the growing managed care system of health delivery and the growing prominence and influence of for-profit health maintenance organizations (HMOs) that the far reaching implications of striking laws which prohibit assisted suicide must be considered. Considering the financial implications of legalizing assisted suicide as it relates to proper patient care, a state not only has the right but the positive responsibility to protect its citizens by prohibiting assisted suicide. [Brief Amicus Curiae of the International Anti-Euthanasia Task Force in Support of Petitioners, Vacco v. Quill (No. 95-1858), Washington v. Glucksberg (No. 96-110), US Sup. Ct., p. 3]
  • Mandated time restrictions are not the only thing that can leave patients feeling demeaned and unimportant. Sometimes the greatest assaults on one’s sense of self-worth emanate from small indignities. When one of the nation’s largest managed care companies experienced losses in l995, it instituted cost cutting measures which included the refusal to provide gowns for gynecological exam patients. Patients were told to disrobe and then, instead of being provided with a gown, they were given a small square of paper on which they were to sit while awaiting the examination. (Auerbach, “As the Marketplace Changes, Consumers Are Caught in the Middle,” Wash. Post., 6/25/96:Z12)It stretches credulity to think that managed care programs — which fail to reimburse for adequate pain control, control exam times down to the minute, and deny a patient even a simple gown with which to cover herself — would allot large sums of money for comprehensive services so that assisted suicide would be used only as a last resort. [Brief, p. 21]
  • This Court faces the momentous task of determining whether the United States Constitution precludes states from enacting statutes prohibiting assisted suicide. Proponents of a constitutional right to have a doctor actively participate in assisted suicide argue that the issue before this Court is one of individual rights. But their assertions ignore the context within which that activity would be undertaken.This Court must decide the issue based not only on abstract notions of individual liberty but on the reality of the environment within which personal and medical decisions would be made. Only then can it determine whether the state laws under consideration sufficiently support valid state purposes and, thus, pass constitutional scrutiny.This brief has demonstrated that the current health care environment is evolving into a system defined by cost-cutting imperatives and dominated by a form of health insurance known generically as managed care. Further, it has shown that the very purpose of managed care, which is to reduce the cost of providing medical care, is accomplished, in large part, through a system that rewards reduced levels of care.In such a milieu, the kind of treatment that modern medicine is capable of providing (e.g. pain control, symptom management, and treatment of depression which is often essential to patient well-being and a desire to continue living) can be difficult to obtain. This problem would be exacerbated if the less costly and less time consuming “service” of assisted suicide were available mandatorily as a constitutional right. This could well create scenarios in which agonized and depressed patients would elect to have their deaths facilitated since their relievable suffering went unalleviated because of their health providers’ financial imperatives. Moreover, forcing physicians to elect between providing patients with care, at the risk of having their own incomes reduced, and suggesting assisted suicide as a cost saving measure, would place doctors in an ethical and moral conundrum. The deleterious impact of that would be felt by the medical professionals, patients, and society as a whole.This is the reality with which the Court must grapple.In sum, legalizing physician assisted-suicide in a health care system in which financial incentives would favor denying care and hastening death would create a profound injustice.Rather than serving the noble cause of individual liberty, it would make a mockery of freedom, since the “choice” to commit assisted suicide would, in many cases, have essentially been predetermined by managed care’s financial imperatives. Decisions to die would often be based, not on the inability of physicians to control pain and limit suffering but on pecuniary determinations.That being so, state legislative decisions to prohibit assisted suicide are constitutional since they serve vital and rational state interests. Such laws ensure that managed health care does not devolve into a system of managed death. They protect and reinforce the traditional ethics of the health care profession. They strengthen the bond of trust essential to the patient-physician relationship by preventing doctors from being tempted to end patients’ lives in order to promote their own financial ends. Perhaps most importantly, they reinforce the essential moral concept that human beings are not commodities, that lives cannot be measured in pecuniary terms, and that rich or poor, powerful or weak, no one should be sacrificed to benefit financial bottom lines. [pp. 28-30]

Editor’s note: The complete IAETF amicus brief can be accessed and downloaded from the IAETF web site at http://www.iaetf.org. Just click on “Library,” then scroll down to “Court Cases.”

Broad-based opposition to assisted suicide reflected in amicus briefs

    Well over 40 briefs from a broad array of concerned organizations and individuals opposed to physician-assisted suicide were submitted to the Supreme Court for consideration in the two “right-to-die” cases currently before the Court (Washington v. Glucksberg and Vacco v. Quill).

    Joining with the Amer. Medical Assn. in its brief were 45 other medical groups, including the Amer. Nurses Assn., Hospice Nurses Assn., Amer. Psychiatric Assn., Amer. Academy of Pain Management, Amer. Neurological Assn., Society of Critical Care Medicine, Amer. Assn. of Critical-Care Nurses, Oncology Nurses Society, Amer. Academy of Hospice and Palliative Medicine, as well as 23 state medical associations and societies. Other brief submissions included the Amer. Suicide Foundation, Nat’l Hospice Organization, Amer. Hospital Assn., Amer. College of Legal Medicine, Amer. Geriatrics Society, Catholic Medical Assn., Nat’l Assn of Prolife Nurses, Nat’l Spinal Cord Injury Assn., Physicians for Compassionate Care, and the Medical Society of New Jersey.

    Additionally, a wide range of religious groups signed on to a number of briefs. A sampling of those groups include the Evangelical Lutheran Church in Amer., Orthodox Jewish Congregations of Amer., Rabbinical Council of Amer., U.S. Catholic Conference, Nat’l Assn. of Evangelicals, Lutheran Church-Missouri Synod, WI Evangelical Lutheran Synod, Christian Life Commission of the Southern Baptist Convention, and the Amer. Muslim Council.

    Also among the long list opposing assisted suicide as a constitutional right were briefs submitted by 20 state attorney generals, the Clinton Administration, U.S. House and Senate Judiciary Committee chairmen, members of NY and WA state legislatures, Wayne County (MI), Oakland County (MI) prosecuting attorney, Milwaukee County (WI) district attorney, disability rights groups Not Dead Yet and ADAPT, Project Death in America, Family Research Council, and the Nat’l Legal Center for the Medically Dependent & Disabled, to name a few. The State of Oregon and the right-to-die group Choice in Dying, to the surprise of some, also submitted briefs in opposition to the Ninth and Second Circuit decisions.

    In contrast, only 17 briefs were submitted in support of a constitutionally protected right to die. Groups presenting that position included the Council for Secular Humanism, ACLU, Nat’l Gray Panthers, Hemlock Society USA, Euthanasia Research Guidance Organization, Americans for Death With Dignity, Amer. Medical Students Assn., Center for Reproductive Law & Policy, WA State Psychological Assn., Coalition of Mental Health Professionals, Nat’l Women’s Health Network, and the AIDS Action Council.

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    News Notes

    • At the Hemlock Society USA’s national meeting in November, it was proposed that fine-tuning terminology might be needed to advance the right-to-die agenda. Continuing in their long history of verbal manipulation, proponents are now suggesting that the term “physician-assisted suicide” be replace by “physician-assisted death,” since the word “suicide” has negative connotations. In addition, it was proposed that the term “Death with Dignity” should be changed to “Death and Dignity.” Conference attendees were also encouraged to get bills introduced in state legislatures, even if there’s no chance of the bill’s passage, so that legislators and the public become more disposed to accept assisted suicide at a later time.
    • The Oregon Board of Medical Examiners won’t decide until next spring whether disciplinary action will be taken against Dr. James Gallant, a Corvallis physician accused by the board of committing “active euthanasia.” After his patient, Clarietta Day, 78, had a brain hemorrhage, she was given massive doses of painkillers, had a magnet placed over her heart pacemaker in an attempt to shut it down, and was taken off life support — against her will. Gallant ordered an injection of a paralyzing drug, and Day died 15 minutes later. (See Update, 7-9/96:8.) The medical board has scheduled a closed hearing for the end of January, and is expected to decide in April if any disciplinary action will be taken. The board could revoke his Oregon medical license, or take lesser action in the form of fines or probation. Good Samaritan Hospital filed the original complaint with the medical board, but has not revoked Gallant’s hospital privileges. [Corvallis Gazette-Times, 10/22/96]
    • Assisted-suicide charges against the husband and son of Velma Howard have been dropped by Newton County (MO) prosecutor Greg Bridges. Velma, who had ALS, had travelled to a Joplin, MO, motel with her husband Bernard J. Howard and son Bernard A. Howard. After the elder Howards celebrated their 50th wedding anniversary, Velma’s son prepared a solution of orange juice, vodka, and sleeping pills, mixed narcotics into some pudding, and gave his mother a plastic bag and rubber bands to secure it around her neck. He then read to her play-by-play instructions from the suicide manual Final Exit. (See Update, 4/96:8.) The prosecutor had originally deferred the charges pending a Supreme Court ruling on physician-assisted suicide, but apparently decided not to wait for the high court’s decision. [AP, 12/25/96] This case, however, did not involve a physician-assisted death, rather it was family-assisted.