2006: Not a good year for the right-to-die movement
As reported in the last Update, the first serious blow came on May 3, when the House Human Services Committee in Vermont’s Democratic-controlled legislature narrowly defeated HB 168 , a clone of Oregon’s assisted-suicide law. The bill was hotly debated over the course of the 2005–2006 legislative session, and proponents mustered hundreds of thousands of dollars from out-of-state groups and individuals in an attempt to finally claim victory in another state besides Oregon. In the 12 years since Oregon legalized PAS, not one state has followed suit despite repeated attempts by activists. For this latest attempt in Vermont, a sizable war chest was used to hire a field director and professional lobbyists, and to conduct an expensive opinion poll. Local media coverage, by and large, was already favorable to their cause. But, in the end, a dedicated, broad-based opposition coalition—consisting of medical, disability rights, and suicide prevention organizations—managed to put an end to activists’ hopes of bringing PAS to the East Coast, at least for now.
While the Vermont defeat was a bitter one, PAS proponents still had hopes for spreading the right-to-die agenda to Oregon’s neighbor to the south, California—a state that has been the target of five attempts to legalize euthanasia and/or assisted suicide by ballot initiatives or legislative bills, dating all the way back to 1988. The latest attempt came in the form of a bill, AB 651, authored by Assembly members Patty Berg (D-Eureka) and Lloyd Levine (D-Sherman Oaks). Like the Vermont bill, AB 651 was patterned after Oregon’s PAS law.
Titled the “California Compassionate Care Act,” AB 651 was a masterpiece of deceptive verbal manipulation. As with most PAS measures, AB 651 contained no reference to assisted suicide other than to say that nothing in the bill authorized that practice. Instead, the purpose of the lethal “medication,” the bill stated, was “ending… life in a humane and dignified manner.” But, the authors apparently felt that even that soothing language was too jarring. With input from paid political consultants, public polling, and the PAS advocacy group Compassion and Choices (C&C), Berg and Levine camouflaged the bill even further for its first hearing in the Senate by amending it to read that the purpose of the prescribed fatal drugs was simply “to provide comfort with an assurance of peaceful dying if suffering becomes unbearable.” [AB 651, Sec. 7195.2 (j)]
A week prior to that first hearing in the Senate Judiciary Committee, chairman Senator Joe Dunn (D-Santa Ana) scheduled an informational hearing to explore the bill’s bioethical ramifications. The main panel was comprised of two invited experts: bill supporter Dr. Ben Rich, a bioethicist from the the University of California in Davis, and opponent Wesley J. Smith, an attorney for the International Task Force and a consutant for the Center for Bioethics & Culture.
Rich dismissed claims that the bill would usher in a “slippery slope” that would expand the use of PAS to increasing numbers of patients. Slippery slopes in other medical areas are managed all the time, he said. When asked by Dunn whether AB 651 would ever be expanded to include non-terminally ill, suffering patients, Rich replied that Oregon has successfully limited the PAS law’s scope to only the terminally ill. After more questioning, however, he admitted that there are a number of well-respected bioethicists who approve of PAS for the non-terminally ill.
Smith countered Rich’s dismissal of the slippery slope by pointing to the Netherlands. “Since 1973,” Smith explained, “Dutch doctors have gone from killing the terminally ill who ask for it, to the chronically ill who ask for it, to the disabled who ask for it, to depressed people who aren’t even physically ill who ask for it.” “Public policy is to protect all citizens, not just the ones who want to live,” Smith added. As for Rich’s contention that Oregon has been able to contain the PAS slippery slope, Smith said what little is known about Oregon PAS practice is questionable because all the data comes from “self-reporting by lethally-prescribing doctors, who are about as likely to tell the state that they violated the law as they are to tell the IRS they cheated on their taxes.” He called the legalization of PAS “dangerous and reckless,” especially given a medical system dominated by cost containment.
The actual Judiciary Committee hearing was held on June 27, 2006, before a standing-room only crowd of supporters and opponents. After three hours of pro and con testimony, the vote on AB 651 was taken. Given the make-up of the committee—3 Democrats and 2 Republicans—supporters expected a “slam dunk” victory. But committee chairman Dunn, a Democrat, stunned those present by voting “no,” thus killing the bill. He explained that his greatest concern was that “in the U.S., public policy decisions are driven, unfortunately, by money concerns, not policy concerns.” “If the power of money were to weigh in on this issue next year, five years from now, 10 years from now,” he questioned, “would we be able to hold this simply to the terminally ill and suffering?”
Co-author Berg angrily called the vote “a crushing disappointment.” “We will be thinking long and hard about our next steps,” she wrote to supporters. [Berg Newsletter, 6/06] C&C president Barbara Coombs Lee echoed Berg’s frustration about the future. “I’m just not sure where we go from here right now,” a flustered Lee told the press. “We’re kind of reeling. It will take a while to find our sea legs again.” Lee dismissed any plans for a future initiative campaign, saying a ballot measure in California would be “much too expensive, much too inflammatory.” [Contra Costa Times, 7/9/06; San Francisco Chronicle, 6/27/06; LA Times, 6/28/06]
As was the case in Vermont, the defeat of AB 651 was largely due to the work of a very broad-based coalition— Californians Against Assisted Suicide—which consisted of medical organizations, disability rights groups, advocates for the poor, minority groups, and various religious organizations. “It was a major victory for the alliance of groups opposing this, but the battle will go on,” said coalition member Paul Longmore, the director of the Institute on Disability at San Francisco State University. “It’s clear proponents are not ready to give up completely,” he added. “I don’t think we can relax.” [Contra Costa Times, 7/9/06]
PAS advocates in Britain have also sustained major defeats this year. As reported in the last Update, Lord Joel Joffe’s Assisted Dying for the Terminally Ill Bill was effectively blocked from passage after a seven-hour debate in the House of Lords on May 12, despite close collaboration with activists from Oregon’s Compassion & Choices.
A second crushing blow came less than two months later, on June 29, when the British Medical Association (BMA) voted overwhelmingly to reverse its year-old neutral position on euthanasia and PAS and go back to a policy of strong opposition to any assisted-dying legislation. Joffe’s PAS campaign had been given a significant boost last year when the BMA changed its 134-year opposition to induced-death practices to one of neutrality. Its reversal again will be a huge obstacle for any future attempts to legalize PAS in Britain. [British Medical Journal, 7/8/06; London Times, 6/29/06; Daily Telegraph, 6/29/06]
Bill to clarify Controlled Substances Act introduced
A new bill amending the federal Controlled Substances Act of 1970 (CSA) to expressly prohibit doctors from prescribing federally-controlled drugs for assisted suicide has been introduced in the U.S. Senate.
Authored by Senator Sam Brownback (R-KY), the Assisted Suicide Prevention Act of 2006 (S. 3788) is the result of a Congressional hearing held last May on “The Consequences of Legalized Assisted Suicide [PAS] and Euthanasia.” Brownback—head of the Senate Judiciary Subcommittee on the Constitution, Civil Rights, and Property Rights—conducted the hearing to explore the “unintended consequences and slippery slope” associated with both induced-death practices. Rita Marker and Wesley J. Smith, attorneys for the International Task Force, presented invited testimony at that hearing. (See Update, 2006, no. 3.)
Much of the media’s reporting on the Assisted Suicide Prevention Act (ASPA) has been less than accurate. Associated Press, for example, called the bill “the first legislative assault on assisted suicide since the U.S. Supreme Court upheld Oregon’s law in January,” referring to the court’s ruling in Gonzales v. Oregon. [AP, 8/16/06] But that ruling neither upheld nor endorsed Oregon’s permissive assisted-suicide law. In fact, it actually left the door wide open for Congress to amend the CSA “by explicit language in the statute” to ban the use of controlled substances (barbiturates) for assisted suicide. [Gonzales v. Oregon, 546 U.S. 04-623 (2006) slip op., p. 25; see also, Update, 2006, no. 2]
The stated intent of the ASPA is “to clarify Federal law to prohibit the dispensing, distribution, or administration of a controlled substance for the purpose of causing, or assisting in causing, the suicide, euthanasia, or mercy killing of any individual.” [S. 3788, p. 1] The bill places the highest burden of proof on the U.S. attorney general to prove “by clear and convincing evidence” that a doctor intentionally prescribed a controlled substance for the purpose of ending a life. [Sec. 3(4)] If that burden is met, the doctor could lose his or her federal license to prescribe controlled substances.
The ASPA also establishes that the “inadequate treatment of pain” is “a serious public health problem” and “physicians should not hesitate to… administer controlled substances when medically indicated….” [Sec. 2(5)] “Alleviating pain or discomfort in the usual course of professional practice is a legitimate medical purpose…even if the use of such substance may increase the risk of death.” [Sec. 3(2)]
The bill in no way alters the traditional roles of federal and state governments in regulating the practice of medicine. States would still be solely responsible for determining “whether action should be taken with respect to the professional license of the practitioner or State prescribing privileges.” [Sec. 3(6)(A)(i)]
Reaction in Oregon to the bill was predictably negative. Senator Ron Wyden (D-OR) said it “would completely unravel the Oregon law” and vowed to block its passage. [The Register-Guard (Eugene, OR), 8/9/06] On September 5, he took the first step to do just that by officially announcing to the Senate that he would block the bill indefinitely by means of a legislative hold, with the intention to filibuster if necessary. In 2000, Wyden successfully filibustered the Pain Relief Promotion Act, an earlier measure which would have also outlawed the use of controlled substances for assisted suicide.
According to Wyden, the ASPA is an affront to states’ rights. “What is ironic,” he said, “is that some who come to the floor of the Senate to talk about states’ rights are essentially saying they only believe in states’ rights if they think the state is right.”
Brownback, who has acknowledged that the bill has little chance of passing this year, disagrees that the issue is about Oregon’s rights. “This is a federal issue regarding the use of federally-licensed pharmaceutical substances to be used for assisted suicide,” Brownback explained. “It’s a big national debate. It applies not just to Oregon, but to what we as a nation are going to allow federally-controlled substances to be used for.” [AP, 9/6/06]
The ASPA is in line with existing federal policy opposing assisted suicide. In April 1997, Congress passed the Assisted Suicide Funding Restriction Act, banning the federal government from funding assisted suicide and euthanasia practices. The bill had bipartisan support, with the House passing it by the overwhelming vote of 398 to 6, followed a week later by the Senate’s unanimous vote of 99 to 0. When he signed the bill into law, President Bill Clinton said, “I believe that to endorse assisted suicide would set us on a disturbing and perhaps dangerous path. This legislation will ensure that taxpayer dollars will not be used to subsidize or promote assisted suicide.” [White House Press Release, Statement by President Bill Clinton, 4/30/97]
Controversy over arrests in alleged Katrina “euthanasia” cases
Ten months after Hurricane Katrina ravaged New Orleans, a doctor and two nurses were arrested for second degree murder for allegedly administering lethal injections of morphine and midazolam (generic for Versed) to four acute-care patients stranded at Memorial Medical Center. Ear, nose, and throat cancer specialist Dr. Anna Pou, 50, and nurses Lori Budo, 43, and Cheri Landry, 49, were arrested on July 17 and released.
The arrests were ordered by Louisiana Attorney General Charles C. Foti, whose office had investigated allegations that seriously ill patients on a floor leased out to LifeCare Holdings, Inc., had been euthanized during the horrendous aftermath of the hurricane. Foti did not officially charge the trio because, in Louisiana, charges can be filed only by the local district attorney. New Orleans D.A. Eddie Jordan plans to present the state’s case to a local grand jury to see if charges are warranted. [AP, 7/18/06, 8/4/06; Times-Picayune, 7/19/06, 7/23/06]
At present, Pou, Budo, and Landry are said to be responsible for the deaths of four patients—Emmett Everett, Sr., 61; Hollis Alford, 66; Ireatha Watson, 69, and Rose Savoie, 90—but more alleged victims may be identified in the future. [Times-Picayune, 8/6/06]
According to a 6-page affidavit released by Foti on events occurring on or about September 1, 2005, LifeCare administrators were told by Memorial Medical Center’s incident commander that the plan for their patients’ evacuations was to “not leave any living patients behind.” They were then told that “they needed to locate Dr. Pou.” Three LifeCare administrators said that Pou told them that “a decision had been made to administer lethal doses” to patients on LifeCare’s seventh floor unit who were probably not going to be evacuated, not likely to survive, and “not aware of what was happening.”
When Pou was informed that one of the patients, Emmett Everett, was “alert and oriented,” Pou said she was going to tell him that “she was going to give him something to help with his dizziness.” One administrator said that Pou “appeared to be nervous” before she entered Everett’s room and closed the door. A Memorial Medical Center nurse who knew Everett well had refused to “participate in sedating” him. Another patient, Rose Savoie, was also alert and aware enough to say, “That burns,” when Budo gave her the injection.
The affidavit further reveals that when Pou was asked which medication she intended to inject, she showed the administrator a pack of 25 morphine vials as well as some loose vials of the drug. Another administrator reported seeing Pou and the two nurses “drawing something up from vials into syringes.” The trio was subsequently seen “walking in and out of the LifeCare patient rooms.”
Test results on tissue samples taken from the four deceased patients, according to the affidavit, were positive for morphine and midazolam. A forensic pathologist reviewed the results and concluded that lethal levels of morphine had been administered in all four cases. In two of the cases, the level of midazolam was higher than what would be normal for therapeutic doses. None of the patients were being given either morphine or midazolam as part of their routine drug therapy during their hospital stay. [Affidavit, State of Louisiana v. Anna M. Pou, Lori L. Budo, and Cheri A. Landry, 7/06]
While the relatives of the four deceased patients applauded Foti for providing answers to their haunting questions about loved ones’ deaths, many others criticized Foti for grandstanding and conducting a witch hunt. News reports and opinion pieces were replete with medical professionals praising Pou, Budo, and Landry for their integrity, commitment to patient care, and heroism in the face of appalling conditions during the days following the disaster. Some opined that government officials, not the three women, should have been arrested for their mishandling of needed evacuations. [Times-Picayune, 7/23/06, 8/9/06; Houston Chronicle, 7/23/06; ABC News, 7/18/06; Time, 7/25/06; NY Times, 8/1/06]
Most of the controversy, however, centered on the pharmacological aspects of the case. Toxicology expert Rob Middleberg, hired by authorities to study the tissue samples, said Versed is a “red flag” when found post-mortem. “Versed is typically used with surgery,” he explained, “it’s used almost exclusively in relation to general anesthesia, and you don’t find it used very often day to day for therapeutic circumstances.”
But other doctors disagreed, saying that Versed is commonly used with morphine to relieve pain in critically-ill patients. “There are better ways to euthanize a patient,” commented Dr. Hank Macler, a Louisiana doctor who treated airlifted Katrina victims. “That choice of drugs doesn’t say to me ‘intent to euthanize.’” Dr. Steven Miles, a professor at the University of Minnesota Medical School, agreed. Barbiturates, he said, would have been far more effective. [Times-Picayune, 8/6/06; NY Times, 7/20/06; ABC News, 7/18/06]
But, for right-to-diers like Hemlock Society co-founder Derek Humphry, Pou, Budo, and Landry’s actions clearly amounted to “mercy killing.” “[T]he most humane thing to do…was to quietly hasten their [patients] inevitable ends with sedative drugs,” he wrote. “It is a pity that it became known….” [Derek Humphry, Right-to-Die Email List Service, 7/18/06]
Study: Doctors contribute to patients’ suicidal wishes
A new study, published in the journal Psychosomatics, found that doctors may be adversely influencing terminally-ill patients’ will to live.
Researchers from the University of Queensland’s School of Medicine, in conjunction with other researchers across Australia, studied 252 doctor-patient pairs and found a significant association between doctors with less training in the psychological areas of medicine and counseling and a higher occurrence of their patients’ wanting a hastened death.
“We found that doctors were more willing to hasten the death of patients if it were legal to do so and if a request by the patient was made,” explained lead researcher Dr. Frank Varghese, a psychiatrist and an associate professor at the University of Queensland.
“A doctor who was overwhelmed by the patient’s unaddressed emotional distress, with limited training in the psychological aspects of medicine, may be more inclined to favor hastening death for a patient,” Varghese added. Any attitude on the part of the doctor that endorsed a patient’s wish for an induced death could illicit that request from the patient.
Another researcher, Professor Brian Kelly from the University of Newcastle, said the study’s findings raise issues regarding the legalization of physician-assisted suicide. “Doctors face many stresses in the care of dying patients,” Kelley said, “and their reactions to the patient’s distress and the doctor’s reactions to severe and incurable illnesses in their patients may inadvertently lead the doctor to support the patient in [his or her] interest of assisted suicide.”
“They should instead be taking an approach that aims to understand the basis of the patient’s request and distress in the usual therapeutic role, and identify the ways of assisting the patient and family,” Kelly added. [Press Release, University of Queensland School of Medicine, 6/25/06; The Age, 6/27/06]
Dutch cost cutting could prove fatal
Cost-cutting health care insurance policies in the Netherlands could cause more people to opt for euthanasia and assisted suicide for financial reasons.
The Dutch government has issued a new report stating that expensive medical treatments should no longer be covered by the national health insurance system. The limit for costly care would be €80,000 ($150,000) per extra quality adjusted life year (QALY).
The report was issued by the Council for Public Health and Care at the request of Dutch Health Minister Hans Hoogervorst. The government has been alarmed by ever increasing health care spending which is outpacing economic growth. To curb this spending, the report argues, all coverage decisions on expensive care should be based on effectiveness, cost, and the seriousness of the illness. Currently, it says, these decisions are not being made uniformly, depending instead on local hospital budgets and pressure from special interest groups and the media. Highlighted in the report are costly conditions such as mental impairment and dementia.
Doctors and patients’ organizations have expressed alarm over this move to restrict treatment options. The Dutch Medical Association (DMA) objected, stating that care should be determined by the merits of individual cases, not by financial concerns. Patients’ groups called the policy change “socially irresponsible.” [British Medical Journal, 7/15/06]
Adding to the desperation some patients may experience over needed care, some Dutch hospitals have reportedly been refusing to treat uninsured patients, turning them away without being seen by a doctor. The DMA called for immediate action, citing “threats to public health” if the government doesn’t set up a fund to guarantee needed treatment access for the country’s estimated 250,000 uninsured patients. The health minister is resisting that action, arguing that the issue needs more investigation. [British Medical Journal, 6/3/06]
Dutch group reports euthanasia of 12 year-old and
a jump in euthanasia/PAS cases in 2005
In the July 2006 issue of its magazine, RELEVANT, the Dutch Voluntary Euthanasia Society (NVVE) reported that, in 2005, the first 12 year-old was euthanized legally under the Netherlands’ euthanasia law. The case was reported to the Regional Euthanasia Review Committee after the unnamed boy’s death. NVVE matter-of-factly described the boy’s demise as follows:
For the first time a 12-year old was euthanized. He had cancer, was completely confined to bed and was practically choking. The doctor in charge considered his suffering hopeless. When the parents also consented the boy’s life was terminat-ed at the end of 2005. The Committee decided that the doctor had acted according to the requirements of medical carefulness.
The NVVE also reported that, in 2005, 1933 cases of euthanasia and/or assisted suicide were reported to the regional committees post mortem. That was 47 more induced deaths than in the previous year. In 1765 of the cases, euthanasia was performed, while 143 cases were assisted suicides, and 25 deaths were the result of a combination of the two practices. [RELEVANT, vol. 32, no. 3, July 2006]
Swiss look to curb “death tourism”
Swiss lawmakers plan to address the complaints of residents of a Zurich apartment complex where the assisted-suicide group Dignitas leases a flat. It is where people walk in alive, but exit dead. Residents have been putting up with a constant parade of corpses in the hallways and elevator, and they are fed up. “The suicides happen almost daily, Tuesday to Friday,” said resident Gloria Sonny. “Friday is a rush day. It’s horror.”
According to spokesman Christian Weber, the Radical Free Democratic Party, one of the four governing parties, will be asking Zurich’s city parliament to prohibit Dignitas from operating in residential buildings. The party also plans to request the creation of an oversight committee to scrutinize all assisted-suicide groups operating in the area, despite a recent decision by the country’s justice minister not to monitor those groups nationwide. (See Update, 2006, no. 3) “Some [right-to-die groups] say foreigners can come, others say no,” Weber explained. “We want clear conditions.”
Georg Bosshard, a physician and researcher at the University of Zurich, is also critical of the current free rein enjoyed by groups facilitating suicides. “Alpinist guides need a license and are strictly controlled, but assisted suicide isn’t,” he said. Swiss law does not penalize assisted suicide, so long as the assistant acts without “selfish motives.” [Swiss Penal Code, Article 115]
Of the two main Swiss right-to-die organizations, Exit Deutsche Schweiz and Dignitas, the latter is the only one which aids in the deaths of foreigners. Of the 138 people who killed themselves last year with Dignitas’ help, approximately 90 percent were foreigners. Most of those were from Germany.
Zurich parliamentarian Gerhard Fischer has formally requested an end to “death tourism.” “We think we have a good chance of stopping it,” he said. [Bloomberg.com, 8/2/06]
Functional MRI tests indicate vegetative state patient is aware
Tests conducted on a 23-year-old, severely brain damaged woman—clinically diagnosed as being in a persistent vegetative state (PVS) as the result of a 2005 car accident—have provided researchers with surprising evidence that she is aware but unable to communicate that awareness.
“I was absolutely stunned,” remarked lead British researcher Dr. Adrian M. Owen from the Medical Research Council Cognition and Brain Sciences Unit in Cambridge. The tests showed that “she is aware,” he said. [LA Times, 9/8/06]
According to the study published in the journal Science, researchers in the U.K. and Belgium conducted functional MRI (fMRI) tests on the woman and compared the scan results with identical tests performed on 34 healthy volunteers. Unlike ordinary MRI scans which show structural brain damage, the newer, more advanced fMRI tests can measure function in specific regions of the brain.
When researchers gave the woman verbal instructions, the fMRI picked up activity in the same brain areas as seen in scans of the healthy volunteers. When she was told to “imagine playing tennis,” her brain fired in the supplementary motor area that controls motor responses. In contrast, when she was asked to “imagine visiting all the rooms in your home, starting from the front door,” brain activity was seen in the areas responsible for spacial mental images. Her test results were indistinguishable from those of the 34 healthy volunteers. Researchers concluded, “These results confirm that…this patient retained the ability to understand spoken commands and to respond to them through her brain activity, rather than through speech or movement.” [Owen et al., “Detecting Awareness in the Vegetative State,” Science, 9/8/06, p. 1402]
While researchers caution that their study focused on only one patient and their findings cannot be applied to all PVS patients, they also recognize that their protocol is a breakthrough for PVS research. Dr. Owens said that the type of brain responses the patient had “require the willed, intentional action of the participant.” Study co-author Dr. Steven Laureys, from the University of Liege in Belgium, agreed. “The activity in her higher-order cognitive areas means, to me, that she was consciously aware of herself and her surroundings,” he said. [Wall Street Journal Online, 9/8/06]
Dr. Laureys also pointed out that the findings could mean “the difference between life and death.” “From cases in the U.K. and the U.S.,” he said, “we know that end-of-life decisions are of course extremely important and this will definitely change the way we deal with these patients. When you have signs of consciousness, you cannot decide to stop hydration and nutrition.” [The Guardian (London), 9/8/06]
Dartmouth University Medical School neurologist James L. Bernat—a member of the Multi-State Task Force on PVS that, in 1994, codified the diagnosis of PVS—called the study’s findings “a little disturbing.” “This suggests there may be things going on inside people’s minds that we can’t assess by interacting with them at the bedside,” he said. [Washington Post, 9/8/06]
Texas futile care law under fire
On August 9, 2006, the Texas House Public Health Committee conducted over an 8-hour hearing to explore claims that the state’s Advance Directive Act, which took effect in 2000, unduly shifts decision-making power to hospitals and doctors rather than to patients if the patient’s life-sustaining medical treatment is deemed futile by the attending physician.
The law stipulates that, once a doctor makes that determination, the patient or the patient’s surrogate decision maker has only 48 hours to prepare for a meeting of the hospital’s ethics committee reviewing the patient’s case. If the committee agrees with the doctor’s determination that life-sustaining treatment should be stopped, the patient, surrogate, or family has only 10 days to prepare for the removal of vital care and possible death of the patient or to transfer the patient to another facility willing to provide the essential treatment. If no facility can be found within the 10-day limit, then the hospital can legally remove the life-sustaining treatment against the patient’s or surrogate’s wishes.
“In the eyes of the disability community, it’s involuntary euthanasia,” testified Colleen Horton, public policy director for the Texas Center for Disability Studies at the University of Texas. “When did doctors, other medical professionals and lawyers become so infallible that we place decisions that we normally leave to God in their hands?” she asked legislative committee members.
In the past 19 months, five contested futile care cases in Houston alone made headlines, with many more cases reported statewide. Family members involved in some of the those cases gave emotional testimony about their experiences battling for the best interest of loved ones. Many found it extremely difficult, if not impossible, to find another facility willing to accept futile care patients, especially if the patients’ Medicare and Medicaid benefits had run out. In one case, that of Lang Yen Thi Vo, the only facility willing to take her was in Illinois, making family visitation extremely difficult.
The debate over the futile care law is expected to continue during the 2007 legislative session. [Houston Chronicle, 7/31/06, 8/9/06; Austin American Statesman, 9/10/06]
News notes . . .
… Returning from a recent trip to Belgium (where euthanasia and assisted suicide are legal), Canada’s Bloc Quebecois MP Francine Lalonde indicated that she intends to reintroduce her Bill C-407 in the near future. Last year’s version of the bill was blocked due to the collapse of Canada’s liberal government. The dangerously far-reaching bill would have legalized both euthanasia and assisted suicide, and opposition to it was strong. But now, Lalonde said, she will make some changes to the bill in the hopes of garnering more support from parliament members, medical groups, and the public. It is likely that it will be patterned after Oregon’s law legalizing only assisted suicide. But oncologist Dr. Joseph Ayoub, a medical ethics professor at the University of Montreal, said most medical organizations will remain opposed to assisted suicide because it erodes human dignity. “Assisted suicide does not honor human dignity,” he said. “Especially now in the modern era of medicine, when there are ways to heal patients physically and psychologically.” Lalonde, however, is determined. “Having seen what’s happening in other countries, it’s important to have the debate, a large debate among the population,” she told the press. [Calgary Sun,7/31/06]
… South Australia Parliament member Sandra Kanck challenged the federal Suicide Material Related Offences Act by giving a speech in Parliament detailing the “best” suicide methods using helium, the barbiturate Nembutal, carbon monoxide, drug overdoses, and treatment refusal. Her intention was to violate the law, using her parliamentary privilege to protect her from prosecution, in the hopes of ultimately getting the law ruled unconstitutional by the country’s high court. [Kanck, Speech to SA Legislative Council, 8/30/06]
The law, passed last year, makes it illegal to distribute suicide information by electronic means, such as the internet, telephone, and fax machines, and carries a maximum penalty of $100,000 for individuals and $500,000 for organizations. It all but shut down the organization EXIT, a euthanasia and PAS advocacy group founded by Australia’s “Dr. Death,” neurologist Philip Nitschke, who collaborated with Kanck before her speech. Since Exit used the internet to conduct most of its business, Nitschke moved the group’s website to a New Zealand server to circumvent the law. But EXIT’s Australian branch is still barred from using the phone and fax to disseminate suicide information.
Kanck’s speech challenging the law, however, backfired, eliciting outrage from political leaders and the public. After South Australia Premier Mike Rann called the speech “shameless,” “shameful,” and “promoting something so grotesque that it has the capacity to lead people to take their own life,” the government struck it from Parliament’s official website. It was the first time ever that a parliamentarian’s speech was removed from the public record. [The Advertiser, 8/31/06; The Age, 8/31/06; The Herald Sun, 8/31/06; The Australian, 9/1/06] Confident that his New Zealand website was beyond Australia’s jurisdiction, Nitschke posted the suicide speech. He said the site had more than double its usual number of hits in the first two days following the posting. [Australian AP, 9/1/06; ABC Online, 9/7/06]
… The extremely controversial Philip Nitschke debuted his new do-it-yourself “suicide pill,” also called the “peaceful pill,” at the World Federation of Right to Die Societies’ conference in Toronto, Canada, on Sunday, September, 10, 2006. He told reporters that he wrote a book telling people how to make a lethal cocktail containing amylobarbitone, which is then synthesized into crystals. “You can do everything yourself, acquire what you need [to] access what is ultimately the most peaceful way of a peaceful death,” he claimed. [CTV.ca News, 9/9/06] He praised 20 elderly and terminally-ill Australians, who, under his guidance last year, pioneered the “pill.” He said they contributed about $1,700 each for materials and, according to a Canadian Press (CP) report, “set up a lab at a farm in New South Wales, pretending to be a gathering of birdwatchers.” Once the 20 pioneers are dead, he said, they will each bequeath their equipment to the next group of people who want to kill themselves. That second group will only have to pay $425 to make their suicide crystals. There is already a waiting list of 100, he told the CP. [CP, 9/9/06]
The costs per person for manufacturing the crystals seem a bit high, given the fact that Nitschke was given thousands of dollars by the Hemlock Society (now Compassion & Choices) to develop the deadly concoction. And the equipment costs should be minimal, given a news article written last October when the 20 pioneers began their work. According to that account, the 20 individuals spent 3 days at an abandoned sheep farm in a tent next to an old shed. They used a “Vegemite jar, an old frying pan and a plastic container of cooking oil,” along with other ingredients, to produce the deadly crystals. [The Bulletin, 11/2/05] One American right-to-die observer at the farm said Nitschke’s PR spin on the project was “a bit starry-eyed.” He also said the crystal-making process was “very touchy” and “very complicated—nothing for the average Joe.” [G. Exoo, ERGO Right-to-Die email list, 11/4/05]
… Leslie Burke, the 46-year-old British man with a degenerative brain condition that will likely leave him unable to communicate his treatment wishes to doctors, has lost his final legal appeal to the European Court of Human Rights. Burke appealed a British court of appeals’ ruling reversing a lower court decision ordering the General Medical Council (GMC) to revise its ethical guidelines to say that doctors must comply with incompetent patients’ advance directives requesting food and fluids. Burke originally took his case to court because the GMC’s guidelines stated that when a patient’s wishes are not known, doctors are to decide whether treatments are in the patient’s best interest. But the European court ruled that there was no “real and imminent” threat that Burke’s food and fluids would be withheld. Burke’s lawyer said, “The court has effectively determined his application is premature.” “However,” he added, “once he loses the capacity to make his own decisions, he will also lose the ability to make such an application on his own right. It is a Catch-22 situation.” [The Guardian, 8/9/06]
… There is good news regarding child abuse victim Haleigh Poutre, once judged “virtually brain dead” by medical experts and the Massachusetts courts. Sandra Sudyka, her biological grandmother, recently told the press that the child has significantly improved and can speak a few words. The Department of Social Services has barred information on Haleigh from the media. “They don’t want people to know how she is doing after they wanted to pull the plug,” Sudyka said. [The Republican, 9/2/06]