Friday, October 31, 2014

"Death With Dignity" or "Cruel and Unusual Punishment?"

Over the past several weeks, many people have been discussing Brittany Maynard's plan to kill herself on November 1st using a drug she obtained through Oregon's so-called "Death with Dignity" Act.  She was diagnosed at the beginning of this year with glioblastoma, the same malignant brain cancer which took the life of Sen. Ted Kennedy in 2012.

During the 2012 ballot initiative to legalize assisted suicide in Massachusetts, his widow publicly opposed it, writing:   "We’re better than that. We should expand palliative care, pain management, nursing care and hospice, not trade the dignity and life of a human being for the bottom line.

She also explained that her husband was only given two to four months to live, but lived another 15 very productive months.  "Because that first dire prediction of life expectancy was wrong, I have 15 months of cherished memories — memories of family dinners and songfests with our children and grandchildren; memories of laughter and, yes, tears; memories of life that neither I nor my husband would have traded for anything in the world."

Similarly, last April, Brittany Maynard was only given six months to live.  Six months later, she said she was postponing her suicide because she'd actually been doing remarkably well -- enjoying regular walks with her husband and visiting the Grand Canyon with her family, which was reportedly the last item on her "bucket list," which is strong evidence that bucket lists are a bad idea if you no longer have goals and then have nothing else to live for.

As it turns out, Brittany killed herself through her state-sponsored suicide on November 2nd.  Her story has been so highly glamourized that there will surely be "copycat suicides," from what's termed the "Werther Effect" -- a phenomenon of "suicide contagion" or "emulation suicide" following a highly-publicized suicide, resulting in "mass clusters" of suicide when spread through mass media.  This alone is cause for concern, but there are a litany of reasons why suicide should not be legalized anywhere.

Several years ago, as an attorney, I was appointed by a judge to act as a Guardian Ad Litem (G.A.L.) in an adult guardianship case involving a woman who was going to be taken to Dr. Jack Kevorkian to be killed.  I was skeptical when I first read the allegations of abuse in the petition, but a simple phone call to the daughter confirmed everything -- the husband and children saw her as a burden, were annoyed with her and in fact were not getting her proper care.  They wouldn’t allow Boy Scouts to build a free wheelchair access ramp to the home, wouldn't allow for her mother to arrange Meals on Wheels, and were otherwise abusing and neglecting her.  The woman was so distraught that she finally agreed to go to Kevorkian to end her life.  But upon court intervention, everything changed.  She actually wanted to live!

And this is the whole point of opposing assisted suicide laws -- hard cases make bad laws, and it's too easy for the most vulnerable members of our society to be exploited.  The "right to die" becomes an expectation to die, then a duty to die, then euthanasia -- outright murder.

Just look at the numbers from the State of Oregon, which has strict reporting requirements:  the top reasons expressed for wanting to kill themselves were loss of autonomy, less able to engage in activities making life enjoyable, loss of dignity and not wanting to be a burden on their family members -- 49% of whom included this last reason.  On the other hand, only 28% expressed inadequate pain control or a concern for it.  In the past, 80% had cancer, now only 64% do, so doctors and individuals are finding more reasons to hasten death, which should be troubling to all of us.

Many people have difficulty recovering from injuries which have resulted in severe burns, loss of limbs, blindness or deafness, etc., and initially express suicidal ideations for the same top reasons cited above, but then overcome these initial feelings and go on to experience joy in life and meaningful relationships again.  When 49% are fearful of being a burden on their families, you can see why they are ripe for exploitation.

This is the reason why our right to life and liberty are inalienable rights under our Declaration of Independence -- rights which not only cannot be taken away, but also cannot be given away.  It's too easy to be exploited.  In the U.S., someone cannot plead guilty to a crime they didn't commit.  They must state in Court in their own words exactly what they did to commit the crime, and this is to ensure that their inalienable right to liberty is not being given or taken away.

There are some minimal "safeguards" in place in the Oregon law, but we see that even though the law provides that those seeking the lethal prescription must be screened for depression and mental illness, this is simply not occurring.  Out of 122 prescriptions issued last year, only 2 referrals were made for psychological evaluations.  63% of those dead from the lethal dose were male, and that fits right in with the gender paradox of suicidal behavior -- just more proof that depression is not being addressed, as well as the stress of gender roles which men face when they lose their strength and independence.

Furthermore, the law requires that they must be given a prognosis of less than six months to live.  However, out of 71 people who killed themselves with the lethal prescription in 2013, 8 of those were given the prescription in 2012 or 2011.  So the 6-month "safeguard" is useless!

We can also see from the State of Oregon's data that the median age was 71, and most were well-educated.  Being older and well-educated, they're far more likely to have amassed wealth, and this is exactly the class of persons most likely to become victims of financial abuse and exploitation -- again, cause for great concern.

Then there's the question of what's happening to all of the unused drugs -- 90% were given pentobarbital, and 10% were given secobarbital.  In 2013, there were 122 prescriptions written under the Act, with 63 deaths as a result of ingestion, while 28 individuals died without taking it.  Accordingly, 31 people received these lethal drugs without taking them, and without otherwise dying.  So, 59 doses were uningested. 

Every year, there are large numbers of unused prescriptions sitting in people's homes.  In case this doesn't sound alarming to you, perhaps you'll be concerned once you realize that pentobarbital, in these high doses, causes respiratory arrest and is a drug used in lethal injections to administer the death penalty.

However, the major brand -- Nembutal, trademarked and manufactured by the Danish company Lundbeck for medical applications such as sedation, is no longer permitted for sale to prisons.  It's hypocritical to consider the death penalty to be “cruel and unusual punishment," while calling it "death with dignity" to give it to someone suicidal.

It's also interesting to note that in 2013, there were no blacks, hispanics or Asians who committed suicide under the Oregon statute.  Nearly 95% were white, while they only account for just over 80% of the population.  Perhaps it's because minority populations are more mindful of discrimination and have learned to fight for their lives.

Only 8 out of 71 dead from the lethal dose had the prescribing physician present.  Some only had 1 week of a relationship with the doctor before he prescribed the drug.

Some of the 752 dead in Oregon under the Act took 1,009 days before ingesting the lethal drug -- almost 3 yrs, when they were supposed to have only 6 months to live in order to get the prescription!  Once again, we see that physicians are often wrong in their diagnoses, but many may be purposeful to further their agenda.  Oregon has physicians who "specialize" in writing these prescriptions.

Another stunning fact from the Oregon data -- since 1997, six people regained consciousness after taking it, and some took up to over 104 hours to die from the dose!  

And this is dignified?


In the Netherlands and Belgium, we've seen the slippery slope of legalized assisted suicide erode into euthanizing children with special needs.  We must not let that happen here.  We must have compassion on those who are suffering physically, emotionally and spiritually after receiving a poor prognosis.  Assisted suicide is misguided compassion, and a risky proposition for a civilized society.

BIO:  Rebecca Kiessling is an attorney from Michigan and the founder and president of Save The 1.

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