AMA Statement on Assisted Suicide (11/17/01) & Letter to AMA House of Delegates (12/02)

Are Euthanasia Advocates Taking Over the Hospice Industry? (12/19/03)

British Doctors No Longer Oppose Assisted Suicide (6/30/05)

British Survey: Public Favors Right to Live in Euthanasia Cases (5/10/05)

Cancer Specialists' Support for Assisted Suicide, Euthanasia Drops By Half in Four Years (10/5/00)

CMA Applauds Assisted Suicide Case Appeal  (11/10/04)

CMA Doctors Urge Courts to Protect Patients (2/22/05)

Pro-Euthanasia Groups Finalize Merger, Will Promote Assisted Suicide (11/19/04)

Hemlock Society-New Name, Same Old Euthanasia-Wesley Smith (5/3/03)

High Court Agrees to Review Nation's Only Assisted Suicide Law (2/22/05)

Living Will May Not Guarantee Wishes Are Followed (2/16/01)

The Media's Deadly Bias on Assisted Suicide (1/5/00)

Not Dead Yet Opposes Media Coverage of "Mercy Killing" Case (1/16/02)

Non-Voluntary Euthanasia Raises Serious Questions (1/10/01)

Oregon-5 Years of Assisted Suicide Too Long, Says AMA (4/21/03)

Oregon's Assisted Suicide Cases, a Pro-Life Analysis (2/25/01)

Oregon-Duty to Die Shows Up in Oregon (1/27/02)

Pain Relief Promotion Act Postponed (12/18/00)

Poll: Assisted Suicide Backing Falls (11/23/04)

Pope John Paul II-Former Pontiff, Church Can't Be Silent in Face of Legal Euthanasia  (10/29/02)

Study: Doctors Show Greater Willingness to be Rigorous in End of Life Care, But Less Willing to Actually Intend Death (12/10/04)

Study Says More Palliative Care Needed for the Dying (7/14/03)

Supreme Court Agrees to Review Nation's Only Assisted Suicide Law (2/21/05)

AMERICAN MEDICAL ASSOCIATION STATEMENTS ON ASSISTED SUICIDE

11/ 7/01 statement: "The Department of Justice's (DOJ) new framework on physician-assisted suicide is in keeping with AMA policy, AMA President-Elect Yank D. Coble, MD, said yesterday.

"'The AMA is opposed to physician-assisted suicide and believes it is inconsistent with the role of physician as healer,' Dr. Coble said.  'Physicians have a fundamental obligation to "do no harm," and the AMA has consistently held that physician-assisted suicide falls outside the realm of legitimate medical practice.'

"At the same time Dr. Coble emphasized that it is important for physicians to be able to aggressively treat their patients' pain with the necessary medication, and he noted that yesterday's action by the DOJ would not hamper a physician's ability to do so.

"'We are committed to relieving the suffering of patients at the end of life,' Dr. Coble said.  'We see nothing in this decision to concern physicians committed to aggressive pain treatment at the end of life.'"

11/5/97 Statement by Thomas Reardon, M.D., Chair, AMA Board of Trustees: "As the beacon for protecting patients and the ethics of the medical profession, the AMA will continue its unyielding opposition to physician-assisted suicide.  We will do everything in our power to see that this practice never becomes a generally-accepted option to quality patient care."

11/12/96 Amicus Curiae Brief to U.S. Supreme Court: "The power to assist in intentionally taking the life of a patient is antithetical to the central mission of healing that guides both medicine and healing. ... [Physician-assisted suicide has been] long viewed as outside the realm of legitimate health care ....  The ethical prohibition against physician-assisted suicide is a cornerstone of medical ethics."  (P. 1, 4-5.)

2/12/97 letter endorsing Assisted Suicide Funding Restriction Act: "We believe that the prohibition of federal funding for any act that supports 'assisted suicide' sends a strong message ... that such acts are not to be encouraged or condoned. ... [T]he Rule of Construction which recognizes ... the provision of adequate palliative treatment, even though the palliative agent may also foreseeably hasten death ... assures patients and physicians alike that legislation opposing assisted suicide will not chil... AMA Policy E-2.211 adopted 6/94; updated 6/96: "Physician assisted suicide is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks"

11/16/94, American Medical News: "The AMA, vigorously opposing Oregon's Measure 16 which would allow doctors to prescribe lethal medications to terminally ill patients, called unethical doctors' participation in patient-assisted suicide.  'It's fundamentally incompatible with the physician's professional role ...,' said AMA Board Secretary Thomas R. Reardon, MD."

Dear member of the AMA House of Delegates:

On behalf of Americans for Integrity in Palliative Care (AIPC), I would like to provide the information below on past AMA statements regarding physician-assisted suicide.  These are relevant to the upcoming debate in the House of Delegates on Resolution 720, which urges the AMA to defend Oregon's use of controlled substances for assisted suicide.

On many occasions the AMA has reaffirmed the ethical prohibition on physician-assisted suicide, filed briefs in federal court  to uphold state bans, opposed Oregon's policy permitting the practice, and voiced support for federal laws against physician-assisted suicide (Assisted Suicide Funding Restriction Act, Pain Relief Promotion Act).  The AMA has long recognized that ethics, medicine and law can and should distinguish between deliberate involvement in killing, and the side-effects which may occur fro
Approval of Resolution 720 would mark a radical change in this longstanding policy.  The resolution is based on the claim that in order to protect pain management we must defend the legitimacy of assisted suicide.   This resolution deserves to be defeated.

AIPC is an ad hoc alliance of health care professionals promoting the dignity of human beings in need of palliative care, and the ethical integrity of professions dedicated to such care.  Our founding members include former U.S. Surgeon General C. Everett Koop, Edmund Pellegrino, M.D., Walter Hunter, M.D. and Eric Chevlin, M.D., among others.

Eugene Tarne
Communications Director
Americans for Integrity in Palliative Care

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by Steven Ertelt, LifeNews.com Editor, June 30, 2005
 

Cancer Specialists' Support for Assisted Suicide, Euthanasia Drops By Half in Four Years

Source: National Right to Life Press Release; October 4, 2000 (Pro-Life Infonet 10/5/00 #2268)

Washington, DC -- A study published October 3 in the Annals of Internal Medicine found that support for assisting suicide and euthanasia among oncologists (physicians specializing in cancer treatment) declined by more than half between 1994 and 1998, a drop the study authors attributed primarily to "expanding knowledge about how to facilitate a 'good death,' making euthanasia and physician-assisted suicide no longer seem necessary or desirable."

Oncologists, who reported that they could get their dying patients all necessary care were over four times less likely to have performed euthanasia, compared to those who reported that administrative, fiscal, and other barriers allowed them to provide only some of the care needed by their dying patients. Those who reported having sufficient time to talk to dying patients and those who believed they had received adequate training in end-of-life care were less likely to have performed euthanasia or physician-assisted suicide. The study authors, Dr. Ezekial Emanuel and seven others, wrote that the date "end some support to [the] concern [that] inadequate access to palliative care might make euthanasia and physician-assisted suicide attractive alternatives."

The study, with 3,299 participants, founds 22.5% of oncologists supported physician-assisted suicide (PAS), compared with 45.5% in 1994. The shift was even more dramatic with regard to euthanasia (here understood to mean the doctor killing the patient, as by lethal injection, instead of providing the patient the means to commit suicide, as in PAS). Only 6.5% supported it, compared to 22.7% in 1994. Of doctors who had actually performed PAS (10.8%), 18% had done so five or more times. Additionally, 3.7% had performed euthanasia, 12% of whom had done so five or more times.

"The significant decline in cancer specialists who support euthanasia demonstrates that the answer to pro-euthanasia activism is not to legalize killing but to redouble efforts to improve care," said Burke J. Balch, J.D., director of NRLC's Department of Medical Ethics. "You don't solve problems by getting rid of the people who have them."

Maine voters will decide November 7 whether to join Oregon in legalizing assisting suicide. A bill now before the U.S. Senate, the Pain Relief Promotion Act (passed by the House in 1999) would end the use of federally controlled drugs to assist suicide, while implementing programs to improve pain relief as a positive alternative.

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CMA Doctors Applaud Assisted Suicide Case Appeal

To: National Desk

Contact: Margie Shealy of the Christian Medical Association, 423-844-1047, margie@cmdahome.org

WASHINGTON, Nov. 10 /Christian Wire Service/ -- The nation's largest faith-based association of physicians today applauded the U.S. government for appealing to the Supreme Court to uphold the federal government's right to regulate controlled substances, which Oregon allows its doctors to use when committing assisted suicides.

The Christian Medical Association applauded the Justice Department's appeal of a slim majority decision of the U.S. Court Of Appeals for the Ninth Circuit, which allowed the use in Oregon of otherwise federally controlled narcotics for assisted suicide.

David Stevens, M.D., Executive Director of the 17,000-member Christian Medical Association (www.cmawashington.org), noted, "The Controlled Substances Act was designed to prevent using drugs for non-medical purposes in every state--not every state except Oregon. When a state or a doctor uses such drugs not to heal or to relieve pain, but simply to kill, that is not a medical purpose; it is killing. Killing doesn't require medical training or compassion."

Associate Executive Director Gene Rudd, MD added, "What we need is not more power for doctors who use drugs to kill their patients, but more power for doctors who use drugs to heal and comfort their patients. That's what medicine is all about. First, do no harm."

To schedule an interview, please contact Margie Shealy at (423) 844-1047 or by e-mail: margie@cmdahome.org. The Christian Medical Association is equipped with Ku Band Digital Uplink satellite and ISDN lines.

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CMA Doctors Urge Supreme Court to Protect Patients, Physicians and the Culture

To: National Desk

Contact: Margie Shealy of the Christian Medical Association, 888-231-2637, 423-341-4254 cell

WASHINGTON, Feb. 22 /Christian Wire Service/ -- The nation's largest faith-based association of physicians today said that in deciding to hear a challenge to the nation's only assisted suicide law, the Supreme Court has an opportunity to protect patients, preserve physicians' role as healers, and send a life-honoring message to the culture.

The court will review whether the federal Controlled Substances Act should only be used for legitimate medical purposes or, as in Oregon, as a lethal prescription for suicidal patients.

David Stevens, M.D., Executive Director of the 17,000-member Christian Medical Association, said, "The Court has an opportunity to insure that patients receive truly compassionate care and pain relief by limiting physicians' use of narcotics for healing--not death."

Dr. Stevens noted, "As the time-tested Hippocratic oath asserts, the role of a physician is to 'use treatment to help the sick according to my ability and judgment, but never to injure or wrong them.' The oath also asserts, 'I will not give poison to anyone though asked to do so, nor will I suggest such a plan.'

"The reason physicians have taken this oath for centuries is to preserve their patients' rights and the healing authority of the medical profession.

"You only have to look at some of the abuses patients have suffered in financially driven healthcare systems to understand what can happen when cheap assisted suicide is offered as an alternative to true comfort care. Do you think the state of Oregon might have a financial interest in choosing cheap suicides for citizens whose care would otherwise be paid for through Medicaid? Do you think third-party healthcare payers might compare ledger sheets with cost estimates for lethal injections of Phenobarbital versus long-term palliative care?

"We don't need to empower physicians to administer lethal doses of narcotics. We need to empower physicians to administer truly pain-relieving doses of narcotics.

"What message do we want to send about suicide to our young people, the disabled community, our aging parents and grandparents? Do we really want the government condoning and promoting suicide? Do we want to reinforce the fear that the infirm are no more than a burden on the healthy? Do we want to reduce the value of life to what's going on in our bodies?

"We need to send a message that even in our darkest hours, life is still worth living, that loved ones will come alongside to help, and that doctors will treat pain effectively and compassionately--not with a lethal prescription."

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Hemlock Society: New Name, Same Old Euthanasia Story

by Wesley Smith
Pro-Life Infonet; May 3, 2003

[Wesley J. Smith is a senior fellow at the Discovery Institute and an attorney and consultant for the
International Task Force on Euthanasia and Assisted Suicide.]

What's not in a name is the question du jour at single-issue advocacy groups. First the venerable National Abortion Rights Action League (or National Abortion and Reproductive Rights Action League in recent years) officially dropped abortion from its name and became "NARAL Pro-Choice America." Now, the Hemlock Society, the premier assisted-suicide group, has decided to recast its image with a new name (still not chosen) and a new P.R.-driven motto: The founding slogan, "Good life, good death," has been discarded for the new and improved "Promoting end-of-life choice." 

Changing the group's name is designed to put a respectable veneer over the organization's raison d'tre--legitimizing suicide. Yet, the word hemlock remains entirely apt. From its inception, the
Hemlock Society has been obsessed with exercising control over death through suicide. Indeed, Hemlockers claim that assisted suicide, which they now euphemistically call "aid in dying," is
the "ultimate civil right." 

I became aware of the organization in 1992 when a friend killed herself under the influence of Hemlock Society literature.  Frances's problem wasn't illness; it was depression over a life
that had become a complete mess. When she was diagnosed with leukemia (which was not terminal), began to experience a painful neuropathy (while refusing to take her pain-controlling drugs), and learned she would soon require a hip replacement, Frances seems to have found the pretext she needed to justify finally doing what she had wanted to do for so long. Indeed, we found out after the fact that months before she died, Frances had entered an appointment in her calendar--the date of her 76th birthday--for her "final passage," an appointment she kept, accompanied by a distant cousin who was paid $5,000 to be with her, and perhaps, to assist her suicide. 

Ever organized, Frances kept a suicide file. It contained several editions of the Hemlock Society's newsletter, then called the Hemlock Quarterly. As I read these newsletters, I was shocked out
of my shoes. Each Quarterly was filled with proselytizing stories about so-called "good deaths" that had been facilitated by Hemlock members. For example, in the January 1988 issue, Frances had underscored the following words describing the suicide of "Sam," a terminal cancer patient:  
Believe it or not, we laughed and giggled and [Sam] seemed to relish the experience. I think for Sam it was finally taking control again after ten years of being at the mercy of a disease and medical protocols demanded by that disease. 

Suicide promoted as uplifting and enjoyable sickened me. But what really infuriated me was the "how to" sections of the newsletters. In one issue, a list of drugs was provided, with their relative toxicity. Frances had underscored the drugs that were the most poisonous.

I realized that this group, made up of people who didn't even know Frances, had been, figuratively speaking, whispering in her ear for years. First, they gave her moral permission to kill herself, fostering a romanticism about suicide that helped push her toward consummation. Then they convinced her she would be remembered with warmth for her act of taking "control." Finally, they taught her how to do it. I felt then, and do today, that while Frances was responsible for her own self-destruction, morally, if not legally, the Hemlock Society was an accessory before the fact.

In the years since Frances's suicide, Hemlock has gone through some outward changes while remaining steadfast to its dark ideology. It changed the name of the Hemlock Quarterly to Timelines, recently renamed again, this time to End of Life Choices. Its leadership changed, too, as the group struggled to appear less fringe, more mainstream and professional. But the more it tried to project a respectable image on the outside, the more obsessed with suicide the group seems to have become on the inside.

No longer satisfied to publish literature teaching people like Frances how to kill themselves or assist the suicides of others, several years ago Hemlock began to train volunteers to visit suicidal Hemlock members to counsel and, it would seem, hasten their deaths through its "Caring Friends" program. According to a tape transcript from the January 2003 Hemlock Society National Convention, the group's medical director, Dr. Richard McDonald, is present at many Caring Friends suicides and extols the use of helium and a plastic bag as a "very speedy process that has never failed in our program."

One need not be dying to qualify for Caring Friends' services.  According to the November 1998 Timelines, access to Caring Friends is available for Hemlock members with "an irreversible physical condition that severely compromises quality of life," which could include a plethora of illnesses and disabilities that are not terminal.

The Winter 2003 End of Life Choices reports proudly that 32 Hemlock members "died with Caring Friends information, support, and presence" in 2002. Knowing that Hemlock members are fascinated by the methods used, the article catalogues them:  "Thirty used the inhalation method and two used the ingestion method."

Choices also informs us that 15 of these suicides were in hospice at the time of their deaths. If so, then the Caring Friends interfered with proper medical treatment of these patients. When I was trained as a hospice volunteer, I was explicitly told that suicidal ideation was a medical issue that hospice could often address successfully in dying patients and instructed to inform the hospice team of any expressed desire to self-destruct. Of course, Caring Friends is not about assuring that dying patients receive proper medical treatment. 

The radical scope of Hemlock's ideological agenda is demonstrated by its financial and moral support of Dr. Phillip Nitschke, the Australian Jack Kevorkian. Nitschke is an out-and-out advocate of death-on-demand, who is infamous Down Under for his plan to purchase a passenger ship, which he intends to steam into international waters on one-way euthanasia death cruises.
Nitschke has been paid tens of thousands of dollars by the Hemlock Society USA to invent a suicide formula that uses common household ingredients: a potion Nitschke calls the "peaceful pill."

In a 2001 Q & A on National Review Online, Nitschke was asked who would be eligible to receive his suicide concoction. His answer is macabre, even by surrealistic Hemlock standards:  
All people qualify, not just those with the training, knowledge, or resources to find out how to "give away" their life. And someone needs to provide this knowledge, training, or resource necessary to anyone who wants it, including the depressed, the elderly bereaved [and] the troubled teen. . . . The so-called "peaceful pill" should be available in the supermarket so that those old enough to understand death could obtain death peacefully at the time of their choosing.

For anyone with any moral sense, Nitschke is clearly a crackpot.  But he remains a hero to members of Hemlock. He was an honored guest at the organization's 2003 national convention in San Diego, where he was invited to unveil his most recently invented suicide machine. Despite being deprived of the chance to ooh and ah at Nitschke's handiwork when Australian customs authorities
seized the contraption, attendees gave him a rousing standing ovation.

Which brings us back to the pending name change. According to an article in the latest issue of Choices, the name change is designed "to increase membership, to accelerate name recognition and approval, and to [facilitate] work with legislators sympathetic to our mission, who find the name Hemlock offensive and difficult to explain." In other words, the name Hemlock Society must change because it is descriptive and accurate.

Not surprisingly, the magic word "choice" is likely to be part of the new name. Among the current contenders are: End of Life Choices America (EOLCA), Voices of Choice at Life's End (VOCAL), the Final Exit Society, and the Promoting Options for a Peaceful End, which translates into the sarcastic acronym (POPE). 

But a simple name change won't heal what really ails Hemlock.  What these death-obsessed folk just don't get is that the word hemlock isn't what offends people; it is their nihilism. Hemlock can change its name to the Mormon Tabernacle Choir if it wants to. But that won't change the fact that a deadly poison perfectly conveys the heart, soul, and purpose of the organization. 

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High court agrees to review nation's only assisted suicide law

Tuesday, February 22, 2005 Posted: 11:21 AM EST (1621 GMT)
 

WASHINGTON (AP) -- The Supreme Court on Tuesday said it will hear a challenge to the nation's only assisted suicide law, taking up a case embracing the Bush administration's appeal to stop doctors from helping terminally ill patients die more quickly.

Justices will review a lower court ruling that said the U.S. government cannot sanction or hold doctors criminally liable for prescribing overdoses under Oregon's voter-approved Death with Dignity Act. Since 1998, more than 170 people -- most with cancer -- have used the law to end their lives.

Arguments will be heard in the court's next term, which begins in October.

Former Attorney General John Ashcroft filed the appeal last November, on the day his resignation was announced by the White House, arguing that physician-assisted suicide is not a "legitimate medical purpose" and that doctors take an oath to heal patients, not help them die.

Oregon countered by saying that regulation of doctors generally has been the sole responsibility of the states. Ashcroft has no authority under the federal Controlled Substances Act to punish doctors because Congress intended the law only to prevent illegal drug trafficking, the state argued.

The San Francisco-based 9th U.S. Circuit Court of Appeals sided with Oregon last May.

"The attorney general's unilateral attempt to regulate general medical practices historically entrusted to state lawmakers interferes with the democratic debate about physician-assisted suicide," wrote Judge Richard Tallman in the 2-1 opinion.

In 1997, the Supreme Court unanimously ruled that individuals had no constitutional right to die, upholding state bans on physician-assisted suicide. In an opinion by Chief Justice William H. Rehnquist, the court suggested it was up to the individual states to decide whether to permit or ban the practice.

The issue now before the high court is whether Congress could step in to prohibit assisted suicide if a state chose to allow it, and, if so, whether the federal Controlled Substances Act authorizes the Justice Department to do so.

Oregon voters approved the law in 1994 and overwhelmingly affirmed it three years later when it was returned to the ballot following a failed legal challenge that stalled its implementation.

The law allows terminally ill patients with less than six months to live to request a lethal dose of drugs. Two doctors must confirm the diagnosis and determine the patient to be mentally competent to make the request.

The Oregon challenge is the second right-to-die case to come before the Supreme Court this year. Last month, justices rejected a legal challenge to Florida's "Terri's Law," a measure to keep Terri Schiavo, who is severely brain-damaged, on life support over the objections of her husband.

Schiavo, whose legal fight is continuing, was scheduled to be taken off life support as early as Tuesday.

In 1990, the Supreme Court ruled that terminally ill people may refuse treatment that would otherwise keep them alive, but declined in the 1997 case to extend that constitutional right to obtaining medication that would put them to death.

The case is Gonzales v. Oregon, 04-623.

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Living Will May Not Guarantee Wishes Are Followed

Source: Archives of Internal Medicine 2001;161:421-430.

New York, NY -- Even when close relatives know what an individual's living will expresses, chances are those treatment preferences will not be followed, results of a study suggest.

A host of prior studies have demonstrated that family members and physicians fare poorly in following an individual's life-sustaining treatment preferences in the absence of a living will (or ``advance directive''), according to Dr. Peter Ditto from the University of California at Irvine, and associates. What has never been tested, though, is whether preferences expressed in a living will are actually honored.

The investigators looked at whether the existence of a living will--with and without thorough discussion of its contents among patients and their relatives--actually improved the accuracy with which an individual's surrogates predicted his or her treatment preferences.

In the absence of a living will, relatives correctly predicted patient preferences less than 70% of the time, the authors report.

Surprisingly, living wills--even with thorough discussions between patients and relatives--failed to improve the accuracy of the surrogates' predictions, the researchers note.

In fact, according to the report in the February 12th Archives of Internal Medicine, there was no subgroup of patients or surrogates and no living will intervention that improved the prediction accuracy over that achieved by surrogates of patients with no advance directives.

Despite these facts, the investigators observe, both patients and their surrogates believed that the living will and discussions improved the surrogates' understanding of the patients' wishes and increased the surrogates' comfort in making medical decisions for the patients.

``The results of the present study clearly challenge the effectiveness of (living wills) as a means of preserving patients' ability to control specific treatment decisions near the end of life,'' Ditto and colleagues write.

``What is less clear is the extent to which the majority of patients and surrogates desire this level of control and the relative value to assign to the goals of accurate surrogate decision making versus psychological benefits in future policy development,'' the authors conclude.

A pro-life alternative to living wills is available called the Will to Live. For more information, contact: National Right to Life, Attn: Will to Live, 419 7th St. NW, Suite 500, Washington, DC 20004.

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The Media's Deadly Bias on Assisted Suicide

Source: Washington Times; January 5, 2000

"The news media . . . often promote death as an answer to the serious problems of grave illness and disability . . . gullibly publishing false assertions of euthanasia advocates without checking the facts.

"A classic example was the episode on 'mercy killing' that aired on '60 Minutes,' a program that led, ironically, to Jack Kevorkian's undoing. Kevorkian videotaped himself as he murdered Thomas Youk, a man with Lou Gehrig's disease [amyotrophic lateral sclerosis or ALS]. He then took the tape to '60 Minutes' correspondent Mike Wallace, a vocal pro-euthanasia advocate.

"In the '60 Minutes' presentation, Kevorkian . . . tells the newsman that he killed Youk, with permission, to keep him from choking to death on his own saliva. Wallace accepted the excuse without blinking an eye . . . .

"ALS is indeed a devastating disease. Yet proper medical care prevents people with ALS from choking or suffocating. . . . Accurate information was just a phone call away. Yet Wallace, who became famous for his hard-hitting, acerbic interviews, apparently didn't bother to verify Kevorkian's assertions before airing the program."

-- Wesley J. Smith, from his new book, "Culture of Death: The Assault on Medical Ethics in America" --

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Not Dead Yet Opposes Media Coverage of "Mercy Killing" Case
Source: Not Dead Yet; January 16, 2002

Chicago, IL -- On January 16, seven representatives of Not Dead Yet, a national disability rights group, gathered at the Cook County Circuit Court in Bridgeview to sit in silent witness to the preliminary hearing of Thomas Harrison, who has been charged with first-degree murder in the shooting death of his wife, Shirley Harrison.

Disability activists are calling on local media to stop biased reporting of the murder of Shirley Harrison, who was killed while she lay in bed at Christ Hospital in Oak Lawn. Her husband has been charged in the murder.

Not Dead Yet, and other national disability rights groups, have been watching with growing anger and horror as the murders of disabled people of all ages have occurred with what seems like ever-increasing frequency.  The news coverage of these tragedies is also a cause for deep concern.  Accused murderers of disabled people are often portrayed by reporters as loving, caring individuals acting out of compassion. The Chicago media coverage of the Harrison murder is no exception to this trend.

Specifically, the coverage in the Daily Southtown and the Chicago Sun-Times has been disturbing to read. From the very first story in the Southtown, the speculations of unnamed police officers, neighbors, and a member of the clergy were quoted - all suggesting that Shirley Harrison was "suffering" and that her murder could be described as a "mercy killing."

The Sun-Times published quotes from unnamed police sources that suggest reporters may have actually suggested that police label this murder a "mercy killing." The Sun-Times recently published a series of articles on elder abuse and should know that it's unwise to rush to label murders of old, ill or disabled women as "mercy killings."

In fact, according to the prosecutors, Shirley Harrison did not ask to die.  She did not complain of suffering or pain. Her condition was expected to improve.

Domestic violence is all too common in our culture. If the victim of that kind of violence happens to be old, ill or disabled, that's no reason to assume the violence was an act of mercy. Shirley Harrison's last moments were spent looking at a gun pointed at her by a person she thought she could trust. It's hard to imagine a more horrible way to die. The murders of old, ill and disabled people need to be treated in the same way as any other murders - labeling these murders as understandable or excusable can encourage such killings - and deprive all other potential victims of the equal protection of the law and, perhaps their lives.

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Non-Voluntary Euthanasia Raises Serious Questions

Source: Charlotte Observer; January 10, 2001

By Diane Coleman

[Moderator's Note: Diane Coleman of Forest Park, Ill., is president of Not Dead Yet, a national disability rights organization.]

Should a guardian be permitted to withhold food and water from a conscious but incompetent person who is not terminally ill and did not ask to die?

Diane Arnder, mother of 29-year-old Tina Cartrette, has asked the North Carolina courts to give her the right to kill her daughter by removing a feeding tube that has provided the majority of her nutrition for several years. Cartrette has life-long physical and cognitive disabilities - disabilities with which many are unfamiliar, since medical professionals have so long recommended institutionalization as the treatment of choice, keeping severely disabled people out of sight and out of mind.

For those more familiar with disability issues, the media reports of Tina Cartrette's situation leave many unanswered questions. Accepting that Dianne Arnder loved her daughter the way most parents do who institutionalize their children, what kind of love spans the distance between them now, after 25 years living apart?

Did Arnder ever become aware of Geraldo Rivera's groundbreaking expose on substandard care, even atrocities, committed against residents of institutions? Did she hear about the many states that have closed all their institutions and moved residents into community settings with in-home support services?

How often did Arnder visit her daughter? Often enough to know whether poor quality of care might explain her joint contractures, and her recurring infections? Often enough to participate in federally mandated meetings to plan her care and discuss her options to move into a community setting?

Though many parents fight the system to enforce their child's rights, perhaps Arnder was kept uninformed. Her words suggest that she accepted the stereotypes about her daughter, and the antiquated institutional system, without question.

But sympathy for the mother, or ignorance about disability, institutions and their alternatives, should not confuse us about the central issue in this case: Is North Carolina prepared to throw out current legal constraints on non-voluntary euthanasia? Such a change could endanger hundreds of thousands of older and disabled people whose families quietly wish they would hurry up and die, including those of us, like Tina Cartrette, who otherwise have years of life ahead of us.

During the 1980s, a right to refuse unwanted extraordinary or "heroic" life-sustaining medical treatment was legally defined, a right initially to be applied only to conscious people deemed "mentally competent." The dangers of allowing other decision-makers - insurance companies, physicians, family members, state guardians - to engage in passive euthanasia seemed obvious at first.

Then, in 1990, in a case upholding a Missouri state law that placed limits on the rights of other decision-makers, the U.S. Supreme Court said that states have the right to ban, or legalize and regulate, such surrogate decision-making as a matter of privacy.

Like most states, North Carolina has decided that food and water by tube constitutes "medical treatment" that can be refused by guardians "on behalf of" an incompetent individual. This has been allowed even though many people in nursing homes and institutions are on tube feeding because there aren't enough staff to feed them, rather than for medical reasons. But the law limits this narrow right to kill by starvation to (a) people who used to be deemed competent and who legally documented or clearly expressed their wish to reject tube-feeding, or (b) people who were never deemed competent who are terminal or permanently unconscious.

Of course, many well-meaning family members may only wish for their ill or disabled relative to be released from suffering. But a major study by the National Center on Elder Abuse estimated 450,000 cases of elder abuse and neglect in 1996, and the majority of known perpetrators were close family.

It doesn't take a PhD in psychology to recognize just whose misery some family members would like to put their older or disabled relative out of.

Add to that a prevalent law enforcement problem: a disturbing pattern of societal failure to identify and prosecute elder homicide.

Are the North Carolina courts being asked, in effect, to decide that some older and disabled individuals are not "persons" entitled to equal protection of the law?

It's bad enough that disabled individuals and families are not getting the in-home support services they need, while the government pays more, on average, to keep individuals in nursing homes and other institutions, often against their will.

It's bad enough that insurance coverage is frequently denied for necessary care, and that doctors don't know or don't disclose important information to patients and families, including the physician's financial conflicts of interest in managed care.

It's bad enough that medical forms are boilerplate, that doctors' predictions are unreliable, and that many people's legal rights in the health care system are violated every minute of every day without

consequence.

What may look like compassion to some people looks more like contempt to many of us with disabilities who have too often heard that someone else thinks we would be better off dead.

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AMA:  5 Years of Assisted Suicides is Too Long

Source:   AMA News; April 21, 2003

[The following op-ed written on behalf of the American Medical Association appears in the April 21st edition of the AMA News, the group's publication.]

Oregon marked a somber anniversary last month when officials released the fifth annual report on physician-assisted suicide under the state's Death with Dignity Act.

For those who believe, as the AMA does, that physician-assisted suicide is fundamentally inconsistent with a physician's professional role, the report is troubling.

While the number of actual suicides under the law remains relatively small -- 38 in 2002 -- that number is more than double the 16 suicides that occurred in 1998, the first year the law was
in place.

Also troubling, as it has been in the past, is the report's findings on the reasons people contemplate physician-assisted suicide.

It would be easy -- and, many would say, understandable -- if intractable pain, a traditional rallying cry for assisted suicide, was at the forefront. Not so. It came in, as it typically does, very near the bottom of the list. Instead, the main reason has remained constant: loss of autonomy.

Joining it at the top of the list are concerns over decreasing ability to participate in the activities that make life enjoyable, losing control of bodily functions and becoming a burden on family, friends or caregivers. 

This represents both a tragedy and a challenge for the medical profession and for society. A dignified and pain-free end of life -- without perverting medicine's mission -- is achievable. The
medical profession needs to do its share, both clinically and in terms of advocacy, to ensure that dying patients are provided optimal treatment for these discomforts, physical or emotional.

With at least two more states contemplating legalization of assisted suicide, it is important that the future debate not surrender to the failure represented by each deadly prescription.

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Pro-Life Analysis of Oregon's Assisted Suicide Cases

Source: National Conference of Catholic Bishops; February 23, 2001

Comments by Richard M. Doerflinger; Associate Director for Policy Development; Secretariat for Pro-Life Activities; National Conference of Catholic Bishops

Re: Oregon's Third Year of Physician-Assisted Suicide

Today's report from the Oregon Health Division on legally permitted physician-assisted suicides in 2000 provides no adequate information on abuses of the state's guidelines, and is not designed to do so. The 27 assisted suicides reported for this third year of Oregon's 'experiment' in lethal medicine are simply those cases which the physician-perpetrators themselves chose to report. The total number of actual cases, not to mention the number of times various 'safeguards' were distorted or simply ignored, remains concealed in the name of physician-patient confidentiality.

However, even the data released by physicians who assist suicides are disturbing enough. Twenty-seven Oregonians died last year from lethal overdoses of controlled substances deliberately prescribed by physicians, who invoked prescribing privileges granted to them by our federal Drug Enforcement Administration. The most significant changes compared to the previous year are as follows:

• A startling 63% of these patients (compared to 26% in 1999) cited fear of being a 'burden on family, friends or caregivers' as a reason for their suicide. Some patients and families are learning all too well the deeper message of Oregon's law: terminally ill patients have received this special 'right' to state-approved suicide not because they are special in any positive way, but because they are seen as special burdens upon the rest of us.
• 30% cited concern about 'inadequate pain control' as a reason for their death (compared to 26% the year before), despite claims by the Oregon law's defenders that legalizing assisted suicide would improve pain control and eliminate such concerns.
• Also rising is the percentage of victims who were married (67%, up from 44%) and who were female (56%, up from 41%). It seems some older married women in Oregon are receiving the message that they are a 'burden' on their husbands, and then acquiescing in assisted suicide.
• Despite a medical consensus that the vast majority of suicidal wishes among the sick and elderly are due to treatable depression, in only 19% of these cases (compared to 37% the previous year) did the doctor bother to refer the patient for a psychological evaluation.
• The median time between a patient's initial request for assisted suicide and his or her death by overdose also decreased markedly, from 83 days to 30 days. Oregon's experiment is taking on more of the features of an assembly line.

These signs of the 'slippery slope' in action, illustrating trends predicted by critics of the Oregon law, underscore the need to end this state's experiment before it claims more lives.

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'Duty' to Die Emerges in Oregon
Source: Focus on the Family; January 27, 2002

Washington, DC -- What happens when you give people the option to commit suicide? Very quickly, the so-called "right to die" turns into a "duty to die." Case in point: Oregon.

Oregon became the first state in the union to legalize physician-assisted suicide in 1997. Now, a survey from Oregon contains a shocking discovery:  Sixty-eight percent of those who died by physician-assisted suicide feared
being a burden on their family.

Burke Balch, director of medical ethics for the National Right to Life Committee, said that number is alarming.

"This is a dramatic increase over previous years, when it was about 12 percent and then about 26 percent," Balch said. "So, what we're seeing is that over time this 'right' of assisted suicide which was sold as a matter of personal choice becomes more and more a matter of vulnerable people thinking that they have a 'duty to die' and get out of the way."

He continued: "This is the sort of culture of death, the sort of lack of caring that is manifesting itself in accepting death as a solution to human problems."

Rita Marker, who heads the International Anti-Euthanasia Task Force, said while proponents of assisted-suicide laws claim to be offering a "choice," they're really leaving the aged and infirm with an obligation.

"Then you have someone who merely offers the option of saying, 'Well, you know you could get this prescription. You could get help,' " Marker said.

"And that 'help' is in the form of a deadly overdose of drugs. Well, then there's the question of 'Would that be better for everybody else?"

And that's not a "choice" anyone should have to make.

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Pain Relief Promotion Act to Wait for Next Congressional Session
Source: Portland Oregonian; December 16, 2000

Washington, DC -- Oregon's law allowing assisted suicide remained intact as Congress closed the doors on its 106th session Friday. But it will face a challenge again from pro-life legislation next year and the pro-life bill should receive increased support from the Bush administration.

The Oregon law had been a target of the Pain Relief Promotion Act, sponsored by pro-life Sen. Don Nickles (R-OK). The pain relief bill would have prohibited doctors from prescribing lethal doses of drugs covered by the Controlled Substances Act for use in assisted suicides.

The pain relief bill passed the House in October 1999, and as recently as August it appeared headed toward easy passage in the Senate. But a determined lobbying effort by pro-assisted suicide Sen. Ron Wyden (D-OR) prevented it from coming to a floor vote before adjournment.

"I'm very proud to be able to announce that with the dust settling on the 106th Congress, an important battle has been won to preserve Oregon's vote on the matter of physician-assisted suicide," Wyden said.

Assisted suicide advocates hailed Friday's development as a reprieve. Many have expressed concern that the pain relief bill would make doctors reluctant to prescribe large doses of painkilling drugs for fear of investigation by federal agents.

Nickles has said the effect of the pain relief bill would be to assure doctors that pain control is an appropriate use of federally controlled drugs. The American Medical Association, National Hospice Association and, in Oregon, Physicians for Compassionate Care, agree.

"We want to make sure people know they can use these very strong drugs to alleviate pain -- not for suicide, but to alleviate pain," Nickles said earlier this week.

If Nickles tries again to pass the pain relief bill in the 107th Congress, which convenes Jan. 3, he'll face a considerably tougher task. 

Republicans, who provided the bulk of his co-sponsors, lost four seats in the election. Meanwhile, Wyden has persuaded influential Democrats to withhold support.

The next hurdle for the Oregon law likely will be a challenge from the incoming Bush administration. As a candidate, Bush said language in the Controlled Substances Act prohibits doctors from prescribing listed drugs for assisted suicide.

"First of all, in principle, I'm against physician-assisted suicide and, secondly, I believe it is the prerogative of the federal government to control drug rules," Bush told The Oregonian in May.

Assuming that the person who becomes U.S. attorney general enforces Bush's view of the Controlled Substances Act, a showdown in federal court is likely, observers said.

A judge would have to answer one central question: What was Congress' intent when it passed the act 30 years ago? 

Backers of Oregon's assisted-suicide law say Congress had no intention of allowing federal drug agents to investigate doctors or to intervene in regulation of the medical profession, a responsibility usually left to the states.

"No one reading the Controlled Substances Act would derive that meaning from it," said Barbara Coombs Lee, who heads Compassion in Dying Federation, a Portland-based assisted suicide advocacy group.

But opponents of the Oregon law say assisted suicide is not recognized by the Controlled Substances Act as a "legitimate medical practice" for which listed drugs can be prescribed.

That interpretation was first articulated in 1997 by Thomas Constantine, then head of the Drug Enforcement Administration. It since has been embraced by proponents of Nickles' pain relief bill, including Sen. Gordon Smith (R-OR) and Bush.

"It is the proper role of the federal government to regulate controlled substances," Bush said in May. "That's been around a lot longer than the Oregon vote."

Observers in Oregon said the Bush administration could challenge the Oregon law in several ways. They include: 

•  Issuing formal instructions to the U.S. Attorney in Portland to begin
  prosecuting Oregon doctors who use the assisted-suicide law.
• Following the formal rule-making process to make official Constantine's
  reading of the Controlled Substances Act. This textbook approach would
  require public hearings that might create unwanted controversy for a new
  administration.
  
•  Instructing the Drug Enforcement Administration to issue administrative
  sanctions against offending doctors rather than prosecuting them as
  criminals. Some officials say this option would most appeal to Bush
  because it would deter doctors from using the law without raising the
  prospect of an emotional criminal trial.
• 
  Kris Olson, U.S. attorney in Portland, said she thinks they will proceed
  administratively at first. Nevertheless, Oregon Attorney General Hardy
  Myers is prepared to defend the assisted-suicide law in court, said David
  Schuman, his deputy. The state would try to prove that Congress had no
  intention of addressing the question of assisted suicide when it passed
  the Controlled Substances Act.
• For now, the Oregon law remains viable because of a 1998 opinion from
  Attorney General Janet Reno in which she overruled Constantine's
  interpretation.

"Until something happens and nullifies that, that is the law of the land," Lee said.

As prospects for his bill dimmed this week, Nickles took solace in the hope that Bush's attorney general would act promptly.

"I think a correct interpretation from the Justice Department and the Drug Enforcement Administration corrects the mistake that the attorney general made," Nickles said.

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Pope-Church Can't Be Silent in Face of Legal Euthanasia, Pope Says
Source:   Zenit; October 29, 2002

Vatican City -- John Paul II warned about the dangers of euthanasia, when he received the new Belgian ambassador to the Vatican. Belgium is the second country, after the Netherlands, to legalize this type of killing.

In his address today to career diplomat Benoit Cardon De Lichtbuer, 60, the Pontiff said that man, "created by God and called to share in his divine life, has always been at the center of the Christian vision of the world and that this is why the Church respects and defends life."

"How can she silence her great anxiety and reprobation in the face of laws recently voted on in different countries which legalize active euthanasia?" the Holy Father asked.

"In a society, in which all too often it seems that only good health and profitability matter, it is necessary to see weak persons or those at the end of life with other eyes; in particular, by applying and developing palliative care for all patients whose situation calls for it," he added.

This care "makes possible the relief of pain and supports in dignity those who are going to die," the Pope explained.

"Recognition of the sacred character and the inviolability of every human person, conferred by the Creator, is, in fact, the only authentic defense against ever possible violation of their dignity," the Holy Father stressed.

He added: "A society that would run the risk of challenging these principles, would expose itself to far graver dangers, in particular, to making the right of persons and fundamental values depend solely on consensus, which is ever changing."

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Study Says More Palliative Care Needed for the Dying

by Steven Ertelt
LifeNews.com Editor
July 14, 2003

New York, NY (LifeNews.com) -- A new study says patients who seek help from their doctors to hasten death are in significant physical pain and discomfort. Dr. Diane Meier, lead author of the study that appears in the July 14 issue of the Archives of Internal Medicine, says the finding shows an increased need for palliative care.

"It is physicians feeling that they have no other means of responding than refusing or agreeing to honor assisted suicide," Meier, director of the Center to Advance Palliative Care at the Mount Sinai School of Medicine in New York City, told HealthDayNews.

If nothing more is done to address pain control for patients, Meier said the country is in danger of having more states that, like Oregon, have legalized assisted suicide. However, Meier says doctors have the ability to do a better job at providing palliative care.

Bills regarding assisted suicide were introduced in four states this year. Three of the bills (in Arizona, Hawaii and Vermont) called for legalizing the objectionable practice, while a North Carolina bill (introduced by two physician legislators) called for banning it. None of the bills advanced.

David Goldberg, spokesman for the pro-assisted suicide Hemlock Society, disagrees with the findings.

"The vast majority of individuals who have made a request for physician-aided death under Oregon's law are not in severe pain or physical discomfort," he says.

Caren Kossin, who has been diagnosed with ovarian cancer, says palliative care programs can be especially helpful.

"They've made a difference," Kossin said. "They're willing to listen to any sort of problem that I have, anything that's bothering me -- because it's not just the cancer, your whole life changes."

Kossin said this treatment gave her the support she needed. "When you have a serious illness, it's very important to get this type of support. It gives you hope."

The study received responses from 1,920 physicians across the country and were in such specialized fields involving care for the seriously ill, including oncology, cardiology, family practice and pulmonary critical care.

Of the 1,902 respondents, 379, or approximately 20%, described 415 instances of being asked to help a patient die and refusing that request. Some 80 physicians they honored the request.

The latest figures from Oregon reveal that 30 patients ended their lives in 2002. Between 1998 and 2001, 91 people legally took their own lives in Oregon.

Patients who had asked for help in dying were mostly male (61 percent), 46 to 75 years old (56 percent), of white European descent (89 percent), Christian (78 percent), middle class (71 percent), and college graduates (50 percent).

About 47 percent had been diagnosed with cancer, 38 percent were experiencing sever pain, 42 percent experiencing other discomfort. More than half (53 percent) were dependent, 42 percent were bedridden and 28 percent were expected to live less than one month.

Forty-nine percent of the patients asking for help in dying were depressed. About half (52 percent) specifically requested a lethal prescription while 25 percent requested a lethal injection.

Of the 80 requests honored, 32 were for prescription drugs (40 percent), 43 for injections (54 percent) and five did not specify (six percent). Specific requests were more likely to be honored, the researchers found.

Meier says the focus on treating pain has been removed in medical school training. She said she completed nine years of medical school and never once had a lecture on how to help patients control pain.

"There was no attention to treatment of shortness of breath or agitation or issues of family burden and family support," she told HealthDayNews. "It wasn't on the radar screen. The only things on the curriculum had to do with pulling people back from the brink of death. We have a medical education that is stuck in the past."

Polls show support for assisted suicide is on the decline.

The latest Gallup poll, which measured Americans' views on "morally acceptable" and "morally wrong" conduct, indicates that support for assisted suicide is ebbing. "Doctor assisted suicide" is losing moral support -- from moral to immoral, with 49 percent of those polled now viewing PAS as "wrong" and only 45 percent considering it "acceptable."

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