Saturday, February 10, 2018

HB 2218 & HB 2736 (Evans & Ruderman) Purported Protections Negated by Other Bill Provisions; Not Enforceable.

HB 2218 &  HB 2736, seeking to legalize assisted suicide and euthanasia in Hawaii, contain purported patient protections such as a the participation of a second doctor and waiting periods.[1] The bills, however, also hold doctors that the attending provider is merely to ensure that all “appropriate” steps are carried out.[4] In addition, the provider is held to an “accordance” standard. The bill states:
The attending provider shall: . . .
(11) Ensure that all appropriate steps are carried out in accordance with this chapter . . . .  (Emphasis added).[5]
The bill does not define “accordance.”[6] Dictionary definitions include “in the spirit of,” meaning “in thought or intention.”[7] With these definitions, the attending provider’s mere thought or intention to comply is good enough. The purported safeguards are unenforceable.

Footnotes

[1]  HB 2739, § 1, p.2, lines 11-12.
[2]  Id , p.3, lines 14-16.
[3]  The bill§ 4,  p. 9, line 13 to p. 11, states:
(a) The attending provider shall: . . . 
(4) Refer the patient to a consulting provider for medical confirmation of the diagnosis, and for a determination that the patient is capable and acting voluntarily; . . . [and]
(8) Inform the patient that a qualified patient may rescind the request at any time and in any manner, and offer the qualified patient an opportunity to rescind at the time of the qualified patient's second oral request made pursuant to section - 9 . . . . (Emphasis added).
[4]  The bill, § 4, states::
(a) The attending provider shall: . . .  
(11) Ensure that all appropriate steps are carried out in accordance with this chapter . . . . 
[5]  Id., § 4
[6]  See the bill in its entirety.
[7]  See definitions of "accordance" and "in the spirit of," here and here. 

Thursday, February 8, 2018

Update: Touted Safeguards Are Neutralized; Unenforceable

Margaret Dore, Esq.
By Margaret Dore, Esq., MBA

HB 2739 seeks to legalize assisted suicide and euthanasia as those terms are traditionally defined. The bill also promotes itself as having “robust" safeguards.[1] Indeed, the bill goes so far as to say that its "rigorous safeguards would be the strongest of any state in the nation and will thoroughly protect patients and their loved ones from any potential abuse."[2]

The purported safeguards are enumerated and include that the attending provider “shall” refer the patient to a consulting provider, and that the attending provider “shall” offer the patient an opportunity to rescind the lethal dose request.[3]

The bill, however, also says that the attending provider is merely to ensure that all “appropriate” steps are carried out, and that the provider is held to an “accordance” standard. The bill, 
§ 4, states:

The attending provider shall: . . .
(11) Ensure that all appropriate steps are carried out in accordance with this chapter . . . .  (Emphasis added).[4]
The bill does not define "appropriate" or “accordance.”[5] Dictionary definitions of appropriate include "suitable or fitting."[6] Dictionary definitions of accordance include “in the spirit of,” meaning “in thought or intention.”[7] 

With these definitions, the attending provider’s mere view of what is "suitable or fitting" is enough for safeguard compliance. The provider's mere "thought or intention" is similarly sufficient. The touted safeguards are thus neutralized to whatever an attending provider happens to feel is appropriate and/or had a thought or intention to do. They are unenforceable.

pain post

D.  The Oregon Statistics Provide Little, If Any, Support for the Idea That the Passage Is Needed Due to Physical Pain

I am not aware of any case in which Oregon’s law has been used for physical pain.  According to Oregon’s most recent annual report, there were 47 people who died under the law in 2016 who expressed the following concern:

Inadequate pain control or concern about it. (Emphasis added).[63]

With use of the word, “or,” the total number of persons who had inadequate pain control could be zero.  In the alterative, the total number could be as high as 47.
If, for the purpose of argument, all 47 had inadequate pain control, this would be 47 people out of approximately 35,000 deaths in Oregon, which is far less than one percent (.127%) and/or not statistically significant.[64]
The Oregon statistics provide little, if any, support for the idea that passage of the bill is needed due to physical pain.  The argument is not supported by the evidence.

http://www.choiceillusionaustralia.org/2017/11/margaret-dore-analysis-opposing.html