New England Journal of Medicine Article Misleading

Dear Editor:

I am a lawyer in Washington State, one of two states where assisted-suicide is legal.  The other state is Oregon, which has a similar law.  Lisa Lehmann's article, "Redefining Physicians' Role in Assisted Dying," is misleading regarding how these laws work.

First, the Oregon and Washington laws are not limited to people in their "final months" of life.[1,2]  Consider for example, Jeanette Hall, who in 2000 was persuaded by her doctor to be treated rather than use Oregon's law.  She is alive today, twelve years later.[3]

Second, these laws are not "safe" for patients.[4][5]  For example, neither law requires a witness at the death.  Without disinterested witnesses, the opportunity is created for the patient's heir, or someone else who will benefit from the patient's death, to administer the lethal dose to the patient without his consent.  Even if he struggled, who would know?  

Third, the fact that persons using Oregon's law are "more financially secure" than the general population is consistent with elder financial abuse, not patient safety.  Do not be deceived. 

* * *

[1]  Margaret K. Dore, "Aid in Dying: Not Legal in Idaho; Not About Choice," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 18-20, September 2010, available at http://www.margaretdore.com/pdf/Not_Legal_in_Idaho.pdf.
[2]  Kenneth Stevens, MD, Letter to the Editor, "Oregon mistake costs lives," The Advocate, official publication of the Idaho State Bar, Vol. 52, No. 9, pages 16-17, September 2010, available athttp://www.margaretdore.com/info/September_Letters.pdf 
[3]  Ms. Hall corresponded with me on July 13, 2012.
[4]  See article at note 1.  See also Margaret Dore, "Death with Dignity": A Recipe for Elder Abuse and Homicide (Albeit Not by Name)," at 11 Marquette Elder's Advisor 387 (Spring 2010), original and updated version available at http://www.choiceillusion.org/p/the-oregon-washington-assisted-suicide.html 
[5]  Blum, B. and Eth, S.  "Forensic Issues: Geriatric Psychiatry." InKaplan and Sadock's Comprehensive Textbook of Psychiatry, Seventh Edition, B. Sadock and V. Sadock editors.  Baltimore, MD: Lippincott, Williams and Wilkins, pp. 3150-3158, 2000. 

Suicide Predator Conviction Upheld

Appeals Court upholds nurse's aiding suicide conviction

by Amy Forliti, Associated Press 

July 17, 2012

[To for more information, charging document click here]

[To link to Nadia's Light, click here]

http://minnesota.publicradio.org/display/web/2012/07/17/news/melchert-dinkel-aiding-suicide-conviction/

MINNEAPOLIS (AP) — The Minnesota Court of Appeals on Tuesday affirmed the convictions of a former nurse who scanned online chat rooms for suicidal people then, feigning compassion, gave a British man and a young woman in Canada instructions on how to kill themselves. 

William Melchert-Dinkel, 49, of Faribault, acknowledged that what he did was morally wrong but argued he had merely exercised his right to free speech and that the Minnesota law used to convict him in 2011 of aiding suicide was unconstitutional. 

The appeals court disagreed, saying the First Amendment does not bar the state from prosecuting someone for "instructing (suicidal people on) how to kill themselves and coaxing them to do so." 

Melchert-Dinkel's attorney, Terry Watkins, was not immediately available for comment.

Court documents show Melchert-Dinkel searched online for depressed people then, posing as a female nurse, offered step-by-step instructions on how they could kill themselves.

Melchert-Dinkel was convicted last year of two counts of aiding suicide in the deaths of 32-year-old Mark Drybrough, of Coventry, England, who hanged himself in 2005; and 18-year-old Nadia Kajouji, of Brampton, Ontario, who jumped into a frozen river in 2008.

He was sentenced to more than six years in prison but the terms of his parole meant he would only be imprisoned for about a year. His sentence was postponed pending his appeal, but at the time of sentencing, he was told that if his convictions were upheld, he'd have seven days to report to jail.

In arguing to overturn the conviction, Watkins said his client didn't talk anyone into suicide but instead offered emotional support to two people who had already decided to take their lives.

Assistant Rice County Attorney Benjamin Bejar had argued that Melchert-Dinkel wasn't advocating suicide in general, but had a targeted plan to lure people to kill themselves. Prosecutors have said he convinced his victims to do something they might not have done without him.

Bejar said Tuesday that prosecutors were pleased with the decision.

In a statement read at his sentencing last year, Melchert-Dinkel said he was sorry for his role in the suicides and that he realized he had rejected a unique opportunity to talk his victims out of killing themselves.

Melchert-Dinkel's nursing license was revoked in 2009

Washington State Annual Report: No Information about Consent

Margaret Dore

Washington assisted suicide act was enacted via a ballot initiative in 2008 and went into effect in 2009.[1]  During the election, proponents claimed that its passage would ensure individuals control over their deaths.  A glossy brochure declared, "Only the patient — and no one else — may administer the [lethal dose]."[2]  The Act, however, does not say this anywhere.

Today, the Washington State Department of Health issued its annual report about Washington's act.[3]  That report, similarly, does not demonstrate that individuals are in control. The report provides no information as to whether the people who died under the act consented and/or acted voluntarily at the time of death.  The report instead talks about "ingestion" of the lethal dose.  A drug can be "ingested" while a person is asleep, sedated and/or not aware of his or her surroundings.

For more information about Washington's act, See Margaret Dore, "'Death with Dignity': What Do We Advise Our Clients?," Bar Bulletin, May 2009.[4]   

* * *

[1]  Washington's act was passed by in November 2008 as Initiative 1000 and has now been codified as RCW chapter 70.245.

[2]   I-1000 color pamphlet, "Paid for by Yes! on 1000."

[3]  See News Release here and report here.

[4]  Further information can be viewed here.

Not Dead Yet: A Deeper Look at Elderly Homicide-Suicides

From Not Dead Yet:  "[S]ociety cannot lose sight of the fact that a person's life was taken, often without their consent." 

May 1, 2012

Last September, this blog discussed an article from a Pennsylvania newspaper that took a thoughtful, in-depth look at the tragically growing trend of elderly homicide/suicides.  When that story was written, there had been three such cases in the state since June of that year.

The number is now up to at least 6 in the last year.  Terrie Morgan-Besecker takes another in-depth look at elderly homicide/suicides and interviews a number of people about the larger picture (including me) to get beyond the 'mercy killing' theme that dominates the coverage of these tragedies.

An excerpt that includes a bit from my interview is below.  From TheAbington Journal, here is a sample of 'Loved to Death': 

But researchers who have studied murder-suicides among the elderly say they're troubled by society's tendency to view such deaths as mercy killings.

"One of the concerns is you don't want to make it sound like it's a viable thing to do," said Sonia Salari, a professor in the Department of Family and Consumer Studies at the University of Utah."  If we romanticize it, it makes it sound like it's OK."

Statistics regarding the number of elderly murder-suicides committed each year are difficult to come by, as no agency specifically tracks that category of deaths, Salari said.

In a 2005 study, Salari analyzed 225 intimate partner murder-suicides involving couples where either the victim or perpetrator was at least age 60. She gathered the data from news reports, police reports and obituaries published from 1999 to 2005.

The research showed that in 55 percent of the cases, health issues   involving either the victim or perpetrator were cited as a contributing factor. Approximately 7.5 percent of the victims had some sort of dementia.

Compassion or murder?

Salari said that, while she sympathizes with survivors who view the deaths as an act of compassion, society cannot lose sight of the fact that a person's life was taken, often without their consent.

"Some people don't consider it domestic violence, but we need to see it as that," she said. "You have two deaths. Most of the time the victim is not in on the plan."

Stephen Drake, a spokesman for Not Dead Yet, a nonprofit group that opposes assisted suicide laws, also expressed concern over how murder-suicides among the elderly are viewed.

"These are acts usually of desperation, not compassion," he said. "These are people who are feeling depressed or overwhelmed. It's often a consequence of an emotional crisis."

Please read the rest of the article here.  --Stephen Drake 

Dore v Morris: Assisted suicide debate deals with abuse, compassion

http://www.kamloopsnews.ca/article/20120419/KAMLOOPS0101/120419759/-1...

Lawyer cautions against legislating through courts

By Mike Youds, Daily News Staff Reporter
 

Margaret Dore (L) and Wanda Morris (R)

A right to medically assisted suicide may sound compassionate and just, but beware the details when it comes to the act itself, a U.S. lawyer warned Wednesday in a debate at TRU.

Margaret Dore shared some of her experiences with assisted suicide in Washington State, where the practice became legal through a ballot measure four years ago.

 "A lot of people think this is a great idea until they start thinking and reading about how you do it," she told an audience of about 30 people in the Irving K. Barber Centre.

In effect, laws in Washington and Oregon empower people who may choose to abuse the responsibility, Dore said.

"Your heir can be there to help you sign up. Once the legal dose leaves the pharmacy, there is no oversight whatsoever."

Hawai'i Teen Sounds Off on Teen-Assisted Suicide Link

Hawaii Free Press
Letter to the Editor

Dear Editor:

As a teenager, legalizing assisted suicide is concerning to me because it seems to counteract the positive messages teens need to hear. According to the US Centers for Disease Control and Prevention, Hawaii ranks number one with the highest prevalence of high school students who have considered suicide. How can we prevent and discourage teen suicides if we pass legislation condoning ending one’s life in certain circumstances? It seems hypocritical to me to tell teenagers to “choose life” and not give up, while permitting other people to end their lives. Read more

Legal Assisted Suicide Does NOT Reduce Murder Rate

http://www.hawaiifreepress.com/ArticlesDailyNews/tabid/65/articleType/ArticleView/articleId/6439/Letters-to-the-Editor-April-2012.aspx

Dear Editor: 

Chad Blair's Civil Beat article, "A Conversation About Aid in Dying in Hawaii," implies that legalizing physician-assisted suicide would eliminate murder-suicide in the elderly.

In Oregon, where assisted-suicide has been legal since 1997, murder suicide has not been eliminated. Indeed, murder-suicide follows the national pattern. Moreover, according to Donna Cohen, an expert on murder-suicide, the typical case involves a depressed, controlling husband who shoots his ill wife: "The wife does not want to die and is often shot in her sleep. If she was awake at the time, there are usually signs that she tried to defend herself."


If assisted suicide were legal, the wife, not wanting to die, would still be a victim.

Our laws against assisted suicide are in place to protect vulnerable people. To learn more about problems with legalizing assisted suicide, please see www.hawaiiagainstassistedsuicide.org.

For more in depth information, see Dominique Bourget, MD, Pierre Gagne, MD, Laurie Whitehouse, PhD,"Domestic Homicide and Homicide-Suicide: The Older Offender," Journal of the American Academy of Psychiatry and the Law, September 2010; Don Colburn, "Recent murder-suicides follow the national pattern," The Oregonian, November 17, 2009; and “Murder-suicides in Elderly Rise: Husbands commit most murder-suicides –without wives’ consent” at WebMD.

Janet M. Grace

Hawaii Against Assisted Suicide & For Living with Dignity

www.hawaiiagainstassistedsuicide.org