Pro-Euthanasia Group Again Promoting Assisted Suicide
in 2008 Washington State Ballot Initiative
By Jennifer Popik
“Compassion & Choices,” the major organization leading efforts to legalize physician-assisted suicide in the United States, is targeting the state of Washington again in 2008. With the help of popular former governor Booth Gardner and a well-funded campaign, the organization is even now attempting to gather the signatures needed to place an initiative on the ballot. If the group can gather 225,000 signatures by July, the proposal will be voted on the Election Day ballot in 2008.
Compassion & Choices is the product of a 2005 merger of “Compassion in Dying” and “End of Life Choices.” End-of-Life Choices started out as Derek Humphry’s Hemlock Society.
In 1994, Oregon became the first state to legalize it, transforming the crime of assisting suicide into a “medical treatment.” There have been nearly 100 failed attempts at euthanasia legalization since.
Proposals patterned on Oregon’s law have been introduced in 22 states—in many states, multiple times. Each has failed, thanks to a diverse mix of groups. A coalition of pro-life, disability, and medical groups are again gearing up for the coming battle.
There have been previous efforts to legalize physician-assisted suicide in Washington, including a prior ballot initiative in 1991. But the current campaign poses a unique threat.
Booth Gardner was governor between 1985 and 1993. Gardner, 71, now has Parkinson’s disease. As a profile in the New York Times Magazine recently put it, Gardner’s “last campaign is driven by his desire to kill himself.” Gardner is putting his considerable popularity and significant fortune behind the campaign.
Further, Compassion & Choices is emphasizing new euphemisms in its marketing campaign. The group is attempting to re-brand physician-assisted suicide as “physician-assisted death,” “physician aid in dying,” and “hastened death.”
While disingenuous, the new verbiage is effective. Polls show that people are more likely to approve legalizing the practice when the word “suicide” is not used in the description.
Another cause for concern is that since the previous Washington referendum lost 54% to 46%, there has been plenty of time for the pro-assisted-suicide forces in neighboring Oregon to advertise Oregon as a physician-assisted suicide “success” story. Because of the virtually identical nature of the Washington initiative and the Oregon law, it is essential to take a hard look at what has been going on in Oregon over the past 10 years.
Public knowledge of the full extent of abuses that have occurred in Oregon is limited. The state conducts no independent reviews of assisted suicide deaths. Moreover, the published data cited by assisted suicide advocates is based primarily on information provided by death-prescribing doctors.
Yet the stories that have filtered out show a dangerous situation on the ground, one in which touted safeguards are failing or are being ignored.
One of the most troubling cases was reported by The Oregonian. Kate Cheney, an 85-year-old woman with dementia, was evaluated by one psychiatrist who diagnosing her as cognitively impaired and therefore ineligible for assisted suicide. The psychiatrist noted that her family appeared to be pressuring her.
Easily skirting this “safeguard,” her family shopped around for another opinion. Although the second psychologist wrote that the patient could not remember that she had cancer, and that the patient’s “daughter … may be somewhat coercive,” he nonetheless said she was competent, according to The Oregonian. Kate Cheney was prescribed the lethal pills, took them, and died.
In another case described in a 2007 Portland Tribune article, two nurses, Rebecca Cain and Diana Corson, intentionally gave Wendy Melcher a fatal drug overdose. Despite the fact that under Oregon law only a physician can prescribe lethal medication, the nurses were allowed to keep their licenses, facing only suspension and probation.
Cain told investigators that she had “administered excessive morphine because she believed [Melcher] to be in uncontrollable pain.” Yet records show that Cain recorded no mention of Melcher’s intolerable pain prior to the day she administered the morphine overdose. Rather than notify the hospice pain management team so that the patient’s pain could be controlled, Cain administered the drugs herself, according to the Portland Tribune. Apparently Melcher was not a candidate for legal physician-assisted suicide as she could not swallow the lethal drugs and her life expectancy might not have been long enough to go through the “informed consent” waiting period mandated by the law.
The Washington initiative would require the attending physician to inform the patient of feasible alternatives including comfort care, hospice care, and pain control. But, in practice, would doctors do better than Cain and Corson in offering adequate pain management as a possible alternative?
A study in a recent issue of Annals of Oncology found that cancer patients are suffering unnecessarily because physicians inaccurately assume that morphine and other opioids ought only to be offered as a “last resort.” The study further noted that as many as 70% of cancer patients may not have their pain properly controlled.
While Oregon’s law requires the collection of compliance information from lethal drug-prescribing doctors, a recent 2007 study published in the New England Journal of Medicine estimated that physicians only file required reports about 80.2% of the time. When questioned about why they had not reported all deaths, the doctors responded with some unsettling reasons.
For 76.1% of these cases, physicians said that they had not perceived their act as the ending of life. Other reasons given were that the physician had doubts about whether the criteria for careful practice had been met (9.7%) or that the physician regarded the ending of life as a private agreement between physician and patient (6.6%).
The Oregon experience has demonstrated the dangers of legalizing physician-assisted suicide. Despite “safeguards,” the day-to-day practice of assisting-suicide has been difficult or impossible to control, and continues to pose serious risks to many of our most vulnerable citizens.