NH has an assisted suicide bill (again); time to say no (again)

[An earlier version of this post had an incorrect time for the hearing.]

What better way to kick off February than with a life-issues extravaganza? That was apparently the thought somewhere in the State House when the the legislative calendar for the coming week was devised. And just to make things more interesting, the Powers that Be scheduled the House hearing for an assisted suicide bill the same time as a hearing on the fetal homicide bill: 1:30 p.m. this Tuesday, February 4 in the Legislative Office Building. I’ll be there. Sprinting between rooms 204 and 208 is not that hard.

The sponsors for assisted suicide legislation come and go, but the goal never changes: death on demand, as as a corollary, put to rest the silly notion that medicine is a healing art. This year’s bill is HB 1325. Text is here, complete with list of sponsors, led by Joel Winters of Concord.

On my desk, I have an inch-thick binder full of my notes and copies of old New Hampshire legislation on assisted suicide. The oldest bill I have is HB 339 from 1995. Do you know how much difference there is between the statement of purpose in the 1995 bill and the one in 2014? None. How about the difference in what the two bills define as “terminal condition”? Again, none.

Stephen Drake of the Not Dead Yet, a disability-rights group, wrote recently about this year’s New Hampshire bill in New Hampshire Assisted Suicide Bill Redefines “Terminal Condition” Broadly Enough to Make Anyone With a Significant Disability or Chronic Condition Eligible.

“[In the bill] ‘Terminal condition’ means an incurable and irreversible condition, for the end stage of which there is no known treatment which will alter its course to death, and which, in the opinion of the attending physician and consulting physician competent in that disease category, will result in premature death.

Read that definition carefully, terminality is defined as having a condition that is irreversible and will result in a premature death. My partner would fit that definition. Many people I work with also fit the definition.

None of them are dying.

Keep in mind that this definition is to be used only in terms of eligibility for assisted suicide. It doesn’t, for example, apply to hospice services which are limited by federal rules to those who are deemed as having six months or less to live.

So, no guarantee of palliative care for people with significant disabilities or conditions, unless they’re thought to be close to death. That would be expensive.

OTOH, this bill would offer help with easy and successful suicide for anyone with a serious, significant, potentially life-shortening condition/disability at any time at all.

So, no guarantee of medical support to make life easier, but a ‘hand out’ to those who want to die, even if they’re not dying.”

I’ve been involved in right-to-life work for too long to believe any longer that medicine is a healing art. The fact that assisted suicide hearings are not overrun by angry health care professionals – everyone from medical technicians to M.D.’s – speaks volumes.

I firmly believe that legalizing medical murder will be a huge disincentive to the development of effective palliative care strategies. The cheaper strategy will prevail, particularly in a government-run health care environment. Alleviating pain can be a complex, multispecialty endeavor. Compare that to the cost of a lethal-dose prescription.

I’ve been with a loved one who was dying in pain. In 2009, my mother died three excruciating weeks after taking a fall on an icy driveway and then being alone and helpless for an estimated 30 to 60 minutes. She was in poor health to begin with. The injury set off the failure of one organ after another, and she hung on as long as she did only because she didn’t want to leave her husband, my stepdad. It took three weeks for her body to get the better of her iron will. Those three weeks gave me plenty of time to consider how it feels to watch a loved one in pain. It also gave me plenty of time to consider how much less care she’d have gotten if prevailing medical wisdom had been about killing instead of caring.

She died in a hospice bed, where she belonged. Somewhere on a balance sheet, the transfer from hospital to hospice is counted as an expense. I shudder to think whether that expense would be considered worth it in a medical setting where assisted suicide is legal. Politics being downstream of culture, I wonder how long Medicare would cover such things as transfers to hospice if physician-prescribed death is accepted.

Someone is reading this and thinking But she didn’t ask for assisted suicide, and her case is irrelevant to the New Hampshire bill. Not so. Once it’s legal for a physician to prescribe a drug for the purpose of ending a patient’s life, it’s only a matter of time before other health care professionals are given the same authority. (Ask any nurse practitioner about “scope of practice.”) It will only be a matter of time before it’s clear how sloppy the law’s definition of “terminally ill” really is. And the minute an assisted suicide bill becomes law, and medically-administered death becomes just another therapeutic option, palliative care will be treated by the bean counters as a luxury.

Not that I have anything against bean counters, but medicine is no longer a matter between doctor and patient. It’s a matter between provider and patient and whoever is footing the insurance bill.

Aside from the substantive moral bankruptcy of assisted suicide, I’m offended by the violence that such legislation does to language. From HB 1325: “Nothing in this chapter shall be construed to authorize a physician or any other person to end a patient’s life by lethal injection, mercy killing, or active euthanasia. Actions taken in accordance with this chapter shall not, for any purpose, constitute suicide, assisted suicide, mercy killing, or homicide, under the law.” Really? A physician can prescribe a drug for the sole purpose of ending a patient’s life, and that’s not homicide on the physician’s part or suicide on the patient’s part?

“‘When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean – neither more nor less.’ — Lewis Carroll. Humpty Dumpty would have been right at home with HB 1325. We’ll soon know how many New Hampshire legislators want to be perched up on that shaky wall with him.

 

 

 

“Alleviating suffering is different from eliminating the sufferer”: confronting the Massachusetts assisted-suicide bill

Undeterred by the defeat of a 2012 ballot initiative promoting physician-assisted suicide (PAS) in Massachusetts, legislators there are working to enact PAS via legislation. I went to Boston today to listen to the hearing on the bill, H.1998. I stayed only two hours, but that was long enough for me to see that the people who want to legalize PAS are relentless. Are those of us opposed to doctor-imposed death just as determined? We’d better be.

Today was one of those days when my social media skills fell flat. I tweeted throughout the hearing – or so I thought. I found later that the tweets never got past my valiant little phone. They’re all unsent drafts. They actually serve as decent notes.

At MA state house for assisted suicide hearing. Many people sporting “My life my choice my death” stickers.

Massachusetts Citizens for Life sent an email this morning claiming that pro-PAS groups were busing in supporters. I can’t verify that, but I can say that the crowd of more than 200 people included an awful lot of folks with those identical green stickers.

Committee chair cautions all to be respectful of those speaking on this “sensitive topic.”

Respect wore thin after the first 90 minutes at this hearing with the Joint Committee on Public Health. There were people testifying that there’s nothing compassionate about killing, and then there were people objecting to anyone saying that. The presiding officer, Rep. Jeffrey Sánchez (D-Jamaica Plain), finally made it clear that he didn’t want anyone accusing anyone else of lack of compassion.

Rep. Sánchez also made it clear that he favors the bill, although he has “struggled with it.”

MA Medical Society testifies in opposition to physician-assisted suicide. “Incompatible with physicians’ role as healer.”

Former Massachusetts Medical Society president Dr. Barbara Rockett, speaking for MMS, was brief and blunt in opposition to PAS. “This is incompatible with the physician’s role as healer.” She went on to say that MMS opposes legislative tinkering with the practice of medicine, which she sees in the bill’s assorted “requirements.” Dr. Rockett was active in the defeat of the PAS ballot initiative, saying during that campaign, “To substitute physician-assisted suicide for care represents an abandonment of the patient by the physician.” 

Interesting: one of the bills today would prohibit health care pros from participating in the torture/abuse of prisoners. Drs testify re Do No Harm ethic. Will same drs apply that Do Not Harm ethic to PAS?

H.1998 was one of twenty bills on the agenda, although it drew most of the day’s testimony. Two other bills, one from each chamber, would “prohibit the participation of health care professionals in the torture and abuse of prisoners.” Physicians and psychologists provided vivid and compelling testimony favoring such a ban. Several of these professionals related how the co-opting of medical professionals in the torture of prisoners violates the “do no harm” ethic. These same professionals did not apply that ethic to H.1998, and in fact were silent on PAS today.

state rep Adkins (sp?) supports PAS, comparing force-feeding against patients’ will to torture.

Rep. Cory Atkins (D-Concord) came out in strong support of PAS, asking “who is in charge of us at the end of life?” She evoked the specter of force-feeding of dying patients against the express wishes of those patients, calling it torture and saying that families who insist on feeding dying loved ones do so “to make themselves feel better.” Chairman Sánchez found nothing objectionable in that declaration, judging from his silence as his colleague spoke.

One could make the case that a dying person’s family members might support PAS “to make themselves feel better.” Or would that be an uncivil thing to say? Would the chairman have been moved to interrupt someone making that claim? I can only guess.

Rep. Atkins declined to say who’s force-feeding a patient if the patient has an advance directive barring such an activity. Massachusetts already has a durable power of attorney/advance directive law on the books. If the kind of force-feeding Rep. Atkins describes is happening, it’s happening in violation of the law. And if medical professionals and law enforcement officials can’t handle a written order regarding feeding, that gives me no confidence that a PAS law full of “safeguards” would promote patient safety.

If Rep. Atkins is right about force-feeding going on in violation of patient wishes, that means the durable power of attorney law is being ignored. Her colleagues did not question her about that today.

MACLU supports assisted suicide bill; right to be free of “unnecessary suffering.”

Carol Rose of the Massachusetts Civil Liberties Union testified in support of PAS, immediately after testifying in support of the anti-torture bill. She said we all have a right to be free from unnecessary suffering, which makes me wonder what “necessary” suffering looks like in the CLU’s eyes. She also warned of “scare tactics” from PAS opponents. She claimed that the experience in Washington and Oregon, where PAS has been legal for years, shows that abuse of the system Just Doesn’t Happen. Besides, she said, the state has no business being involved in end-of-life decisions.

Her assertion that abuse doesn’t happen requires taking a lot on faith. The Patients Rights Council has tracked euthanasia measures all over the world, including the ones in effect in the U.S. Their information about Oregon’s PAS law includes a warning about incomplete record-keeping regarding acts taken pursuant to the law.

One legislator, whose name I unfortunately did not catch, questioned Ms. Rose: if the state has no business being involved in end-of-life decisions, why do you want the state involved in encouraging suicide? Ms. Rose’s answer was as chilling as it was simple: if the patient is terminally ill, then it’s not suicide for the patient to take her own life.

Her answer was not an aberration. A retired psychiatrist, who is also a former medical director of a hospice, echoed her thought, saying PAS is “not suicide as we understand it.”

Several pro-assisted suicide people testifying re agony of watching a parent die. I’ve been there. Not easy.

Not easy, indeed. Yet PAS is supposed to be about the patient, not the patient’s loved ones, if I understood the bill’s supporters today.

Every supporter of H.1998 who was not affiliated with a group testified about a loved one’s suffering and death. I saw today, and I’ve seen at similar hearings in my own state, that people promoting suicide have no reluctance to tell their stories. People opposed to state-sanctioned, physician-aided death will learn to speak up about their own experiences and those of their loved ones – or else they will lose the political argument, plain and simple.

MCFL: bill encourages lying on death certificate by saying “suicide” won’t be listed as cause of death in PAS cases.

I’m glad Massachusetts Citizens for Life got this into today’s record. This is a feature of every assisted-suicide bill I’ve ever read, including those that have been introduced in my own state: deaths pursuant to PAS are not to be listed as “suicide” on the patient’s death certificate. Whose delicate sensibilities are offended by recording the truth? Does the medical community honestly think that such subterfuge will prevent distrust between patient and provider?

 “Alleviating suffering is different from eliminating the sufferer.” – John Kelly

“To have power of life and death over a person is criminal.” – Kate Ryan

Powerful testimony against PAS came from John Kelly of Second Thoughts, a disability-rights advocacy group, and from Kate Ryan, an advocate for people with autism. I tweeted (well, thought I tweeted) their best lines, which beautifully crystallize the passionate concern for human dignity shared by opponents of H.1998. In their own ways, Kelly and Ryan defended inherent human dignity, not a dignity that depends on being healthy or physically independent or mentally intact. Kelly actually got the attention of the committee, and most of the people in the room – I was sitting in back and could see this – when he started his testimony by taking legislators to task for not making sure sidewalks were cleared around the State House. “That kept some of our people from getting here today.”

#boom, as the social-media saying goes.

Also supporting the bill: Compassion and Choices, a PAS-advocacy group active nationwide. No surprise. C&C sends a lobbyist to any state contemplating end-of-life legislation. Oh, that name! The euthanasia movement has come a long way (and learned a lot about marketing) since the days of Derek Humphry’s Hemlock Society. The C&C lobbyist today said that the ballot initiative failed because PAS opponents outspent pro-assisted-suicide forces 5 to 1  on a “media blitz” of misinformation. (That’s the same figure claimed by assisted-suicide supporters the night the ballot initiative failed, before the final expenditure reports had to be filed.) He considers the legislative route for PAS to be a more considered, more measured way to get the job done.

Keep the public at a distance, in other words. The Massachusetts legislature and governor may yet manage to do just that.

So what’s on your state’s agenda?

Rep. Rowe’s straight talk: “The total thrust of this bill is euthanasia”

Rep. Robert Rowe (R-Amherst)
Rep. Robert Rowe (R-Amherst); photo by Ellen Kolb

New Hampshire advocates of physician-assisted suicide have finally learned what some public-policy activists never figure out: sometimes it’s more productive to go after a big goal one little slice at a time. Rep. Charles Weed (D-Keene) has seen the light, allowing his HB 403 to be amended by the House Judiciary committee into a bill to “study end-of-life decisions.” The original bill sought to set up a commission full of “experts” to investigate “death with dignity.” The House passed HB 403 this week, where it awaits a Senate hearing.

Rep. Robert Rowe (R-Amherst), ranking Republican member of the Judiciary committee, wasn’t having any of it. Rowe used to lead Judiciary when the Republicans were in the majority. He is not a man to pick fights. He values collegiality. He also values plain speaking.

At the conclusion of the debate before the February 20 House vote, Rowe spoke up despite Speaker Norelli’s attempt to gavel him down. “The total thrust of this bill is euthanasia.” He is absolutely right. He knows that Rep. Weed has tried twice since 2009 to promote physician-assisted suicide. I consider it unlikely that Weed has abandoned his goal.

The House passed HB 403 on a division vote, 212-140, with no roll call. This comes after inexpedient-to-legislate votes on Weed’s earlier assisted-suicide bills by votes of 242-113 in 2010 and 234-99 in 2011.

Rowe was joined by Rep. (and physician) Joseph Hagan (R-Chester) on the House floor to speak against the bill. They were countered by Rep. Rick Watrous (D-Concord), Judiciary committee member and co-sponsor of the bill, who attempted to allay fears. “This will study end-of-life decisions, including hospice and end-of-life care,” he said. “It’s been awhile since the legislature has looked at this. It’s time to do so again.”

What has changed since the last time the legislature “looked at this”? In a word, money. The legislature should not be open to everything. It ought to come down hard & fast against any move toward legalizing physician-assisted suicide. If that option is on the table, in a world of spiraling health care costs, it will prove irresistible. Care is expensive; ending it is cheap.

That debate is yet to be joined in full here in New Hampshire, but it’s coming.

Basic Books by Rita Marker and Abby Johnson

I expect this to become a recurring feature in this blog. I’ll recommend books that have influenced me in my pro-life journey.  I’d like to hear your recommendations as well.

Today, it’s something old & something new.

Deadly Compassion: the Death of Ann Humphry and the Truth About Euthanasia by Rita Marker (1995, William Morrow & Co., ISBN 9780688122218; also available as PDF download at www.patientsrightscouncil.org/site/deadly-compassion/)
Unplanned: the Dramatic True Story of a Former Planned Parenthood Leader’s Eye-Opening Journey Across the Life Line by Abby Johnson with Cindy Lambert
(2010, Tyndale House Publishers, Inc., ISBN 9781414339399; also available as e-book)

Deadly Compassion
Don’t be put off by the ponderous title. This is the best one-volume briefing available on the pro-euthanasia movement.  The style of writing makes for easy reading, despite the heavy topic. Rita Marker is founder and director of the Patients Rights Council, formerly the International Anti-Euthanasia Task Force, based in Ohio. In the course of her work, she met Ann Humphry, whose husband Derek Humphry was a leading light of the Hemlock Society. At first on opposite sides of a seemingly impassable philosophical divide, the two women formed an unlikely friendship that ended only with Ann’s tragic death, the circumstances of which were closely tied to the movement founded by her by-then-estranged husband.

Chapters alternate between the story of the friendship and the history of pro-euthanasia activities. At first somewhat jarring, this arrangement becomes smoother after the first few chapters. By the end, which is harsh even though the reader can see it coming, the personal and the political have merged to devastating effect. Marker does not resort to melodrama, although you might be misled into thinking so by some of the jacket blurbs. Marker’s smart enough to know that the bare facts are dramatic enough on their own.

Seventeen years after publication of this book, euthanasia advocates have scored some serious victories here and abroad. Reading Deadly Compassion is one good way to prepare to participate in the ongoing debate. Marker’s work with the Patients Rights Council continues today.

Unplanned
You’ve probably heard by now of Abby Johnson. A former Planned Parenthood clinic director in Texas, Johnson is now a full-time pro-life activist. She wants the world to know what PP looks like from the inside, and she is tenacious in calling for examination of PP’s finances.

Hers was not an overnight conversion. She went to work for PP out of compassionate motives, believing that women’s health was a priority there.  Two experiences in particular forced her to question what she was doing.  She was once asked to assist at an ultrasound-guided abortion to terminate a 13-week pregnancy. The image of the preborn child as the abortion was completed left her shaken. Later, as a clinic director, she was shocked to be given an “abortion quota” by PP, which clearly put the bottom line ahead of women’s health.

While this was going on inside PP, an exceptional ongoing pro-life witness was maintained outside the facilities. Protesters who were abusive toward PP workers had only increased solidarity within PP. A group called Coalition for Life took a different approach, relying on peaceful prayer and gentle communication. Gradually, as Johnson saw Coalition members outside her facility day after day, she got to know some of them. The personal connection was critical as Johnson attempted to come to terms with her doubts about her work.

The Coalition is the group responsible for the 40 Days for Life campaigns nationwide, and Johnson’s story is a testament to their effectiveness. Coalition leaders (including David Bereit, who will be visiting NH later this year) became mentors and friends to Johnson, standing by her as she came to her decision to leave PP.

From the Foreword: “I reveal my story not because I am proud of it. I am not. But my thinking and choices are not unlike those of so many people I have encountered. And until we each set aside our own preferences for how we wish others would think and behave, or how we assume others think and behave, we won’t be able to understand those with whom we differ in order to engage in real dialogue and discover truth.”