NH assisted suicide bill, round 1

For hours yesterday, people spoke up against assisted suicide in New Hampshire, essentially saying “hell, no.” The count was impressive. The only decisive count will come from legislators, though, and the outcome is very much in doubt. Here’s this morning’s Facebook post by a committee member, referring not only to HB 1325 but to a second bill, HB 1226, to set up a committee to study end-of-life decisions

“NH Voters: If you are concerned with end of life decisions and you are against Assisted Suicide, please send e-mails to the House Judiciary Committee, flood our in boxes. We had two public hearings yesterday on the subject and some committee members are actually planning on voting for this to pass. NO ONE spoke in favor of these two horrific bills, but plenty of people spoke out against it. Unfortunately, some of the speakers were from out of town and most e-mails have come from out of town. Their thinking is that since no one is speaking out in NH, it must not be something people are concerned about, so let’s pass it…… The link is HouseJudiciaryCommittee@leg.state.nh.us. Thank you!”

The setting for the hearing

Too much was going on at once yesterday. Two hearings, only a few yards apart in Concord’s Legislative Office Building, and I had to choose. I went with door #2. Over an hour later, first round of business done, I hurried to where the House Judiciary Committee was having its hearing on HB 1325.  I hoped I wasn’t too late.

I could barely get in the door.

There was the committee, seated around its big U-shaped table taking up two-thirds of the room, with no one aside from House staff permitted to stand along the walls. This is the standard set-up for New Hampshire House committees. In the remaining third of the room, the two rows of seats were full, with more people standing in clusters at each end of the rows. When I managed to squeeze into the room, I became the de facto doorkeeper as people entered and left.

I was so wedged in that I couldn’t reach my phone or use my tablet, so the world had to get along without my livetweeting (and at last report the world was getting along fine without it). Just as well, since I’d been using the hashtag #hb1325, which someone later pointed out to me was the same hashtag used for a bill in Colorado on a different subject. In the future I’ll use #noPASnh (with PAS standing for physician-assisted suicide).

Some of the testimony

I had earlier provided the committee clerk with the testimony I had prepared on behalf of the New Hampshire nonprofit organization for which I work. The committee members will see this, even though I didn’t testify in person. The core of the testimony is here:

Nothing is more certain to inhibit support for palliative- and supportive-care strategies than to make physician-prescribed death a treatment option. Pain management, respite care, and adaptive technology can require complex, time-consuming effort. Taking a handful of pills is cheap. The negative message to vulnerable, depressed individuals would be unmistakable.

I recognized friendly faces in the crowd, including legislators who have worked for years to resist assisted-suicide legislation. I also saw many people I didn’t know, and I could only hope they were there to protest the bill. I later heard from a committee member that they were indeed opponents – and articulate ones, too. Two of them posted their testimony online via links on PRWeb. They’re worth quoting, but I heartily recommend you go to the PRWeb link to read the statements in full.

From John Kelly, on behalf of Not Dead Yet and Massachusetts Second Thoughts:

We were the progressive voice in Massachusetts that defeated the assisted suicide ballot question.  Our opposition is based in universal principles of social justice that apply to everyone, whether disabled or not….We chose our name Second Thoughts because we find that many people, once they delve below the surface appeal of assisted suicide, have “second thoughts” and oppose it.  In Massachusetts a month before the election, 68% of Massachusetts voters supported the ballot question.  But upon closer look at the real-world threats the legislation posed, voters had serious “second thoughts.”  …

There is nothing in this or any other assisted suicide bill that can protect people who are being abused.  Every year in New Hampshire, it is estimated that there are over 26,000 reported and unreported cases of elder abuse.  No independent, disinterested witness is required when the lethal dosage is taken, which means that the stipulation that someone “must” self-administer the drug is merely a recommendation.  These bills take no notice of how self-interest can motivate family members and caregivers.  Because of the typical provision in these laws that death certificates list the cause of death as the underlying illness, investigations are foreclosed….

HB 1325 uses a definition of “terminal condition” that directly threatens the lives of me and many of my disabled friends.  Section 13 reads:“Terminal condition” means an incurable and irreversible condition, for the end stage for 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.

The day this bill goes into effect, thousands of people will be instantly made eligible.  For example, my quadriplegia constitutes “an incurable and irreversible condition.”  It has “no known treatment,” and likely “will result in premature death.”  This bill would authorize a New Hampshire doctor, whom I saw “regularly,” to validate temporary feelings of being a burden as being worse than death.  Legalizing assisted suicide sends the wrong message to anyone who depends on caregivers, the message that feeling like a burden is not only an acceptable reason for suicide, but a justification for our health care system to provide the lethal means to end your life.  We are not better off dead.

From Stephen Mendelsohn of Second Thoughts Connecticut:

This bill, with its expansive eligibility targeting a wide range of people with long-term disabilities who are nowhere near death, morphs New Hampshire’s honored state motto, “Live Free or Die” into an ableist obscenity: “Live Nondisabled or Die.”… 

Let us remember that people in Oregon and Washington [where assisted suicide is legal] are killing themselves not because of pain, but because of fear of disability, because they view needing assistance with eating or toileting as a “loss of autonomy,” a “loss of dignity,” and a “burden” on others [according to Oregon’s 2012 report on the Death with Dignity Act]….

As Oregon’s experience shows, death is always the cheapest “treatment.”  Barbara Wagner and Randy Stroup found that out when Oregon Medicaid refused to pay for chemotherapy, but offered to pay for lethal drugs so they could commit suicide under that state’s “Death With Dignity Act.”…

And what message does this legislation send toward those contemplating suicide?  We constantly hear the six-word slogan from proponents, “My Life. My Death. My Choice.”  If “my death” is “my choice,” what message are we sending to an autistic or LGBT teenager who is being mercilessly bullied?  After all, victims of bullying also experience “severe, unrelenting suffering.”  Why even have suicide prevention? … Let us reject HB 1325 and instead work to build a world where no one feels they ought to die merely because they cannot do everything for themselves and instead receive blessing from others, whether they may have days, months, or many years of life ahead.

When I arrived at the hearing, Margaret Dore was speaking, trying vainly to compress extensive testimony into just a few minutes. It’s a fact of life that even when a committee chair goes out of her way to be accommodating, as did Judiciary chair Marjorie Smith (D-Durham) yesterday, all those who testify late in a hearing bear the burden of everyone’s impatience. Dore is an elder-law attorney from Washington state, and she has come to New Hampshire before to fight other assisted suicide bills. Her experience with her own clients has thoroughly schooled her in the risks of abuse inherent in any law that makes physician-prescribed death just another medical option.

The hallway conversations – and what must be done next

Before the hearing began, I spoke with a veteran legislator from the Judiciary committee. He was not optimistic. “Lobby the Senate. Now.” I raised an eyebrow (perhaps two) and asked for his count of the votes on the committee. He declined to elaborate.

Another committee member caught up with me after the hearing and filled me in on what I had missed. She said the turnout by anti-1325 forces had been great. Then this morning, she wrote the warning with which I opened this post. As if the truth changes at the state line … but I appreciate her candor.

Yesterday, a lot of people did a good day’s work. I wish it were enough. Instead, it’s only round one. If this gets through House and Senate – and I concede nothing at this point – it may come down to a veto by Governor Maggie Hassan. Hassan has not addressed this bill directly, but she did veto a bill last year for an end-of-life study committee, introduced by an assisted-suicide supporter. At that time, she said our focus should be “on helping all of those in our society to fully live their lives with the dignity that they deserve.” That sounds promising.

 

 

“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?