Source: https://www.choiceillusionsouthdakota.org/2017/09/updated-analysis-of-initiated-measure.html
Timestamp: 2019-04-24 11:51:46+00:00

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To view this analysis as a pdf, click the following links containing: an index; a memo; and an appendix, parts one and two.
I am an attorney in Washington State where assisted suicide is legal. Our law is based on a similar law in Oregon. Both laws are similar to the initiated measure.
The measure seeks to legalize assisted suicide and euthanasia as those terms are traditionally defined. If enacted, it will apply to people with decades to live; it will encourage elder abuse and financial exploitation, which are already problems in South Dakota. It will allow legal murder.
Don’t make Washington and Oregon’s mistake. I urge you to reject the initiated measure.
Persons assisting a suicide can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton, in Oregon. Two days after his death by assisted suicide, she sold his home and deposited the proceeds into bank accounts for her own benefit.
In other states, reported motives for assisting suicide include: the “thrill” of getting other people to kill themselves; and a desire for sympathy and attention.
This year, the South Dakota Legislature passed Concurrent Resolution 11, opposing physician-assisted suicide. The vote to pass was nearly unanimous.
This year, Alabama passed the “Assisted Suicide Ban Act,” which renders any person who deliberately assists a suicide, guilty of a felony. The Act went into effect on August 1, 2017.
Last year, the New Mexico Supreme Court overturned a lower court decision recognizing a right to physician aid in dying, meaning physician assisted suicide. Physician-assisted suicide is no longer legal in New Mexico.
Oregon and Washington State legalized assisted suicide via ballot measures in 1997 and 2008, respectively. Since then, just three states and the District of Columbia have passed similar laws. In the fine print, these laws also allow euthanasia.
The measure has an application process to obtain the lethal dose. Once the lethal dose is issued by the pharmacy, there is no oversight. No witness, not even a doctor, is required to present at the death.
If the proposed measure is enacted and South Dakota follows Oregon’s interpretation of “terminal disease,” assisted suicide and euthanasia will be legalized for people with chronic conditions such as insulin dependent diabetes. Such persons can have decades to live.
According to government statistics from Oregon and Washington State, most people who die under their laws are elders, aged 65 or older. This demographic is already an especially at risk group for abuse and financial exploitation. This is true both nationally and in South Dakota.
[A]pproximately one in ten elders living in their homes experience abuse, neglect, or exploitation each year. . . .
[A]pproximately 90% of abusers were known perpetrators, and 66% were adult children or spouses.
Concerned citizens often related that existing legal processes – including powers of attorney, court-appointed guardians/conservators, and joint accounts - had been manipulated to exploit elders. Financial exploitation was the predominant form of elder abuse cited by these sources. (Emphasis added).
In some cases, elder abuse and financial exploitation are fatal. More notorious cases include California’s “black widow” murders, in which two elderly women took out life insurance policies on homeless men. Their first victim was 73 year old Paul Vados, whose death was staged to look like a hit and run accident. The women collected $589,124.93.
Many [victims] are simply too embarrassed or frightened to ask for help. They may be reluctant to press charges against the abuser, especially if the abuser is a family member.
With assisted suicide laws in Washington and Oregon [and with the initiated measure], perpetrators can . . . take a “legal” route, by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over administration. Even if a patient struggled, “who would know?” (Emphasis added).
The attending physician may sign the patient’s death certificate which shall list the underlying terminal disease as the cause of death. (Emphasis added).
“... the patient’s death certificate ... shall list the underlying terminal disease as the cause of death.” [and] “Any action taken in accordance with this Act does not, for any purpose, constitute suicide, assisted suicide, mercy killing, or homicide, under the law.” (Emphasis added).
If South Dakota enacts the proposed measure and follows Washington State, there will be an official legal cover up.
Notwithstanding any other provision of law, the information collected is not a public record and may not be made available for inspection by the public. (Emphasis added).
[Oregon’s Death with Dignity] Act specifically states that information collected is not a public record and is not available for inspection by the public (ORS 127.865 (2)). The protection of confidentiality conferred by the Death with Dignity Act precludes the Oregon Health Authority from releasing information that identifies patients or participants, to the public, media, researchers, students, advocates, or other interested parties. (Emphasis added).
The officer’s report describes how he determined that the death was under Oregon’s assisted suicide law act due to records other than from the State of Oregon. The officer’s report also describes that he was unable to get this information from the Oregon Health Authority, which was not willing to confirm or deny whether the deceased had used the act. (Emphasis added).
Even law enforcement is denied access to information collected by the State of Oregon. (Emphasis added).
If South Dakota enacts the initiated measure and follows Oregon’s interpretation of “not a public record,” there will be a similar lack of transparency in which even law enforcement will be denied access to identifying information from the state.
The significance is that Oregon’s annual reports are unverifiable. If South Dakota, based on its similar statutory language, follows Oregon, South Dakota’s annual reports will also be unverifiable.
The measure has enumerated patient protections, including that the attending physician “shall” refer the patient to a consulting physician, and that the attending physician “shall” offer the patient an opportunity to rescind the lethal dose request at the end of a fifteen-day waiting period.
The attending physician shall: . . .
(11) Ensure that all appropriate steps are carried out in accordance with this Act . . . . (Emphasis added).
The measure does not define “accordance.” Dictionary definitions include “in the spirit of,” meaning “in thought or intention.” With these definitions, the attending physician’s mere thought or intention to comply is good enough. The purported patient protections are not enforceable.
Being familiar with a patient’s manner of communicating is a very minimal standard. Consider, for example, a doctor’s assistant who is familiar with a patient’s “manner of communicating” in Spanish, but she herself does not understand Spanish. That, however, would be good enough for her to communicate on the patient’s behalf during the lethal dose request process. The patient would not necessarily be in control of his fate.
“Self-administer,” [means] a qualified patient’s act of ingesting medication to end the patient’s life . . . (Emphasis added).
With self-administer defined as mere ingesting, someone else is allowed to administer the lethal dose to the patient. The patient is not necessarily in control of his or her fate.
The measure allows euthanasia as traditionally defined.
Nothing in this Act authorizes a physician or any other person to end a patient’s life by lethal injection, mercy killing, or active euthanasia.
Any action taken in accordance with this Act does not, for any purpose, constitute suicide, assisted suicide, mercy killing [euthanasia], or homicide, under the law. (Emphasis added).
Under current South Dakota law, patients have a right to “informed consent,” which includes the right to be apprised of “any reasonable alternative treatment,” for example, to cure cancer.
[W]here general words . . . precede the enumeration of particular classes of things, [the rule of] . . . ejusdem generis . . . requires that the general words . . . be construed as applying only to things of the same general kind as those enumerated. (Emphasis added).
With the initiated measure, the general words, “feasible alternatives,” precede enumerated words all having to do with death and dying (“comfort care, hospice care, and pain control”). Per the rule, this enumeration limits the general words, “feasible alternatives,” to those having to do with death and dying. Patients no longer have a clear right to be told about alternatives for cure.
The measure also allows conduct normally used to prove undue influence. For example, the measure allows an infirm person with a terminal disease to request the lethal dose. Physical weakness is a factor generally used to prove undue influence.
How do you prove that undue influence occurred when the measure does not define it, and the measure also allows conduct generally used to prove it? You can’t. The felony for undue influence is illusory and unenforceable.
Elder abuse and financial exploitation are already significant problems in South Dakota. Moreover, they are occurring in the context of existing legal processes, including court-appointed guardians/conservators, which have actual safeguards and transparency.
This is opposed to the initiated measure in which administration of the lethal dose is allowed to occur in private without a doctor or witness present. Even if a patient struggled, who would know? The death certificate will, regardless, list a terminal disease as the cause of death. This will prevent prosecution for murder. The measure, if enacted, will create the perfect crime.
Passage of the initiated measure will only make a bad situation worse. Enacting the measure will encourage people with decades to live to throw away their lives. I urge you to reject the initiated measure seeking to legalize assisted suicide and euthanasia in South Dakota.
 See e.g., The American Medical Association Code of Medical Ethics, Opinion 5.7 (defining physician-assisted suicide). Attached to the appendix at A-5.
 “Mercy killing” - The Free Dictionary, attached to the appendix at A-6.
 See: Associated Press for Minnesota, “Former nurse helped instruct man on how to commit suicide, court rules,” The Guardian, 12/28/15 (“he told police he did it ‘for the thrill of the chase’”) attached to the appendix, at A-9 & A-10, the quote is at A-10; and “Woman in texting suicide wanted sympathy, attention, prosecutor says,” CBS News, June 6, 2017, attached to the appendix at A-11.
 South Dakota Legislature, Bill History, Senate Concurrent Resolution 11, “Opposing physician-assisted suicide,” attached to the appendix at A-12.
 The initiated measure, § 1(12), attached in the appendix, part 2 of 2, at A-102.
 Or. Rev. Stat. 127.800 s.1.01(12), copy available in the appendix, part 1, at A-16.
 “Diabetes mellitus” is listed as a qualifying terminal disease in Oregon government reports. See Declaration of William Toffler, MD, attached hereto at A-14 to A-15, ¶¶ 2-4, and attached report excerpts at A-17 & A-18.
 Toffler Declaration, A-15, ¶ 5.
 Cf. Jessica Firger, “12 million Americans misdiagnosed each year,” CBS NEWS, 4/17/14, attached hereto at A-19, and Nina Shapiro, “Terminal Uncertainty — Washington's new 'Death with Dignity' law allows doctors to help people commit suicide — once they've determined that the patient has only six months to live. But what if they're wrong?,” The Seattle Weekly, 01/14/09. (Excerpts in the appendix, part 1, at A-20 to A-22).
 Affidavit of John Norton, in the appendix, part 1, at A-23 to A-25.
 Affidavit of Kenneth Stevens, MD, also attached in the appendix, part one, at A-26 to A-33; Jeanette Hall discussed at A-26 to A-27; Hall declaration, attached in the appendix, part one, at A-33.
 Declaration of Jeanette Hall, ¶4, in the appendix, part one, at A-33.
 See: excerpt from Oregon’s most recent annual report, in the appendix, part one, at A-34; and excerpt from Washington State’s most recent annual report, in the appendix, part one, at A-35.
 Task Force Report excerpt, attached in the appendix, part 2, at A-39.
 Id, attached in the appendix, part 2, at 41.
 See South Dakota Elder Abuse Task Force Final Report and Recommendations, December 2015, Summary of Findings, p. 1, attached in the appendix, part 2, at A-39 (describing studies).
 See the measure in its entirety, attached in the appendix, part 2, at A-101 to A-112.
 The initiated measure, § 4, last sentence, attached in the appendix, part 2, at A-105.
 Id. and § 18, first ¶, attached in the appendix, part 2, at A-109.
 Washington State Department of Health death certificate instructions, attached in the appendix, part 2, at A-46.
 The measure states: "The Department of Health shall generate and make available to the public an annual statistical report of information collected under this section," The Measure, § 15, attached in the appendix, part 2, at A-108, third ¶.
 The measure, § 15, second ¶, in the appendix, part 2, at A-108.
 ORS 127.865 s.3.11(2), attached in the appendix, part 2, at A-47.
 Oregon Data Release Policy, copy attached in the appendix, part 2, at A-53.
 Declaration of Testimony, ¶ 8, September 18, 2012, attached in the appendix, part 2, at A-49.
 Id., ¶ 2, attached at A-48.
 Oregon Health Authority, Frequently Asked Questions, attached in the appendix, part 2, at A-56. See also email from Alicia Parkman, Oregon Health Authority, in the appendix, part 2, at A-54.
(4) Refer the patient to a consulting physician for medical confirmation of the diagnosis, and for a determination that the patient is competent and acting voluntarily; . . .
(8) Inform the patient that the patient may rescind the request at any time and in any manner, and offer the patient an opportunity to rescind at the end of the fifteen-day waiting period . . . . (Emphasis added).
Initiated Measure, § 4, attached in the appendix, part 2, at A-104 to A-105.
 The measure states: "The attending physician shall: . . . (11) Ensure that all appropriate steps are carried out in accordance with this Act . . . . " (Emphasis added). Id.
 See definitions attached in the appendix, part 2, at A-57 & A-58, respectively.
 The measure, § 1(2), attached in the appendix, part 2, at A-101.
 Id., §§ 1(6) & (10), & 2, attached in the appendix, part 2, at A-101 & A-102.
 Id., § 1(11), attached in the appendix, part 2, at A-102.
 www.yourdictionary.com, attached hereto at A-59.
 Opinion 5.8, to the appendix at A-5 (lower half of the page).
 The measure, § 18, attached in the appendix, part 2, at A-109.
 Report excerpts in the appendix, part 2, at A-62 & A-63 (page with quote).
 Oregon Health Authority Report excerpt, in the appendix, part 2, at A-64 & A-65 (page with quote).
 Oregon State Report attached in the appendix, part 2, at A-66.
 Wheeldon v Madison, 374 N.W.2d 367, 375 (1985), excerpt in the appendix, part 2, at A-67.
 See Measure, §§ 7 and 1(6), attached in the appendix, part 2,at A-106 and A-101, respectively.
 Crawford v Schulte, 829 N.W.2d 155, 158 (2013), quote attached in the appendix, part 2, at A-68.
 Initiated measure, § 24, second ¶, attached in the appendix, part 2, at A-111.
 See Initiated measure, § 2 (specifying that a person “suffering from a terminal disease” may request the lethal dose). Attached in the appendix, part 2, at A-102.
 Cf. Neugebauer v. Neugebauer, 804 N.W.2d 450, ¶17 (2011)(“physical . . . weakness is always material upon the question of undue influence”).

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