Source: https://www.choiceillusion.org/2015/08/memo-to-california-state-assembly-no-on.html
Timestamp: 2019-04-19 15:24:23+00:00

Document:
A. Physician-Assisted Suicide; Assisted Suicide; and Euthanasia.
The American Medical Association defines “physician-assisted suicide” as occurring when “a physician facilitates a patient’s death by providing the necessary means and/or information to enable the patient to perform the life-ending act.” “Assisted suicide” is a general term in which the assisting person is not necessarily a physician. “Euthanasia,” by contrast, is the direct administration of a lethal agent with the intent to cause another person’s death.
B. Withholding or Withdrawing Treatment.
III. FACTUAL AND LEGAL BACKGROUND.
A. In the Last Five Years, Four States Have Strengthened Their Laws Against Assisted Suicide.
In the last five years, four states have strengthened their laws against assisted suicide. These states are: Arizona, Idaho, Georgia and Louisiana. For more information, please see the materials attached here.
In 2009, MetLife Mature Market Institute released its landmark study addressing financial elder abuse nationwide. The estimated financial loss by victims was $2.6 billion per year.
The study describes financial elder abuse as a crime “growing in intensity.” The study says that perpetrators are often family members, some of whom feel themselves “entitled” to the elder’s assets. They often start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or coercing elders to sign over the deeds to their homes, change their wills, or liquidate their assets.
C. Victims Do Not Report Abuse.
Elder abuse victims often live in silent desperation . . . . Many remain silent to protect abusive family members . . . .
A. How the Bill Works.
SB 128 has an application process to obtain the lethal dose, which includes a lethal dose request form with two required witnesses. One of the witnesses is allowed to be the patient’s heir who will financially benefit from the patient’s death.
Once the lethal dose is issued by the pharmacy, there is no oversight. No doctor or other medical person is required to be present when the lethal dose is administered. Not even a witness is required.
B. No Witness at the Death.
As noted above, SB 128 does not require a witness at the death. Without disinterested witnesses, the opportunity is created for someone else to administer the lethal dose to the patient without his consent. Even if he struggled, who would know?
With assisted suicide laws in Washington and Oregon [and with SB 128], 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. . . . [E]ven if a patient struggled, “who would know?” (Emphasis added).
C. Any Study Claiming that Oregon’s Law is Safe, is Invalid.
D. If California Follows Washington State, the Death Certificate Will Be Required to Reflect a Natural Death: This Will Allow the Perfect Crime.
Actions taken in accordance with this part shall not, for any purposes, constitute suicide, assisted suicide, homicide, or elder abuse under the law.
Actions taken in accordance with this chapter do not, for any purpose, constitute suicide, assisted suicide, mercy killing, or homicide, under the law.
If you know that the decedent used the Death with Dignity Act, you must comply with the strict requirements of the law when completing the death record: . . .
i. Pentobarbital or Nembutal (Emphasis added).
With the death required to be treated as “Natural” simply because the act was used, there is no criminal recourse if the patient was pressured into taking the lethal dose, or even outright murdered via the lethal dose. The Medical Examiner, the Coroner and the Prosecutor must certify the death as Natural without any indication of the true cause of death.
E. “Eligible” Patients May Have Years, Even Decades, to Live.
1. If California follows Oregon’s interpretation of “terminal disease,” assisted suicide will be legalized for people with chronic conditions such as diabetes.
“Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, result in death within six months.
In Oregon, this nearly identical definition is interpreted to include chronic conditions such as chronic lower respiratory disease and insulin dependent diabetes. Indeed, government reports from Oregon list these conditions as qualifying underlying illnesses for the purpose of assisted suicide. See, for example, Oregon’s assisted suicide report at pages A-33 and A-34 (listing these conditions).
Our law applies to "terminal" patients who are predicted to have less than six months to live. In practice, this idea of terminal has recently become stretched to include people with chronic conditions . . . . Persons with these conditions are considered terminal if they are dependent on their medications, such as insulin, to live. (Emphasis added).
Such persons, with treatment, could otherwise have years or even decades to live.
2. Misdiagnosis occurs; predictions of life expectancy can be wrong.
Patients may also have years to live due to misdiagnosis and because predicting life expectancy is not an exact science. See 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, January 14, 2009.
Affidavit of John Norton, ¶ 5.
3. Treatment can lead to recovery.
This last July, it was 12 years since my diagnosis. If [my doctor] had believed in assisted suicide, I would be dead.
F. If SB 128 Is Enacted, There Will Likely be Pressure to Expand.
In Washington State, we have had informal “trial balloon” proposals to expand our law to non-terminal people. For me, the most disturbing one was in the Seattle Times, our largest paper. A columnist quoted his readers who suggested euthanasia as “a solution” for people without funds in their old age, which could be any of us, say if the company pension fund went broke.
If SB 128 is enacted in California, it’s not unlikely that there will be a similar push for expansion to “non-terminal” people.
G. SB 128 Legalizes Euthanasia.
Generally accepted medical practice allows a doctor, or “a person acting under the direction of a doctor,” to administer drugs to a patient. Common examples of persons acting under the direction of a doctor, include: (1) nurses who administer drugs to patients in a hospital setting; (2) parents who administer drugs to their children in a home setting; and (3) adult children who administer drugs to their parents in a home setting.
Under SB 128, an “aid-in-dying drug” is a drug that a patient “may choose to self-administer” to bring about his or her death. There is, however, no language making self-administration mandatory. For example, there is no language stating that administration of the drug “must” be by self-administration.
H. Euthanasia Is Not Prohibited.
Nothing in this part may be construed to authorize a physician or any other person to end an individuals’s life by lethal injection, mercy killing, or active euthanasia.
Actions taken in accordance with this part shall not, for any purposes, constitute suicide, assisted suicide, homicide [another word for “euthanasia”], or elder abuse under the law.
I. The Provision Making “Undue Influence” a Felony Is Too Vague to Be Enforced.
Knowingly coercing or exerting undue influence on an individual to request an aid-in-dying drug for the purpose of ending his or her life or to destroy a withdrawal or rescission of a request is punishable as a felony. (Emphasis added).
In California’s Welfare and Institutions Code, by contrast, a determination of undue influence is based on a list of enumerated factors, for example, that the victim was ill and the person influencing her was a health care professional.
This scenario is specifically allowed by SB 128. Under the bill, an “attending physician” is permitted to “counsel” (influence) an ill person to end her life.
How do you prove that criminal “undue influence” occurred under SB 128, when the bill: does not define it; provides no elements of proof; and specifically allows conduct used to prove undue influence in another context? It’s hard to say.
A statute which . . . forbids . . . the doing of an act in terms so vague that men of common intelligence must necessarily guess at its meaning and differ as to its application violates the due process requirement of adequate notice. (Internal punctuation removed).
With SB 128's prohibition against undue influence too vague to be enforced, the purported liability for violating that prohibition is illusory. Patients are not protected.
V. PUBLIC POLICY, SAFETY AND WELFARE.
A. Assisted Suicide Can Be Traumatic for Family Members as Well as Patients.
[E]xperienced full or sub-threshold PTSD [Post Traumatic Stress Disorder] related to the loss of a close person through assisted suicide.
2. My cases involving the Oregon and Washington assisted suicide laws.
I had two clients whose fathers signed up for the lethal dose. In the first case, one side of the family wanted the father to take the lethal dose, while the other did not. The father spent the last months of his life caught in the middle and traumatized over whether or not he should kill himself. My client, his adult daughter, was also traumatized. The father did not take the lethal dose and died a natural death.
B. Enacting SB 128 Will Allow California Health Care Providers to Steer Patients to Suicide.
If SB 128 is enacted, California health care providers and insurers will be able to steer patients to suicide through coverage incentives, a practice that is well documented in Oregon. For more information, see the affidavit of Oregon doctor Kenneth Stevens at pages A-39 through A-48.
The Oregon Health Plan is a government health plan administered by the State of Oregon. If assisted suicide is legalized in [your state], your government health plan could follow a similar pattern. Private health plans could also follow this pattern. If so, these plans would pay for you . . . to die, but not to live. (Emphasis added).
The cost of suicide [and attempted, but unsuccessful suicides] is enormous [for Oregon]. In 2010 alone, self-inflicted injury hospitalization charges exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars.
Oregon is the only state where there has been legalization of assisted suicide long enough to have statistics over time. The significant financial cost due to increased conventional suicides in Oregon, positively correlated to physician-assisted suicide legalization, is a significant factor for this body to consider regarding SB 128, which seeks to legalize physician-assisted suicide in California.
If California with its tenfold larger population enacts SB 128 and has the same experience as Oregon, the cost could be substantial.
A. SB 128 Will Still Allow the Perfect Crime, and Will Encourage People with Years to Live Fulfilling and Productive Lives to Cut Their Lives Short.
The bill analysis for SB 128, prepared by the Assembly Health Committee on July 2, 2005, suggests amendments regarding data collection, reporting and who may act as a witness on the lethal dose request form. A copy of these suggested amendments can be viewedat this link.
These amendments do not remove the bill’s major problems: (1) There is still a complete lack of oversight when the lethal dose is administered with not even a witness required (if the patient struggled, who would know?); (2) The death certificate is still required to reflect a natural death (preventing prosecution even in a case of outright murder); and (3) “Eligible” persons still include people with years, even decades, to live.
SB 128 will still allow the “perfect crime.” The bill will still encourage people with years to live fulfilling and productive lives to cut their lives short.
B. The Suggested Amendments Promote the Idea That People are “Burdens” Who Should be Killed, Which is Contrary to California Public Policy.
The suggested amendments propose a check-the-box form for doctors to complete, in which people who died under SB 128 will be referred to as having been a “burden.” (Pages A-80 and A-81 at this link). Referring to someone as a “burden” is a recognized warning sign of abuse. The proposed amendments promote the idea that California residents are burdens who should be killed. This notion should be clearly and strongly rejected.
If SB 128 becomes law, people with years to live will be encouraged to throw away their lives; patients and their families will be traumatized.
With the required falsification of the death certificate, the bill allows the “perfect crime.” Even if you are for the concept of assisted suicide, SB 128 is the wrong bill.
DATED THIS 7th DAY OF AUGUST 2015.
Choice is an Illusion, a nonprofit corp.
 I have been licensed to practice law in Washington State since 1986. My practice has included appeals and elder law (wills, probate and guardianships). I am a former Law Clerk to the Washington State Supreme Court and a former Chair of the Elder Law Committee of the American Bar Association Family Law Section. I am also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. See www.margaretdore.com andwww.choiceillusion.org.
 See Kathryn Alfisi, “Breaking the Silence on Elder Abuse,”Washington Lawyer, February 2015 (regarding Astor, other elder abuse victims and elder abuse generally), at https://choiceisanillusion.files.wordpress.com/2015/08/5-breaking-silence_001.pdf; People v. Rutterschmidt et al, 147 Cal.Rptr.3d 518 (2012)(affirming the “black widow” convictions); LAPD Blog, “Two Elderly Women Arrested for Insurance Fraud,” May 19 2006, athttps://choiceisanillusion.files.wordpress.com/2015/08/6-lapd-blog_001.pdf; and CrimeJail Editor, “American Greed: The Black Widows (Helen Golay and Olga Rutterschmidt),” January 31, 2014, at http://crimejail.com/american-greed-black-widows-helen-golay.
 California Department of Justice, “A Citizen’s Guide to Preventing and Reporting Elder Abuse,” page 4, available at http://ag.ca.gov/bmfea/pdfs/citizens_guide.pdf.
 See SB 128, § 443.11(a) (describing the form), at pp. A-5 and A-6, at https://choiceisanillusion.files.wordpress.com/2015/08/sb-128-as-of-8-6-15_001.pdf.
 Id. at page A-6 (allowing one of two witnesses be an heir “entitled to a portion of the person’s estate upon death”).
 SB 128, § 443.18, second sentence, at page A-9, at https://choiceisanillusion.files.wordpress.com/2015/08/sb-128-as-of-8-6-15_001.pdf.
 RCW 70.245.180, second sentence, athttps://choiceisanillusion.files.wordpress.com/2015/08/7-rcw-70-245-180_001-1.pdf.
 Affidavit of Kenneth Stevens, MD ¶¶ 5-9, Jeanette Hall discussed beginning at page A-40.
 Affidavit of Jeanette Hall, ¶ 4. Jeanette is still alive today, fifteen years later.
 Declaration of Dr. Kenneth Stevens, MD, ¶10. (Attached A-54).
 SB 128, § 443.17(b), page A-9, at https://choiceisanillusion.files.wordpress.com/2015/08/sb-128-as-of-8-6-15_001.pdf.
 See e.g., SB 128, § 443.5(a)(5).
 Oregon’s assisted suicide report for 2014, first sentence.
 See Oregon Health Authority News Release, September 9, 2010, at http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000").

References: V. 
 v. 
 § 443
 § 443
 § 443
 § 443