Source: https://www.choiceillusion.org/2017/05/south-dakota-initiated-measure-stacked.html
Timestamp: 2019-04-19 21:30:47+00:00

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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, which seeks to legalize assisted suicide and euthanasia in South Dakota.
The initiated measure is sold as a promotion of patient choice and control. The measure is instead stacked against the patient and a recipe for elder abuse.
If enacted, the measure will apply to people with years or decades to live. People with years or decades to live will be encouraged to throw away their lives. I urge you to reject this measure.
[T]he physician provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide.
Assisted suicide is a general term in which an assisting person is not necessarily a physician. Euthanasia is the administration of a lethal agent to cause another person’s death.
This year, the South Dakota Legislature passed Senate Concurrent Resolution 11, opposing physician-assisted suicide. The vote was 32 to 3 in the Senate and 67 to 1 in the House. The vote to pass was nearly unanimous.
Last year, the New Mexico Supreme Court overturned a lower court decision that had recognized a right to physician aid in dying, meaning physician assisted suicide. Physician-assisted suicide is no longer legal in New Mexico.
In the last six years, five other states have strengthened their laws against assisted suicide. These states are Arizona, Louisiana, Georgia, Idaho and Ohio.
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 (Vermont, California and Colorado). In the fine print, these laws also allow euthanasia.
Elder abuse is a prevalent and largely hidden problem throughout the United States, including South Dakota. Perpetrators are often family members who start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or to coercing victims to change their wills or to liquidate their assets.
[These men] sought companionship and found instead . . . someone who siphoned their savings, slipped drugs into their food and, in the case of one man, ran him over with a car and left him dead on a dirt road.
The measure has an application process to obtain the lethal dose, which includes a written lethal 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.
After the lethal dose is issued by the pharmacy, there is no oversight. No doctor, not even a witness, is required to present at the death.
When signing a will, having an heir act as one of two witnesses can support a finding of undue influence. Washington State’s probate code, for example, provides that when one of two witnesses receives a gift under a will, there is a rebuttable presumption that the gift was procured “by duress, menace, fraud, or undue influence." The proposed measure, which allows an heir to act as one of two witnesses on the lethal dose request form, invites coercion.
“Terminal disease,” [means] an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.
“Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.
If the proposed measure is enacted, assisted suicide and euthanasia will be allowed for people with chronic conditions such as insulin dependent diabetes. Such persons can have years or decades to live.
If the proposed legislation is enacted, people like Jeanette Hall, with years or decades to live, will be encouraged to throw away their lives.
"Informed decision," [means] a decision . . . that is based on an appreciation of the relevant facts and after being fully informed . . . of . . .
(e) The feasible alternatives, such as, comfort care, hospice care, and pain control. (Emphasis added).
[W]here general words . . . precede the enumeration of particular classes of things, . . . 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 having to do with 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 dying. Patients lose the right to be told about alternatives for cure.
“Competency,” in the opinion of a court or in the opinion of the patient’s attending physician or consulting physician, psychiatrist, or psychologist, a patient’s ability to make and communicate an informed decision to health care providers, including communication through persons familiar with the patient's manner of communicating if those persons are available .... (Emphasis added).
Note that the communicating person is not required to be the patient’s designated agent. Being familiar with a patient’s “manner of communicating” is, regardless, 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 for the patient during the lethal dose request process. With this situation, patient choice and control is far from guaranteed.
With assisted suicide laws in Washington and Oregon [and with the proposed 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 significance of requiring a terminal disease to be listed as the cause of death is that it creates a legal inability to prosecute. The official legal cause of death is a terminal disease (not murder) as a matter of law.
More to the point, a perpetrator will be let off the hook: The measure will create the perfect crime.
The measure says that a patient may self-administer the lethal dose. There is no language, however, that administration “must” be by self-administration.
“Self-administer,” a qualified patient’s act of ingesting medication to end the patient’s life . . . (Emphasis added).
[T]o take (food, drugs, etc.) into the body, as by swallowing, inhaling, or absorbing. (Emphasis added).
With this definition, someone else putting the lethal dose in the patient’s mouth will qualify as self-administration because the patient will be “swallowing” the lethal dose, i.e., “ingesting” it. Someone else placing a medication patch on the patient’s arm will qualify because the patient will be “absorbing” the lethal dose, i.e., “ingesting” it. Gas administration, similarly, will qualify because the patient will be “inhaling” the lethal dose, i.e., “ingesting” it. With self-administer defined as mere ingesting, someone else is allowed to administer the lethal dose to the patient.
Euthanasia is the administration of a lethal agent by another person to a patient . . . (Emphasis added).
The proposed 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.
[T]he patient’s death certificate ... shall list the underlying terminal disease as the cause of death. (Emphasis added).
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).
1. The underlying terminal disease must be listed as the cause of death.
If South Dakota enacts the proposed measure and follows Washington State, death certificates will not even hint that the actual cause of death was assisted suicide or euthanasia. This will happen simply because the measure was “used.” There will be an official legal cover up.
Oregon is not a valid case study due to a near complete lack of transparency regarding its law. Even law enforcement does not have access to the information collected and source documentation is destroyed. The bottom line, Oregon’s official data cannot be verified.
experienced full or sub-threshold PTSD (Post Traumatic Stress Disorder) related to the loss of a close person through assisted suicide.
In Washington State and Oregon, I have had two cases where my clients suffered trauma due to legal assisted suicide. In the first case, one side of the family wanted the father to take the lethal dose, while the other side did not. The father spent the last months of his life caught in the middle and torn over whether or not he should kill himself. My client, his adult daughter, was severely traumatized.
The father did not take the lethal dose and died a natural death.
In the other case, it’s not clear that administration of the lethal dose was voluntary. A man who was present told my client that his (my client's) father had refused to take the lethal dose when it was delivered, stating, "You're not killing me. I'm going to bed," but then he (the father) took it the next night when he was intoxicated on alcohol. The man who told this to my client subsequently changed his story.
My client, although he was not present, was traumatized over the incident, and also by the sudden loss of his father.
A person who coerces or exerts undue influence on a patient to request medication to end the patient’s life, or to destroy a rescission of a request, is guilty of a class A felony. (Emphasis added).
The measure also allows a patient’s heir to be one of two witnesses on the lethal dose request form, which is 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 used to prove it in another context? You can’t. The felony for undue influence is illusory and unenforceable.
Passing the proposed measure will encourage people with years or decades to live to throw away their lives.
Administration of the lethal dose is allowed to occur in private without a doctor or witness present. If the patient objected, or even struggled, who would know?
The death certificate will list a terminal disease as the cause of death. This will prevent prosecution for murder, no matter what the facts. The measure, if enacted, will create the perfect crime. Don’t make Oregon and Washington’s mistake. I urge you to reject the proposed measure.
 I am an elder law and appellate attorney licensed to practice law in Washington State since 1986. I am also a former Law Clerk to the Washington State Supreme Court. I am president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. My CV is attached in the appendix at A-1 to A-4. See also www.margaretdore.com, www.choiceillusion.org.
 The measure is attached hereto in the appendix at A-101 through A-111.
 The AMA Code of Medical Ethics, Opinion 5.7.
 Id, Opinion 5.8, “Euthanasia,” (lower half of the page).
 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; article can also be viewed in the appendix at A-6, quote at A-8.
 Bill History, South Dakota Senate Concurrent Resolution 11, “Opposing physician-assisted suicide,” attached in the appendix at A-9.
 Morris v. Brandenburg, 376 P.3d 836 (2016).
 The measure’s lethal dose request form can be viewed in the initiated measure at § 3, in the appendix at A-102 to A-104. The witness section can be viewed at A-104.
 See the measure in its entirety, in the appendix at A-101 to A-111.
 Wash. Rev. Code Ann. § 11.12.160(2), in the appendix at A-10.
 The initiated measure, § 1(12).
 Or. Rev. Stat. 127.800 s.1.01(12), attached to Toffler Declaration at A-22.
 See Declaration of William Toffler, MD, at A-20 to A-21, ¶¶ 2-4.
 Cf. Jessica Firger, “12 million Americans misdiagnosed each year,” CBS NEWS, 4/17/14, attached hereto at A-25, 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 at A-6 to A-8).
 Affidavit of Kenneth Stevens, MD, also attached in the appendix at A-29 to A-35; Jeanette Hall discussed at A-29 to A-30; Hall declaration, also attached in the appendix at A-36.
 Declaration of Jeanette Hall, ¶4, also in the appendix at A-36.
 See initiated measure, §§ 1(6) & 7, also attached in the appendix at A-101 & A-106.
 Crawford v Schulte, 829 N.W.2d 155, 158 (2013).
 The initiated measure, § 2.
 The initiated measure, § 4, last sentence.
 See id., § 2 ("the patient may self-administer").
 See the measure in its entirety.
 Opinion 5.8, “Euthanasia,” (lower half of the page).
 Id., § 4, last sentence.
 Again, see Washington State’s probate statute in the appendix at A-43.

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