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True Dignity Vermont is a grassroots, independent, citizen-led initiative in opposition to assisted suicide in Vermont. Vermonters deserve true dignity and compassion at the end of life, not the abandonment of assisted suicide. Killing is not compassion, and True Dignity Vermont will work to ensure our end-of-life choices respect the dignity of all Vermont citizens.

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Bloggers from True Dignity attended the East Coast Conference Against Assisted Suicide on Saturday in Hartford, CT. Thank you to Peter and Leslie Wolfgang from Connecticut Family Foundation for organizing a successful event. We will be blogging periodically about some new interesting perspectives on assisted suicide gained from the convention.

A few of the speakers have been directly engaged with the pro-assisted suicide / euthanasia lobby over the years, which led to a very interesting chain of comments and discussion about what was encountered within the assisted suicide lobby. Learning the demographics of this group was incredibly interesting.

Alex Schadenberg from the Euthanasia Prevention Coalition spoke about attending the annual conference for the pro-assisted suicide / pro-euthanasia lobby. He expected to meet a room full of people that looked much like our lobby in opposition to assisted suicide and euthanasia, with the opposite opinion on the issue. We know our lobby looks like America, consisting of different ethnic groups, people from all walks of life, both elderly and young, representatives from disability groups and the medical community.

Instead Alex encountered a group of middle-aged white people who were involved in helping others complete the act of suicide. There were not masses of people begging for the option to kill themselves, but instead a small group of people who had broken the law in various states by aiding in the killing of another human being. These people wanted assisted suicide legalized to protect them from being prosecuted for their illegal actions.

How do you exactly assist someone in completing the act of suicide in places where it is illegal? Exit bags have been commonly used. These are bags affixed over the head of the person committing suicide, often accompanied by helium or nitrogen to help lessen the panic encountered during suffocation. Those very compassionate people who are helping someone using an exit bag sit at that person’s sides and and hold her arms down when she begins to struggle, of course in a compassionate way. These were the majority of people that filled the seats at the conference Alex attended.

Award winning author Wesley Smith also discussed the demographics of the pro-assisted suicide lobby with attendees at the conference. He discussed his encounter with them during the suicide of his friend who used their propaganda and aid to kill herself. He referred to them as a very small group of ideologues with large amounts of propaganda. “We look like America, they don’t,” Wesley explained. He detailed reading through their propaganda that was studied by his friend before committing suicide. He hauntingly described it as proselytizing for suicide. The information was presented with the zeal of religion. They even used the word “delivering” for the act of suicide among the depressed.

Also speaking at the conference via Skype was Tom Mortier, PhD, from the University of Leuven in Belgium who lost his mother to euthanasia in Belgium. He was notified of her death by a letter he received in the mail. She battled depression throughout her life but was 100% physically healthy. She was euthanized at her own request for psychiatric suffering.

Shocked and horrified, Tom went to visit the man who euthanized his mom looking for answers. Tom received no answers. He was denied the ability to see her medical file so he could know what had happened that led to her death. He recounted his meeting with the man who killed his depressed mother by explaining that the man was completely devoid of any empathy for him. He described the man as a detached, stone cold killer unaffected by human emotion and sorrow.

Thank you to Alex, Wesley and Tom for sharing their personal experiences with the pro-suicide lobby. It sheds light on the cruel and heartless demographic of abandonment that they are.

“You don’t see people marching in the street demanding the right to be killed by a doctor,” Attorney and Award winning Author Wesley J. Smith told a packed conference room at Saturday’s East Coast Conference Against Assisted Suicide in Hartford, Conn., coordinated by the Family  Institute of Connecticut and the Euthanasia Prevention Coalition.

“Suicide pushers are a small group. We look like America, they don’t,” Smith emphasized.

The “we” to whom Smith referred, are essentially anyone for whom legally sanctioned, assisted suicide poses a very real risk. The elderly, the frail, the mentally ill, those who face serious illness or disability of any kind– all eventually may be judged as “better off dead” in a culture where the solution to suffering is to kill the sufferer, Smith told the audience.

“We’re not talking about a theoretical slippery slope, we’re talking facts on the ground,” he said.

Yet, despite their small numbers, the persistent efforts of the “suicide pushers” to pass legislation to allow doctors to help patients kill themselves have begun to change the national consciousness about suffering and perhaps more significantly, about those who suffer. The exploitation in recent weeks of Brittany Maynard by Compassion and Choices, formerly the Hemlock Society, has catapulted the topic into the headlines and onto social media, putting a sympathetic, but deceptive face on the realities of legalized assisted suicide.

The cultural consciousness about suffering is quickly devolving into a mindset where anyone who suffers is viewed as the “cause” of suffering—their own, and the suffering of those around them. As Smith aptly demonstrated with numerous examples from the United States and around the world, any one of us may one day be at risk if the “suicide pushers” succeed.   Elder abuse is already a serious problem in the U.S., and legally-sanctioned doctor-prescribed death will only exacerbate cases of abuse. Over the past 30 years in the Netherlands, legal euthanasia has expanded to include children, the mentally ill, and people with disabilities as diverse as blindness, anorexia nervosa, and autism. There have been cases where elderly married couples afraid of leaving one another widowed have been euthanized together, on request, to avoid being left alone. It’s entirely legal, and what’s more—approved by society at large. Smith provided some chilling anecdotes of witnessing the applause of onlookers at staged home suicides, a macabre tableau which he labeled, “Cruel and Unusual Death with Dignity.”

Smith’s message, a theme repeated by speakers throughout the conference, was clear: when society accepts killing as a solution to some kinds of suffering, it is only logical that it will eventually expand to include killing for any suffering. The so-called “choice” to die will become a “duty” to die.

Conference attendees heard from numerous speakers who described personal experiences with such attitudes, including:

  • Maggie Karner, a woman with glioblastoma multiforme brain cancer, the same cancer that Brittany Maynard had until her suicide on Nov. 1. Her video plea to Maynard to rethink her suicide went viral:  http://www.youtube.com/watch?v=1ZR-qB3HaQY
  • Tom Mortier, a Belgian man whose otherwise physically healthy mother was legally euthanized by her psychiatrist, after requesting death in response to her suffering from chronic depression, and without the knowledge of her family.  http://www.mercatornet.com/articles/view/how_my_mother_died
  • John Kelly, a leader in the disability-rights group Second Thoughts-Massachusetts;  http://www.second-thoughts.org/
  • Kathy Ludlum and Stephen Mendelsohn of Second Thoughts Connecticut

True Dignity plans to report in more detail on some of the presentations and themes that emerged from the conference over the next few days.

During the Brittany Maynard publicity explosion, bioethicist Arthur Caplan wrote that young people, identifying with Maynard, would come out in droves to push the legalization of assisted suicide.  There is, however, a cohort of young people reacting to the Maynard videos in exactly the opposite way, by expressing their strong opposition.

Meghan Schrader, a thirty-two year old from Massachusetts with whom we became acquainted just this week,  is part of this cohort.  As a person with disability working with people with disabilities  who also have socio-economic and racial disadvantages, she is acutely aware of just how dangerous widespread legalization would be in the prevailing social context of inequality.  Below, in italics, is an article Schrader originally posted as a comment on a closed Facebook page. She has expanded and revised it for True Dignity.  The title of this post is also hers.

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Brittany Maynard could have been my classmate. Like her, I am a member of the millennial generation, born two years before her in 1982. Since Maynard’s entrance into the public arena, many have speculated that she will inspire the “the Millenial Generation,” to support choice in dying. But as a disability advocate who has lived and studied the experience of systemic ableism, I am firmly and unequivocally against this practice. I am very disturbed by what I regard to be the lookist, ableist, racist and classist way in which Brittany’s image has been promoted as the new face of assisted suicide.

Maynard’s appeal lies largely in her whiteness, the vulnerability associated with her gender, and the impression of able-bodiedness conferred by her wedding photos. What’s more, the concept of autonomy she represented is based on the circumstances of those who share that privileged status.

For instance, Brittany Maynard’s privileged conception of autonomy was reflected in her editorial demanding that (palliative care physician) Ira Byock not discuss “her.” This ironic request for privacy was waylaid by the fact that Maynard wanted society to effect social policy based on her story. Hence, her characterization of her decision as being between her and her doctor was inappropriate: Maynard’s decision was between her and the rest of the country. The public has a right to consider such legislation in the context of other cancer patients, who have an equal claim to the country’s consideration.

For example, since 2008 I have spent time as a Special Education Surrogate Parent in the Massachusetts school system. Volunteers assume the responsibilities of a parent in making educational decisions for special needs students in foster care. All of the students I’ve had were younger members of the millennial generation, all of whom were people of color who had been maltreated by their families and by social services. If one of them got cancer, their experience of autonomy would be much different than Maynard’s. Unlike her, they would navigate their options through the agency of over-extended or apathetic social workers. They would not have loving families to stand by them as they underwent chemotherapy, or sit vigil at their bedsides during their last weeks in hospice; they would be subject to the ministrations of volunteers like me. Hence, a choice for assisted suicide on their part would be made in the context of social subjugation.

At most, Brittany spoke for *some* millennials. But when I think of the colleagues I have met through the Society of Disability Studies, many of whom are also millennials, I’m once again reminded that there are entire demographics whose perspectives are not included in this pivotal discussion. As a millennial who grew up in special education and witnessed the pernicious influence of systemic oppression, I am adamantly opposed to assisted suicide, as are my colleagues who were almost allowed to die in infancy or who have faced medical professionals urging them not to choose medical treatment that would save their lives. Much of this discrimination was the result of cultural invisibility; the latter of which results in historical and political ignorance.

Brittany came from an upper middle class family; enjoyed post-secondary education at a top tier school, traveled extensively, and thus lived her life in a socially dominant position. If she had chosen hospice care, her family would have supported her financially, physically and emotionally. Her story and its presentation in the mainstream media represent the social sphere in which most right-to die ideology is formed: that of able-bodied, educated, privileged white people. As the media encourages lawmakers to focus myopically on Maynard’s story, I hope that they will remember the thousands of people whose faces will never appear on the cover of People Magazine.

 

Below is an excellent article by Wesley J. Smith detailing how Swiss Nursing homes are now advertising assisted suicide to patients, without conscience objection. Forced participation in assisted suicide, in violation of conscience, is already happening to some degree in the United States. Nancy Valko, RN, explains how nurses are already being forced to facilitate assisted suicide in the United States:

After Oregon passed its assisted suicide law, the Oregon Nurses Association published assisted suicide guidelines for nurses that state: “[i]f the nurse becomes involved in a situation where he/she is unwilling to be involved in the care of a patient who has chosen assisted suicide, the nurse continues to be obliged to provide for the patient’s comfort and safety, and to withdraw only when assured that alternative sources of end of life care are available to the patient. If the nurse is unable to transfer care to another provider, the nurse has the responsibility to provide for ongoing end of life care.” and that nurses may not ““subject your patients or their families to unwarranted, judgmental comments or actions because of the patient’s choice to explore or select the option of assisted suicide.” (emphasis added). (Source: “Assisted Suicide: the Debate Continues.” The Oregon Nurse. Vol 62, No.3, September 1997. Online at: http://c.ymcdn.com/sites/www.oregonrn.org/resource/resmgr/imported/Assisted%20Suicide%20Adjusted.pdf)

So the groundwork for being forced to facilitate assisted suicide has already been laid out in the US.

And just as disturbing, also note that Compassion and Choices has pushed for VSED (voluntary stopping of eating and drinking) to be included with end of life discussions in the US. VSED is on C and C’s options page on their website as a legal option for states without legalized assisted suicide laws. C and C, of course, already opposes conscience rights for ethical health care providers.”

In his article, Wesley J. Smith discusses how the Swiss legislature has recently passed legislation to allow assisted suicide groups to advertise and promote within government-funded nursing homes.

There are no exemptions for conscientious objection by managers in the homes…The new regulations specify that nursing home personnel will not be allowed to interfere if a patient chooses to die. In fact, they are required to set aside a room where the staff of the assisted suicide organisation Exit will help the person to die…Imagine the potential impact on other patients. Imagine knowing that there is a suicide room in your nursing home…And imagine knowing your caregivers have to cooperate in the suicides of you or your friends.”

Wesley J. Smith’s full article is available here:

http://www.lifenews.com/2014/11/17/nursing-homes-forced-to-facilitate-suicide-push-killing-services-on-elderly/

 

Governor Chris Christie’s remarks on the issue of assisted suicide show an indication that he is not inclined to support the New Jersey legislation A2270, legalizing assisted suicide.

According to Tim Rosales from the New Jersey Alliance Against Doctor Prescribed Suicide, “We remain cautiously optimistic that the NJ State Senate, Gov. Christie and others will listen to the bipartisan and diverse chorus of voices weighing in against New Jersey’s assisted suicide bill. As always, once people begin to get more informed and educated about what assisted suicide is and weigh it against non-controversial options like hospice and palliative care, the more they see assisted suicide itself and Compassion & Choices mission as antiquated and unnecessary.” The New Jersey Alliance Against Doctor Prescribed Suicide in a diverse a group of opposition including patients rights and disability organizations, religious and policy groups and medical organizations including doctors and nurses.

Gov. Christie has at times expressed direct opposition to assisted suicide legislation. Given the complete lack of safeguards, A2270 puts the elderly and disabled at risk and jeopardizes the conscience of the entire medical community. If the New Jersey Senate passes this legislation it would present Gov. Christie with the perfect opportunity to use his veto power to avoid a reckless social experiment with publicly sanctioned suicide.

Attorney Margaret Dore has reminded us of a very important side story to the widely publicized Barbara Wagner case, in which the Oregon Health Plan (Oregon Medicaid) declined coverage of life extending chemotherapy for Ms. Wagner’s lung cancer in a a letter listing, among other options it would cover, physician assisted suicide ((http://abcnews.go.com/Health/story?id=5517492). After an explosion of negative publicity, the Oregon Health Plan, according to testimony given to the VT legislature, quit sending letters offering such stark alternatives. It does, however continue the practices it no longer dares to state: rationing care, favoring preventive care over care for the sick, covering assisted suicide, and refusing to cover treatment that does not have at least a 5% chance of producing a 5 year survival rate.

At the time of the Wagner story, Barbara Coombs Lee, the national spokesperson for Compassion and Choices, the group that has lobbied for assisted suicide laws for many years, wrote an op-ed defending the Oregon Health Department (http://www.margaretdore.com/pdf/Coombs_Lee_against_Wagner.pdf). Here is a quote from her essay:

As a publicly funded service, Oregon Health Plan aims to do the greatest good it can. It assigns a high priority to preventive care, health maintenance, and treatments that ofter (sic) a near-certain cure. Elective, cosmetic or ineffective, “futile” care is not covered. Futile care is defined as any treatment without at least a 5 percent chance of 5 year survival. “We can’t cover everything for everyone,” said the medical director of OHP. “Taxpayer dollars are limited for publicly funded programs. We try to come up with policies that provide the most good for the most people. “

From a utilitarian viewpoint that reduces a person to dollars and cents, this practice seems rational and necessary. We are, however, dealing with human beings, and True Dignity believes the numbers must be secondary to human needs, among them the need for the very autonomy in decision-making that the proponents of assisted suicide demand in their mantra: “My life. My death. My choice.”   What about Barbara Wagner’s life, death, and choice? While a person wanting assisted suicide is perfectly capable of committing suicide without assistance, Barbara Wagner’s only chance to get her wish was the chemotherapy.  Barbara Coombs Lee does not seem to support Wagner’s right to any choice except the cheap one of suicide.

The biographical note at the end of the article tells us that Barbara Coombs Lee has been a managed care executive. The real question here is who is going to manage medical care: an insurance provider, tax-funded or not, or the patient who is affected? Do we really want to tell patients like Barbara Wagner that we will not pay the $8000 it would have cost to give her a couple of more months of life that she, well aware that it would likely be no more than that, said she wanted and needed? After the publicity, the drug maker stepped in and provided the medicine. Wagner’s death three weeks after starting it could have been hastened by the stress and delay involved in getting it.  The death certainly does not prove that the state was right in its denial, as Ms. Coombs Lee asserts, or even that the three weeks were not the gift of the drugs.

A physician whose comment you can read at the end of the Coombs Lee article wrote that there are methods of reducing runaway medical costs without impinging on patient autonomy. His suggestions are:

  1. Figuring out a way to reduce very expensive emergency room visits for care that could be provided by a doctor at less cost. Unfortunately, emergency room visits have increased, not decreased, since the adoption of Obamacare
  2. Encouraging healthy lifestyles that could prevent or delay chronic illnesses that are expensive to treat
  3. Providing incentives for people to use their health insurance wisely, perhaps by making them pay a greater percentage of the cost of tests like MRIs and CAT scans

This doctor says the end of life is not the time for cost cutting. He says that accepting the utilitarian viewpoint that judges the worthiness of living in terms of dollars and cents would logically lead society to refuse to pay for any cancer care at all. By that logic why pay for any care of the sick, since a human being costs zero dollars if he or she is dead? The doctor says that the end of life is the very time when people should be able to get the care they want. True Dignity was going to add “and that their doctors want”, but we are hearing from patients that the corruption of medicine under the influence of people like Barbara Coombs Lee and of programs that incentivize doctors to deny care is so complete that the patient now has to fight for his own right to live without help from doctors. We speculate that fear of doctors may also be contributing to the explosion, not only in emergency room visits, but in visits to urgent care centers, which are growing in numbers and making lots of money in taxpayer subsidized insurance payments.

True Dignity agrees with the doctor/commenter. Pundits, doctors, and medical ethicists who complain about and want to reduce spending at the end of life are disrespectful of the contributions every person has made during his life, by his relationships, his work, and his simple existence, but also by his payment of taxes and insurance premiums through many healthy years, made under the presumed existence of a social contract in which he expected to pay for sick people’s health care then and have his own paid for when he became sick. In many cases, retired people and poor people dependent on Medicaid continue to pay premiums. The optional Medicare Part B is not free by any means, and required Medicare Part A premiums continue to be deducted from pension checks for those of us lucky enough to have them. Medicaid also has premiums and co-payments, set by each state.

Are we as a society so divorced from centuries of custom and ethics that valued caring, and so sold on the Barbara Coombs Lee “managed care” “ethic”, that we are willing to use our laws to push suicide in order to save money? True Dignity continues to hope not, and so we continue our fight against legalization of assisted suicide.

There is bad news out of New Jersey this afternoon where the New Jersey Assembly approved assisted suicide legislation, bill A2270, by a vote of 41-31-0. Support for the bill included 37 Democrats and 4 Republicans.

The bill will now move to the New Jersey Senate where we will keep you up to date, and ask you to engage and voice opposition as well.

This fight is not over. As John Kelly, a New Jersey native, said this afternoon “We’re not dead yet!”

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