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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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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!”

East Coast Conference Nov 22!

East Coast Conference Against Assisted Suicide Nov 22 in Hartford Register Now

There will be a conference hosted by several East Coast groups Nov. 22 in Hartord CT.  Some great speakers will be present, including Nancy Elliot the former New Hampshire State Representative who helped orchestrate the astounding defeat of Assisted Suicide in New Hampshire this year.  Peter Wolfgang of Connecticut and John Kelly of Massachusetts who also helped lead the defeats in their states will also speak.

The keynote will be by Attorney and award winning author Wesley J. Smith a bioethics consultant and writer for the National Review Online.  Alex Shadenberg, an international leader in the fight against assisted will also speak. And there are still more great speakers!  For a full list visit their site.

This conference promises to be the premier event this year for those interested in learning more about Assisted Suicide on the east coast and the unique concerns of several New England states.

If you do go, tell us!  Though we are not sponsors of the event, some of the board members will be attending to report for True Dignity, so keep an eye and ear out.

East Coast Conference Against Assisted Suicide Nov 22 in Hartford Register Now

Endorsements and donations from Patient Choices, the VT pro-assisted suicide group backed up by the nationwide group Compassion and Choices, do not seem to have paid off in the 2014 VT elections.

The most spectacular defeat for a Patient Choices-endorsed legislator was that of Linda Waite-Simpson, about whom we have written several times. Waite-Simpson was instrumental in getting the VT law passed, then took a paying job as state director of Compassion and Choices when it moved into VT, then testified in the CT legislature’s assisted suicide hearings as a VT legislator without revealing her ties to C&C, then spent the summer traveling the state trying to “educate” reluctant doctors and patients into “using” the law, while simultaneously running for re-election. The vote wasn’t even close!

Several other Patient Choices-endorsed legislators were also defeated.

The elections were very good news for Vermonters working to defeat assisted suicide!

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