The Voices Behind the Defeat of New Hampshire's Aid in Dying Bill.

The bill in New Hampshire to legalize aid in dying has been voted down. Below are a few news sources regarding the vote and an interesting appearance of one particular character, Margaret Dore, who has appeared on these pages before.

If you remember, Dore wrote me a series of impassioned emails back in October, then called to rant at me on the telephone for over an hour. We "discussed" the ins and outs of the Death with Dignity bills in Washington, her home state, and Oregon. Numerous times I asked her to calm down. During the call she was demeaning, patronizing, curt, and, to tell the truth, she sounded about at her wits' end. (I received a call of apology two days later, not from Dore but from someone who knows her.)

Dore, it seems, is not wasting away her wits' end just on bloggers like me. Lifenews quotes Alex Schadenberg (a follower of this site) as commending Dore and other members of his Canada-based Euthanasia Prevention Coalition for defeating the bill.

Either I assume that EPC has American members or the group is doing a little cross-border work to save us Americans from ourselves.

From Nashua Telegraph and Vermont's WCAX, via AP.

From conservative lifenews, told with the self-righteousness of one who thinks his God's laws the only:

Representatives defeat a bill on Wednesday that would have made the state the fourth to legalize assisted suicide. Oregon, Washington and Montana already allow the practice and the New Hampshire bill would have targeted the elderly and terminally ill as well.

The House voted 242-113 against the measure, which would have allowed physicians to dispense lethal drugs to patients to use to kill themselves.

The vote came after a majority of the members of the House Judiciary Committee recommended the state House kill the bill. Some lawmakers wanted to send the legislation back to the panel for more study but a majority decided to defeat the measure.

Alex Schadenberg, the head of the Euthanasia Prevention Coalition, told LifeNews.com today that Margaret Dore and members of the coalition worked hard to defeat the legislation.

"This vote proves that assisted suicide is a recipe for elder abuse and Choice is a Lie," he said.

The language of the bill could have turned the Granite State into a suicide haven because the measure, HB 304 by Representative Charles Weed, would not only have allowed assisted suicide but would have gone further by making it so a terminally ill patient need not be actually suffering serious symptoms to qualify for assisted suicide.

Rep. Nancy Elliott, a member of the committee opposed to assisted suicide, told AP after the committee vote, "It's not the function of government to encourage suicide in the young or the old. It's a prescription for elder abuse."

Supporters of assisted suicide opposed the bill because it did not take into account current laws and needed more safeguards before moving forward. They promised to bring back another bill with them.

Bioethics attorney Wesley J. Smith criticized the bill when it was introduced and said it would make it so a terminally ill patient need not be actually suffering serious symptoms to qualify for assisted suicide.

"Assisted suicide advocates are cultural imperialists who, as they pretend they only want a 'limited' change in law and culture, actually seek to widen and expand the euthanasia/assisted suicide license through the use of loose definitions and broadly worded 'restrictions," he said.

The Weed measure said a “qualified patient” for assisted suicide "means a capable adult who us a resident of New Hampshire or is a patient regularly treated in a New Hampshire health care facility."

That opens the door to residents of new England states to drive to New Hampshire to kill themselves under the law.

"This would generally spread assisted suicide access to citizens of Massachusetts, Vermont and Maine," Smith explained. "But it also at means people from all over the country could easily qualify for assisted suicide by traveling to New Hampshire for treatment, then obtain the prescription, and go home."

"Usually, state laws and proposals require that patients asking for assisted suicide be residents," he noted.

Kevin Smith of the conservative Cornerstone Policy Research and Bob Dunn, spokesman for the Catholic Diocese of Manchester, also strongly opposed the bill.

New Hampshire Bill to Legalize Death with Dignity Rejected by Committee.

From WMUR comes this development in the effort to legalize aid in dying in New Hampshire:

A bill to legalize assisted suicide in New Hampshire lost key backing Tuesday from a legislative committee when both supporters and opponents joined forces to reject it.

The House Judiciary Committee voted 14-3 against the Death With Dignity bill, which would let terminally ill patients over age 18 obtain lethal prescriptions, with safeguards to prevent abuses.

Supporters of assisted suicide said the bill was flawed and teamed up with opponents to vote against recommending the measure to the full House. The committee has been working on the bill since September.

The House votes on the recommendation in January. If the chamber accepts the committee recommendation, legislative rules make it nearly impossible for the issue to be brought up again next year.

Rep. Nancy Elliott, a committee member who opposes assisted suicide, said she was pleased with the panel's decision.

"It's not the function of government to encourage suicide in the young or the old," she said. "It's a prescription for elder abuse."

Elliott, R-Merrimack, said both sides were opposed for slightly different reasons.

Rep. Lucy Weber, who made the motion to reject the bill, said she supports legalizing assisted suicide, but the bill did not take into account an existing state law against aiding someone to commit suicide.

"There are no death squads in this bill. There are no lethal injections in this bill. This bill is not allowing doctors to make a determination of when somebody's life ends nor is it allowing the state to determine when the life ends. It is about individual self-determination, but I think (the bill) needs more work," said Weber, D-Walpole.

Read more here.

New Hampshire Prepares Death with Dignity Bill.

WCSH6, a channel out of Portland, ME is reporting that the New Hampshire legislature will make its Death with Dignity bill recommendations tomorrow, Tuesday:

A New Hampshire House committee plans to make its recommendation Tuesday on a bill to legalize assisted suicide for the terminally ill.

The Judiciary Committee this fall has been working on the bill, which was introduced last session but held over for more work. The full House votes on the measure next year.

The bill would let terminally ill patients over age 18 obtain lethal prescriptions, with safeguards to prevent abuses.

Opponents call the bill a recipe for elder abuse. They say doctors should be treating the terminally ill, not helping them die.

Oregon has approved assisted suicide ballot questions twice. Washington state followed suit last year.

Discerning Coercion or Abuse Under the Death with Dignity Act.

Margaret Dore is a very new acquaintance. I posted a rebuttal to her article in Washington State Bar News; she called me and vigorously contested my points. And then she emailed me a number of times to make sure she had been clear and understood.

As someone who works to eliminate elder abuse, Dore's issue with the Death with Dignity Act in Oregon boils down to three main points, as I can discern:

1. a family member, perhaps one who is working to coerce their loved one into Death with Dignity, can act as one of two witnesses to the Death with Dignity document

Dore contends that allowing one of the two required witnesses to be a family member opens the door to elder abuse and coercion.

2. a patient, according to her interpretation of the Act, is not required to self-administer the lethal medication

The language regarding self-administration seems clear enough to me but Dore insists that "self-administration" is defined as "ingest" and therefor allows someone else to inject the medication into a feeding tube or to administer the medication in another way, perhaps for their own nefarious purposes. (See above link for more of our exchange.)

3. the act does not require that a witness be present at the time the lethal medication is ingested

Again, Dore insists that this opens the door for elder abuse. Her concern is that most abuse of the elderly is perpetrated by family members. A "loved one" who wishes to end the life of a patient can, without supervision, achieve that goal once the patient has received the medication. Dore contends that the Act serves as an alibi for the acting family member, that no investigation is likely if the patient has successfully fulfilled the qualifications for Death with Dignity and has received the lethal medication.

How this witnessing differs from the common practice of assigning a medical proxy is unclear to me.

Today Dore writes a letter to the ConcordMonitor:

Re "Doctors shouldn't facilitate suicide" (Monitor Opinion page, Oct. 16):

I am an attorney in Washington state, where assisted suicide was recently legalized via a citizens' initiative. Voters thought that they were voting for "choice." Our new law is instead a recipe for elder abuse. Your proposed assisted suicide bill, House Bill 304, has the same problem.

Under HB 304, someone else is allowed to talk for the patient during the lethal dose request process. This someone else could be an heir or new "best friend" who will benefit from the death. There are also no required witnesses at the death. Without disinterested witnesses, the opportunity is created for someone other than the patient to administer the lethal dose to him without his consent. Even if he struggled, who would know? The lethal dose request facilitated by the heir or new "best friend" would provide the alibi.

Don't make Washington's mistake. Protect yourself and your family. Keep assisted suicide out of New Hampshire.

MARGARET DORE

Seattle

Without betraying my private communications with Dore, I feel it necessary to say that no Death with Dignity advocate wishes to promote elder abuse or coercion. In fact, advocates state repeatedly that their efforts are to ensure patient and elder rights and choice at the end of life. My interpretation of the Act - and the state's, and voters' - is that necessary safeguards are in place to prevent coercion or elder abuse.

I am clearly not a lawyer, but I wonder if use of the Act removes motive from any nefariously acting family member. The patient must verbally state their desire for Death with Dignity, then restate it again within 15 days. The attending physician must determine that the patient is terminal and mentally competent and a consulting physician must concur. The request must then be made in writing. Someone other than the family member must also witness the signing. A period of 48 hours must pass before the prescription is written. The physician must deliver or see to the delivery of the prescription. Any doctor working in compliance of the Act must determine that no coercion or abuse is present and the Act states that both coercion and facilitation of the medication is prosecutable. The patient may at any time, whether mentally competent or not, choose not to use the prescription.

If a patient is determined qualified for Death with Dignity, is dying, and has stated repeatedly a wish to die, I wonder if this removes motive from a coercing or abusive family member? Getting to one's inheritance a few days, weeks, or months sooner is cause to act in this situation, at the threat of prosecution? According to Dore, we don't know because the Act, as she says, provides the coercing family member with an alibi.

Connecticut Court Case: Distinguishing Between "Aid in Dying" and Assisted Suicide.

Kevin B. O'Reilly posts a story at AmericanMedicalNews about the pending court case in Connecticut regarding aid in dying:

Gary Blick, MD, an HIV/AIDS specialist in Norwalk, Conn., and Ronald M. Levine, MD, an internist in Greenwich, Conn., in October filed a legal challenge to the state's assisted-suicide statute, saying the threat of punishment prevents them from prescribing lethal doses of medication

Dr. Blick said that since he started practicing in 1987, he has received numerous requests for lethal prescriptions from terminally ill patients with "agonizing pain" and poor quality of life. "I always tell them I can't do that -- I could be tried for manslaughter."

"For anyone who is terminally ill, who is mentally competent, for whom we know there's no hope, who has lost quality of life and is in chronic pain, we can help them to die with dignity," said Dr. Blick, medical and research director of the HIV/AIDS clinic Circle Medical. "That's what we call aid in dying. This is not assisted suicide."

The distinction between "aid in dying," also called Death with Dignity where legal in Washington and Oregon, and assisted suicide, a prosecutable act, is one that anti-choice advocates are working to prevent. O'Reilly quotes "pro-life" advocate Wesley J. Smith:

"The argument is to replace assisted suicide with a euphemistic advocacy term in the statute," said Wesley J. Smith, senior fellow in human rights and bioethics at the Discovery Institute, a conservative think tank. "It's an amazing and hubristic idea."

By hubristic, we can assume that Smith finds the idea of an individual controlling their last days and weeks in order to escape suffering an affront to either God, the state or the medical profession. His position assumes that an individual is not entitled to oversee and determine the care of their own body, dignity, or quality of life. And considering that most hospitals and hospice facilities already practice Continuous Deep Sedation to alleviate pain until death, without patient consent or the strict regulations determined by the Death with Dignity law, the concept is hardly amazing.

Yet, the nature of the two acts, aiding a mentally competent, terminally ill patient - who is going to soon die - to choose their time and manner of death is not the same as assisting someone physically healthy to end their life.

As we wait for the Montana Supreme Court to deliver a decision on Baxter v Montana and watch the New Hampshire legislature draft a Death with Dignity bill, the case in Connecticut will teach us much about how aid in dying translates under that state's constitution.