More Men in the News - Killing Ailing Wives and Calling it "Mercy"

Here are a few recent killings that have made news around the country -

New Rochelle man charged with murder in 'mercy killing' (NY):

Paul Weinstein told police that an argument with his wife ”set him off“ and that he shot her dead in their New Rochelle home after he failed to suffocate her with a pillow.

Later in the article, he says his wife was "losing it" and that he'd promised to help her kill herself rather than put her in a nursing home or other facility.  He has no proof of that, though.

Police cite claim of mercy killing (AZ):

A 56-year-old woman was killed by her husband early Thursday in what police say was intended to be a murder-suicide. 

 

Police received a 911 call at 4:43 a.m. from a 51-year-old man who said he had just killed his wife and then had taken pills in an attempt to take his own life, said Sgt. Fabian Pacheco, a Tucson Police Department spokesman.

While the article is unclear, it appears that he shot his wife and attempted to kill himself through a drug overdose, but called 911 when he apparently changed his mind about killing himself.

Man accused in shooting described as caring (HI)

(Happily, this is a case in which the murder attempt did not succeed)

Seventy-one-year-old Robert Yagi had tended daily to his terminally ill wife's needs and kept her company since she was hospitalized in October.

Now he faces a charge of attempted murder after allegedly firing a plastic flare gun at her Tuesday night.

A police affidavit filed with the court to support the charge says Yagi "may have tried to end his life at the same time using another loaded orange flare gun" loaded with 12-gauge buckshot.

His wife, Leatrice, suffered only minor injuries when she was shot as she lay in her hospital bed at Castle Medical Center.

This is fairly typical of the cases of successful or attempted murder/suicides seen in elderly people.  The perpetrators are men.  The women have have significant health issues.  There is no evidence that the wives in question wanted to die.

Nevertheless, that didn't stop a spokesperson for the Hawaii Death with Dignity Society from attempting to exploit this last case of domestic violence to promote his own organization's agenda:

Scott Foster, spokesman for the Hawaii Death with Dignity Society, believes Yagi was trying to end his wife's suffering.

"When I saw it (on the news), I knew exactly what I was hearing," he said. "We hear it all the time all over the world, rich people, poor people, people in pain, people suffering."

He said Hawaii came close in 2002 to passing a law to allow assisted suicide. The so-called Death with Dignity bill died when three state senators changed their votes at the last minute following intense lobbying by opponents.

 So how, exactly does this relate to any legalization of assisted suicide?   There is no indication that Yagi's wife wanted or wants to be killed.  Or does Mr. Foster believe there should be some sort of law allowing caregivers to order the euthanasia of their spouse or child?

In fact, Foster is just doing what many representatives of pro-euthanasia groups have been doing for years - exploiting cases of domestic violence in which the victim is an elderly, disabled, ill woman by framing them as acts of compassion.

For more information on the research on these types of domestic violence, please read this previous blog entry, in which the research of Professor Donna Cohen is discussed.  Interestingly, she gave a presentation at a Compassion and Choices Symposium in October.  I cannot think of any excuse for the continued exploitation of these tragedies by assisted suicide/euthanasia advocates after that.  --Stephen Drake

Canada: New Pro-Euthanasia Group Misinforms -- and Doesn't Want Anyone to Know Much About Them

From Alex Schadenberg at his blog for the Euthanasia Prevention Coalition:

New Group Misrepresenting Canada's Euthanasia Law

Excerpt:

I received a call from Stephen Drake, the research director for Not Dead Yet, a disability rights group. Drake asked me whether I knew the group Dignity in Death? I answered no. In fact when I went to the website there was no information about who they actually are, but it did tell me that they either do not understand Canadian law or that they are deliberately misrepresenting the law for their political purpose. Link to Not Dead Yet: http://notdeadyetnewscommentary.blogspot.com/

The website states:

Dignity in Death offers information on voluntary euthanasia and the ethical issues that surround assisted suicide. In Canada, voluntary euthanasia is legal and may be used to end the lives of those who are suffering and terminally ill. However, assisted suicide is illegal.

This new group (read the blog for more info) has launched an ad campaign putting its messages on faux memorial plaques on park benches in Toronto through an ad agency.  November and December seem strange months for this kind of campaign, since traffic in parks goes down, benches are often covered in snow and almost no one sits down on them.  But it gets stranger - the plaques direct readers to a website:

If there is nothing wrong with euthanasia or assisted suicide, why does the Dignity in Death group need to lie about Canadian law and why does Dignity in Death not have an address or identify the leaders of the group?

It's really really odd.  What kind of group invests in advertising and yet (judging by the lack of info on the website) doesn't really want anyone to want to know just who is running the group or how to contact them (aside from a general info email address)?

Well, for starters, maybe no one wants to be held accountable for the misinformation that is published on the website (www.deathindignity.com)) or deal with any awkward follow-up questions.  --Stephen Drake

Addendum: Alex graciously gave me a cred for the heads-up on this, but the only reason I saw this news was due to an alert sent to me by my friends at the blog "Turner & Kowalski."

Health Care: "People Like Me" - Ben Mattlin Reflects on Being Disabled and the Health Care Debate

Ben Mattlin is a disability activist and writer (he also gets paid for writing outside of the disability arena).  I've had the privilege of knowing him for over a decade.

He's authored an op-ed in the Chicago Tribune that reflects the current realities many of us who have disabilities face in the health care system right now.  He also shares how so much of the debate around "reform" isn't convincing to many of us - no matter which side of the political aisle is speaking.

Here's the intro to "People like me - Is there room in health care for the disabled?":

Last year, I was rushed to the hospital after a severe gastrointestinal infection became septicemia. I was unconscious, inches away from death, but before the doctors would perform their magic they asked my wife, "Are you sure you want us to do this?"

Actually, they said, "Is he full code?" but it meant the same thing.

It's hard not to take that personally, and to be more than a little fearful for your life when similar stories get shared around the disability community.

Like me, he's not real impressed with either end of the political spectrum in the current debate over "reform," which seldom touches on the realities many of us deal with right here and now:

Every day, lawsuit-wary doctors, many with misguided notions about the quality of life for people with disabilities, and the penny-pinching insurance companies who pay them render judgments about who does and does not receive certain kinds of care. So when the right wing warns about medical rationing as a bleak future possibility, I don't listen. I and countless others on the margins already feel the squeeze. Could the feds really do a worse job?

On the other hand, when the left wing talks about health care reform as a kind of panacea, I raise a skeptical eyebrow too. There's more wrong with our current system than Washington can fix. I don't like the outrageously expensive premiums I pay as a "high risk" customer, but the most galling obstacles I face can't be easily legislated away.

In the end, like many of the people I know in the disability community, Mattlin figures the reform that might happen is better than nothing - there are some small ways it might help him and others similarly situated and it probably won't make things worse.

 But don't take my word for that - go read it yourself. --Stephen Drake

Art Caplan "Debunks" 23-year Misdiagnosis of PVS in Belgium, But Omits Some Details

Over the past week, there has been a lot of news coverage regarding the case of Rom Houben, a man in Belgium who was labeled as being in a persistent vegetative state.  He was severely injured in an auto accident in 1983, and since shortly after that has been regarded as being in a persistent vegetative state.

Twenty-three years later, things looked very different.  Houben's family believed he still had consciousness.  He was fortunate enough to come to the attention of Dr. Steven Laureys, with Belgium's Coma Science Group.  They tested Houben with new brain scanning equipment and found that his level of brain activity was identical to that of a person who had no brain damage.  Professionals on the team have worked with Houben to develop a way to communicate.

This has become a somewhat sensationalized and "inspirational" story.  And it's already receiving blowback.

The most prominent of the critics to surface is bioethicist Art Caplan, who says he isn't buying it.  He has three major concerns that I can identify.  Two of them lose a lot of substance when additional information is taken into account - information that Caplan doesn't provide.  All three - and my responses - are below:

1. Use of facilitated communication as a way to communicate.
(Full disclosure: As is noted in my bio, I used to work at the Facilitated Communication Institute at Syracuse University.  I have friends and colleagues associated with the technique, including people who at one time used facilitated communication (FC) as a means to communicate, but type independently now.)

From Caplan's article:

Most troubling about the claim that Houben is communicating are the facts that he is doing so with the help of a therapist who points his finger to the keys on a computer keyboard.

The therapist, Linda Wouters, has told news reporters that she can feel Houben guiding her hand with gentle pressure from his fingers. She feels him objecting when she moves his hand toward an incorrect letter. But, given his injuries, Houben should not be able to generate any pressure in his fingers. And if he can do so, why did no one else detect this ability over the past 23 years?

 First of all, even though Caplan says he read a lot about this case, he has missed the fact that we're talking about 26 years, not 23.

That's important to this particular issue and in an upcoming one as well.

Maybe Caplan didn't read the AP article he's quoted in, or he might have noticed that Houben has used another way to communicate in the past:

Houben's mother, Fina, told the AP her son has been communicating for three years and she believes no one is guiding him.

"At first he had to push with his foot on a sort of computer mouse which only had a yes-no side," she said in a telephone interview. "Slowly he got better and developed through a language computer and now communicates with this speech therapist holding his hand."

 Got that?  He initially used an independent yes/no response with a foot device.

As to the reliability of the communication in this instance?  They tested:

Laureys' team showed Houben an object while his aide was taken outside, and when she came back in he was able to write it down correctly, said Prof. Audren Vandaudenhuyse, a colleague of Laureys.

"So all that has been checked and confirmed, so we are sure it is him who is talking," Vanhaudenhuyse said.

One caveat here.  It's a very loose description of the "message-passing" exercise.  Ideally, in a situation like this, the most convincing accurate result occurs when neither the facilitator nor the testers in the room know what the object, word, message, etc. to be passed was.

2. Locked-In Syndrome is usually a result of stroke.

From Caplan:

The major cause of this horrible condition is a stroke in a key artery in the brain that causes severe damage to the lower brain and brain stem but not the cortex, where thought and consciousness reside.  It is not clear how a car accident may have caused a locked-in situation.

Well, it's not clear to me how that could happen, either.  But the fact is that we have a group of highly-regarded neurologists who are saying that is exactly what has happened here.  They might not have a clue either.  It could be something that happens very rarely, and hasn't been detected until now simply because - since it's not something that people associate with a trauma event - it isn't explored as a possibility.  Heck, it even gets overlooked in stroke patients.

3. He's in unbelievably good mental shape for someone left in virtual isolation until recently.

I'm paraphrasing here, but Caplan's writings imply that Houben has only been interacting with people for a short time and that it's remarkable that he's so fluent and lucid.

Here's what Caplan actually says - read to see what the wording implies about how recently Houben has been interacting with those around him:

To add to my skepticism, Houben reportedly has been lying in a bed with relatively little stimulation and communication from others for 23 years. This is worse than being in solitary confinement for a very long time.

 The phrase "has been lying in bed" implies that Houben has been shut off from communication until very recently.

As noted earlier, Laureys and his team have been working with Houben for three years.

I'd love to know more - I'd imagine it was quite possible his thinking and communication was more disjointed three years ago than it is now.  Three years gives you a pretty good amount of time to get your cognitive processes reorganized and used to communicating again.

I agree with Caplan - I have a hard time wrapping my head around the concept of how one could live that way for so long and keep any type of sanity.  I hope I never get a chance to find out.

But I do know of at least one other person who has done that.  She lived that way for six years, only about a quarter of the time that Houben had to endure with his ability to think unrecognized.  That's exactly the experience reported by Julia Tavalaro, who went on to write a book about the experience titled "Look Up For Yes."

As for me, I have lots of thoughts and questions.

I'd love to know if they're trying to develop a more independent communication method for Houben, such as with an eye-pointing system.  I'd love to know, for his own welfare, if they're using his independent yes/no periodically to ask him to verify the accuracy of his communication through FC.

How many people like Houben are there out there?  Are there better and more reliable ways that we can judge people's state of consciousness?  Do we have to modify what we think we "know" about the recovery process from brain injuries?

I think there are a lot of questions that this episode provokes.  But you need more information than Caplan provides to get an idea of what kind of questions might be appropriate here.  --Stephen Drake

New Hampshire: House Judiciary Committee Votes Against Assisted Suicide Bill

Some good news from New Hampshire:

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

The House Judiciary Committee voted 14-3 against the bill that 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. 

Good news, but there is reason to remain vigilant.  Allies in the state tell us that it's highly unusual for the full legislature to approve a measure defeated in committee, but it is possible. Assisted Suicide activists could make a push for a full vote - or they might decide this could be a year in which most legislatures have enough on their plates without pushing the envelope on the "right to be killed."

Our local NDY organizers Tom Cagle and Bunny McLeod will continue to make sure that the disability rights perspective opposing legalized assisted suicide continues to be heard.  --Stephen Drake

Disability Activists "Greet" Euthanasia Activist in San Francisco

This just in from Marilyn Golden, Policy Analyst at Disability Rights Education and Defense Fund (DREDF):

(The date for the events below was November 10, 2009)

On Tuesday morning, three anti-assisted suicide advocates from the San Francisco Bay Area disability community, Paul Longmore, Walter Park, and myself came to the San Francisco Buddhist Center (which had been rented for the occasion but was not connected to the event itself) in order to leaflet outside an event by Dr. Philip Nitschke (the "Australia Kevorkian," as some have termed him). Paul had come early, done a wonderful job speaking with the media, and had to leave. Walter and I continue to relaxedly leaflet newcomers outside the building and calmly discuss with those who were interested, our deep concerns with Nitschke and Exit International. (Several of them commented that these discussions were interesting and enlightening.) When it came time to go in to hear the program, Walter and I were actually refused entry to this presumably public event (we were actually physically resisted and barred from entering) and termed a "security threat" by Nitschke's partner, Fiona Stewart (Ph.D.), who become much more agitated and upset than we had been at any point. This highly bizarre experience was another object lesson in how threatening to them the truth can be.

The leaflet text is pasted in below.

Marilyn

-------------------------------------

We are disability rights advocates.

Dr. Philip Nitschke and Exit International endanger vulnerable people who are already unconscionably neglected and at risk.

Nitschke advocates death on demand for ANYONE of ANY AGE for ANY REASON. This irresponsible position threatens lonely people, depressed people, older people, and people with disabilities.

Nitschke believes that anyone, including teenagers, should be able to get suicide drugs on demand. He thinks lethal drugs should be available to “anyone who wants it, including the depressed, the elderly bereaved, [and] the troubled teen … .” [Kathryn Lopez, "Euthanasia Sets Sail," National Review Online, June 5, 2001.]

Nitschke calls for suicide on demand at a time when drastic budget cuts in many states are slashing funding for crisis counseling and suicide intervention programs.

Nitschke favors facilitating suicide by older people at a time when elder abuse is rampant in the US. The perpetrators are often family members.[1] Given the prevalence of abuse of older people by their own relatives, many can easily be pressured into "choosing" to die.

Nitschke supports suicide by people with disabilities at a time when in California tens of thousands of individuals are being cut off from the In-Home Support Services that keep them out of nursing homes. Some say they would rather die than go into a nursing home.

Nitschke supports suicide even by physically healthy people. Many of his victims were physically healthy at the time of their induced deaths. None of his seven "patients" had severe pain. Palliative care expert Prof. David Kissane concluded that some just needed better medical and psychiatric care. Kissane warned: "It is evident that the regulations did not serve as an effective safeguard to protect the vulnerable."

Even people who do not oppose voluntary euthanasia have had second thoughts about legalizing assisted suicide because of Nitschke's reckless behavior. Andrew Bolt wrote in the Herald Sun, Northwest Territory, Australia:

Giving the likes of Philip Nitschke licence to kill could create all sorts of horror for the lonely, scared, helpless and impressionable. … Few people could have been more in favour of euthanasia than was I.… In fact, what most influenced me far more has been -- ironically – Philip Nitschke, founder of Exit International. It's Australia's most famous lobbyist for euthanasia who has best shown me how dangerous it can be and what evil might be unleashed in legalising it. I saw how he started by helping people to die who were not in pain or dying. I saw him move on to helping people to die who were not even sick. Here we see the slippery slide that is inevitable when you remove the taboo against murder and suicide. What then stops anyone from killing themselves? Or, soon, from killing others?

Philip Nitschke's advocacy of suicide on demand is extremist paternalistic medicine at its most irresponsible and lethal.

We demand an equitable and just health care system that guarantees people's right to appropriate and adequate health care, including suicide intervention.

-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --

[1] The National Elder Abuse Incidence Study (NEAIS) was conducted by the National Center on Elder Abuse at the American Public Human Services Association. It showed that, in 1996, 450,000 elders age 60 and over were abused, according to a study of observed cases. In almost 90 percent of the elder abuse and neglect incidents with a known perpetrator, the perpetrator was a family member, and two-thirds of the perpetrators were adult children or spouses. [National Center on Elder Abuse: “National Elder Abuse Incidence Study,” Washington: American Public Human Services Association, 1998.]

Below is a link to video coverage of the event that includes an interview with Paul Longmore:

New Ad from FRC Seems to Say Old People Shouldn't Get Expensive Operations

My reactions to what passes for a "health care" discussion in the US kind of vacillates - between eye-rolling and outright gagging. The ad below evokes both reactions. It's the latest from the Family Research Council, defenders of "family values" and who claim to respect and value human life.

In the clip below, however, is a short exchange between a young boy and his grandfather, presumably when some version of expanded health coverage has been passed. The message - as near as I can figure out - seems aimed at disrespecting and devaluing the lives of seniors.

FRC doesn't provide captioning for its video, so here's a summary:

The young boy asks if his grandpa is still going to see a doctor about the operation and asks if it will be expensive.

Grandpa says he's going to have it and it will be expensive, but it's free, thanks to the government program (gee, Medicare, maybe?).

The kid says his dad says nothing is free and that dad is paying for the operation.

Grandpa laughs and says that's silly - it's the kid that is paying for it. At that point, the kid picks up his briefcase and his Wall Street Journal and goes off to work.

What's the message here?

Old people are greedy bloodsuckers?
We should get rid of Medicare?
Old people shouldn't get expensive operations (unless they're rich)?

Really, please please explain this to me. Tell me how this isn't a message that selfish old people shouldn't just shuffle off and die.

Yeah, yeah... I get that FRC is talking about the deficit and its impact on future generations, but I don't remember similar complaints during the previous administration. That's when the President and Congress were keeping the huge costs of the Iraq war off the books, accompanied by tax cuts for the wealthiest, resulting in a huge deficit.

Apparently, they liked the war, but don't like the idea of funding health care. And that makes it OK to go after Grandpa. Check the video out for yourself below. --Stephen Drake