Milwaukee Magazine: NDY featured in profile of elderly couple who died through a suspected suicide pact

Back in November last year, I was contacted by a reporter at Milwaukee Magazine in preparation for a feature story on a local elderly couple who had allegedly died through a "suicide pact."  I succeeded in a few things during our conversation:

• Made the point that if the death was a suicide pact, it was atypical of elderly homicide/suicides;'
• Referred him to Donna J Cohen to discuss her research on elderly homicide/suicide cases;
• Was able to document that assisted suicide supporters in this country want broader "eligibility" for assisted suicide than what is available in Oregon and Washington state.

The article was published in the March edition of the magazine earlier this week and is available online.  Those who are familiar with pieces that report on the (alleged) double suicides of a respected elderly couple will find what you generally expect - family and friends who saw it coming and who defend the action as brave or admirable.

But reporter Kurt Chandler found room to fit in some broader context in the story Tender is the Night.

The opening is typical of these pieces:

On that Saturday summer night, Daniel and Katherine Gute made the short drive from their River Hills home to the Milwaukee Country Club for an early dinner. They held hands walking into the restaurant and sat at a table near a window overlooking the Milwaukee River. They sipped chardonnay and shared a bowl of vichyssoise, a favorite soup of theirs, having a quiet, romantic evening.

But they must have known it was their last meal together.

It was July 17, 2010, just four days after their 53rd wedding anniversary.

The broader discussion on assisted suicide - and the players in the debate - is better than we generally get:

Physician-assisted suicide is only legal in three states. Oregon in 1997 became the first state to pass a law allowing residents who are terminally ill – certified that they have six months or less to live – to end their lives with lethal medications prescribed by a physician. A similar law was passed in Washington in 2008, and a state Supreme Court ruling made assisted suicide legal in Montana in 2009.

The issue is hotly contested. On one end of the spectrum, the Final Exit Network argues the Oregon and Washington laws are inadequate because only those who are terminally ill are allowed to receive lethal drugs. The 3,000-member group, an outgrowth of the Hemlock Society, believes people who are not terminal should also be permitted to end their lives.

“There are many illnesses, awful illnesses, with no time limit,” says Jerry Dincin, Final Exit’s president. “And you can suffer for years and years – Parkinson’s, Alzheimer’s, ALS, Huntington’s disease, strokes.”
Members of his group who wish to hasten their own deaths must provide a letter from their doctor corroborating their medical condition, Dincin says. With approval from a Final Exit Network committee, made up of three physicians, patients can request voluntary “exit guides” to advise them. Two guides will visit the patient’s home to discuss methods. At the patient’s request, the guides also can be present for the suicide. Dincin emphasizes that an exit guide is not allowed to purchase, operate or handle any equipment – pill bottles, syringes, helium tanks. Guides legally can attend a suicide as long as they don’t actively assist or participate.

Since 2004, between 200 and 250 people have died in the presence of an exit guide, Dincin says. “More than 50 percent of the people we have supported are religious. They rationalize their action by saying they believe in a loving God, and a loving God would understand.

“We feel very keenly this is a human right, that your life is your own,” he adds. “Given dire medical circumstances, there is no public interest in keeping you alive if you don’t want to be.”

On the other end of the spectrum is the group Not Dead Yet, operating within the Center for Disability Rights in Rochester, N.Y. The group was formed in 1996 after the acquittal of Dr. Jack Kevorkian, who facilitated the suicide of two nonterminal women with disabilities.

“We felt assisted suicide statutes, as they were being proposed by advocates, were targeted for old, ill and disabled persons,” says Stephen Drake, research analyst for the group. “Since then, what’s been put on the table has expanded dramatically.”

He cites a 2007 case in Arizona, where four exit guides were criminally charged after helping a 58-year-old woman kill herself with helium. The Phoenix woman suffered from chronic mental illness but was not terminally ill. Two of the guides pleaded guilty last year to facilitation to commit manslaughter.

To Drake, the right-to-die movement is heading down a slippery slope, pushing for assisted suicide of people who are nonterminal or physically unable to commit suicide on their own – including those with disabling diseases.

“When it comes to the euthanasia of children and adults unable to express a wish to die, I believe the goal for many is to have some sort of medical panel evaluate the request for killing the individual,” he says. 

The article also shares some doubts that Katherine Gute - who had alzheimer's disease - could have had the cognitive capacity to consent to her death (through asphyxiation) and how that fits the larger context of elderly homicide/suicides:

An autopsy report released by Dr. Brian Peterson, Milwaukee County medical examiner, lists Dan Gute’s manner of death as “suicide.” Kitty’s death is classified as “undetermined.”

“It’s a hard one,” says Peterson. “If they agreed to do it together, it’s a tandem suicide. If someone’s demented, can they give consent, can they understand what they’re doing? In the world of forensic pathology, there are two equally valid possibilities, and we have no way to choose between the two.”

“If indeed she had the capacity to consent and sign, it’s a pact,” says Donna Cohen, a University of South Florida professor who has studied assisted suicide and suicide-homicides among the aged. “Suicide pacts are extremely rare. They account for less than one-half percent of all suicides” – just 150 of some 30,000 suicides annually in the U.S.

Cohen, however, questions the state of mind of the Gutes in their last days. “Even though they were strong-willed about living and dying arrangements, it’s quite possible they were depressed,” says Cohen, a former editor of the Journal of Mental Health and Aging. “The questions I would want answered in this situation: Were they getting the right help in dealing with depression? When men caregivers perceive there is nothing else they can do, [depression] could precipitate this act.”

We always wish there was more of our side represented in any coverage of these issues, but if more reporters exercised due diligence in the way Kurt Chandler did on this report, the coverage of these issues might be recognized as far more complex than they generally are.  --Stephen Drake

"Interesting" Op-ed by PR Guy for Hawaii Death With Dignity Society

Well, whatever else you can say about Scott Foster, Communication Director of Communications at the Hawaii Death with Dignity Society, he churns out an op-ed pretty quickly.  Like lots of communications folks, he regurgitates stuff he's written elsewhere, but every once in awhile he introduces some new gem and there are several items of interest in his op-ed in the Star Advertiser after the defeat of the assisted suicide bill last week.

Foster wants a "better" debate - an ironic request from an assisted suicide zealot who exploited the tragic attempted murder-suicide in late 2009.  Robert Yagi attempted to kill his wife with a flare gun loaded with shotgun shells.  It was unsuccessful.  However, Yagi succeeded in killing himself a short time later when police sent him home after being charged with attempted murder, left alone in his home.  Like "Conflation and Con Jobs," Foster jumped on this incident to promote legalized assisted suicide, making the bizarre case that an attempted murder of a woman who didn't want to die somehow would have been prevented by a "death with dignity."  Draw that reasoning up on a chalkboard and it would have a striking similarity to some of Glenn Beck's exercises in fantastical "logic."

The first "gem" in Foster's op-ed is that he comes very close to "speaking" Derek Humphry's "unspoken argument" - that an aging population and rising health care costs are powerful hidden motivations in supporting assisted suicide.  Here's what Foster says:

I remain convinced that the well-organized opposition to DwD legislation in Hawaii and elsewhere is more about money and God than about our solving the many challenges associated with an aging population, the resulting end-of-life issues, or the out-of-control cost of health care in our state and nation. If you wonder where all that money is going, according to the U.S. Department of Health & Human Services Office of Research, Development, and Information: "Medicare provides 64 percent of total health expenditures for beneficiaries in their last year of life ..." and the numbers for private insurance and out-of-pocket expenditures are similar. Despite the smoke and mirror arguments about "compassion," as it is, there's big money in death for many in the health care industry and DwD seems to threaten the status quo. (Emphasis added.)

It's fascinating, really.  If you read that carefully, what Foster is saying is "assisted suicide will save money."  After you look beyond "the smoke and mirror arguments about 'compassion'" (to use Foster's words) you see what Foster and the rest are really betting on.

Another interesting aspect of this op-ed is his attack on the chair of the Committee that held the hearings on the assisted suicide bill.  Pro-assisted suicide advocates normally portray physicians as absolutely trustworthy professionals who would never abuse or expand killing beyond what an assisted suicide statue allows.  That doesn't mean that Foster wants one to run a hearing on assisted suicide:

It is also clear that an M.D. should not be chairing health committees. It's an inherent conflict of interest.

 There's a contradiction there - trust a doc with your life but not your legislation?  Seriously, though, I doubt that Foster would object to the hearing being chaired by a pro-euthanasia doctor.

For anyone interested, there's been a fairly heated exchange between myself and another commenter at the newspaper site.  I wouldn't be surprised if the other person was Foster himself, since he or she uses the same tired old arguments and fantasy scenarios about husbands who murder their wives.

Check out the comments section at the end of the article and chime in if you wish.  --Stephen Drake

Montana Senate Judiciary Committee Hearing on Pro and Con Assisted Suicide Bills Will Be Webcast Feb 9, 2011

Sorry to all for the short notice, but no sooner is a skirmish in the Hawaii battle won (as distinguished from the battle or the war, so we can't get complacent0, but the Montana Senate Judiciary Committee is holding a hearing tomorrow (February 9) on two bills related to assisted suicide.

Here's a short summary on the bills and the hearing:

On Wednesday, Feb. 9, at 8am (Mountain Time), the Montana State Senate Judiciary Committee will hear the bill to implement the Baxter decision (SB 167 – Blewett) and the bill to overturn it (SB 116 – Hinkle).  We support the Hinkle Bill.


The hearing will take place at 8am on Wednesday, Feb. 9th in Room 303 (Old Supreme Court Chambers) at the State Capitol. (For any Montana readers who might be able to make it on short notice)


If you're like me and can't be there, you can view the hearing online at: 
http://leg.mt.gov/css/audio/audio_broadcast.asp.

For Montanans Only:
 
Call the legislative hotline at (406) 444-4800 to leave one message for all Senate Judiciary Committee members and ask them for a “YES” vote on SB 116 and a “NO” vote on SB 167.


More news as it comes in.  --Stephen Drake

Hawaii Senate Panel Votes to Hold Assisted Suicide Bill in Committee - No Broader Legislative Action Anticipated

(Image above - Disability Rights Advocate/Activist Michael Tada testifying against Senate Bill 803, which would legalize assisted suicide in Hawaii.)


From the Star Advertiser:

After citing numerous examples of loved ones who outlived a doctor's terminal diagnosis or of their own victory over suicidal depression, opponents of a proposal to legalize physician-assisted suicide in Hawaii applauded as a Senate committee defeated the measure last night.

The Senate Health Committee heard more than 4 1/2 hours of often-emotional public testimony before voting 4-0 to hold the bill in committee.

"After considering the large body of testimony presented to us, I have determined that community sentiment here today has been overwhelmingly opposed to moving this measure forward in its present form," said Sen. Josh Green, committee chairman. "There is truly compelling testimony on both sides of this matter — for and against — but from my perspective, for an issue of this magnitude, I believe we need to have more agreement as a community.

"So for now we need to find other ways to support those dealing with end-of-life decisions, with the greatest possible compassion and respect."

Senate Bill 803 would have allowed a terminally ill, competent adult to receive medication to end life. The bill specifically prohibits mercy killings, lethal injections and active euthanasia, and requires patients to receive informed consent.

Alternate doctors would be allowed to substitute for those who decline to participate, and the law also would have provided immunity from civil and criminal liability for acts taken in good faith.

Most of the testimony in opposition came from health care providers, disabled individuals, religious organizations and senior advocate groups, who likened the proposal to state-sponsored killing and arguing that many seniors would feel a "duty to die" to ease the burden on family members charged with their care. (Emphasis added.)

The practical consequence of the Committee's decision to put the bill on hold is that it's extremely unlikely the assisted suicide bill will be put in front of the legislature this year.  (I'm told there are ways it could be pulled off, but it's still not likely.)

I find it interesting that the paper - which has generally supported the idea of legalized assisted suicide - described the broad-based coalition that came to testify against the bill.  There is no similar description of just what groups might have been represented by the supporters of the bill who testified - I'm tempted to think that they might all have been members of Final Exit Network and/or other pro-assisted suicide membership organizations.  Not exactly a rich cross-section of the public in that latter group.

At NDY, we're thankful for all the members of the broad coalition that mobilized to oppose this bill, and especially for the disability advocates and activists who took the time and energy to mobilize during a year when some basic life-sustaining services are under budgetary assault.  --Stephen Drake

Hawaii Senate Panel to Debate and Hear Testimony on Assisted Suicide Bill Today

Because of the time difference between New York and Hawaii, the Senate hearing on assisted suicide hasn't begun yet.  Here is the news from Friday's Star Advertiser:

Hawaii would become the fourth state to legalize physician-assisted suicide under a proposal being brought back for debate in the Legislature for the first time in four years.

Senate Health Chairman Josh Green is reviving the issue with a hearing Monday afternoon in the state Capitol auditorium.

Senate Bill 803 would allow a terminally ill, competent adult to receive medication to end life. The bill specifically prohibits mercy killings, lethal injections and active euthanasia, and requires patients to receive informed consent.

Alternate doctors would be allowed to substitute for those who decline to participate, and the law also would provide immunity from civil and criminal liability for acts taken in good faith.

Green, an emergency room doctor in Kona, said he supports palliative and hospice care, but he believes the testimony is compelling on both sides of the argument.

"I'm very sensitive to the concerns of everyone involved in this issue -- from those suffering with terminal conditions and their families, to those who provide them with medical care," he said. "We need to find a way to support those dealing with end-of-life decisions with the greatest possible compassion and respect."

An assisted-suicide proposal introduced in the House has not been scheduled for a hearing.

Versions of the doctor-assisted suicide proposal have been floated at the Legislature since 1999.

Green (D, Milolii-Waimea) was the last committee chairman to hear it in either chamber, doing so as the House health chairman in 2007 and 2005. The bill failed to make it out of his committee both years, most recently with members voting 6-1 to hold the measure.

Green has said that with so much turnover in the Legislature, he feels it is healthy to have fresh debate on difficult issues.

Hearings have been characterized by emotional testimony, bringing many to tears as they have recounted tales of loved ones suffering near the end of life.

The issue was last heard in the Senate in 2002, when it came to the chamber floor for a final vote on the final day of the session. Four senators changed their votes between second and third reading -- three from "yes" to "no" -- as the measure failed 14-11.

There are at least three disability rights activists in Hawaii who are offering testimony - either through written submissions or in person.   Both Marilyn Golden of the Disability Education & Defense Fund (DREDF) and NDY's Diane Coleman have submitted written testimony.

Below is an excerpt from Diane Coleman's testimony:

An increasingly common form of domestic violence became the subject of news coverage in Hawaii in late 2009.  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 that year.  He faced a charge of attempted murder after allegedly firing a plastic flare gun at her. 

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

Nevertheless, that didn't stop a spokesperson for the Hawaii Death with Dignity Society from attempting to exploit this case of domestic violence to promote his own organization's agenda.  Scott Foster, spokesman for the Hawaii Death with Dignity Society, asserted that 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."

There is no indication that Yagi's wife wanted 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 falsely framing them as acts of compassion.

Note - see blog entries here and here for coverage of the exploitation of the Yagi tragedy by Hawaiian euthanasia advocates.

Any coverage of the panel hearing will be shared here when it's available.  --Stephen Drake

Prize Given to Oregon Documentary on Assisted Suicide Tells Us More About the Judges Than the Film

From The Oregonian:

“How to Die in Oregon,” an intimate and poignant film about the impact of Oregon’s 1994 Death With Dignity Act, won the Grand Jury Prize in the U. S. Documentary Competition at the 2011 Sundance Film Festival tonight, one of the most prestigious awards that can be won by a non-fiction film anywhere in the world.

Director Peter D. Richardson, an Oregon native whose debut feature, “Clear Cut: The Story of Philomath, Oregon,” played to acclaim at Sundance in 2006, stood atop a field of 16 competing documentaries that were selected from a field of 841 submissions. 

I'm not exactly surprised that this film received top honors.  The memory of the 2005 "Kill the Cripple" night at the Oscars is still fresh.  Two films dealing with the euthanasia of characters with disabilities were nominees in both the Foreign Picture and Best Picture categories.  Here is part of what we wrote at the time:

To be fair, other movies dealing with disability ended up with nominations as well. The movie "Ray," for example, received a "best picture" nomination. This only proves that Hollywood will love someone who is blind as long as the person is lucky enough to be talented, famous and musical.

We figure critics left the movie "Ray" humming. When those same critics left from seeing "Baby," which ends with Eastwood's character killing the now-paralyzed character played by Swank, they were in tears. This, they've told us all, is how pictures are supposed to be.  Now the Academy is telling us the same thing.

And, in fact, both "Million Dollar Baby" and "The Sea Inside" won in their respective categories.

So, it's not a shocker that a bunch of folks in the film trade would go head over heels for a documentary that sounds an awful lot like a PSA for legalization of assisted suicide.  In other words, the award probably tells us more about the judges granting the award than it does about the film itself.  I doubt I'd lose any money if I bet that the judges were predisposed to approve of legalized assisted suicide, and when the film preached at them, they didn't recognize it as a sermon.

If that seems a little harsh, I came across an interesting review by Matt Goldberg at Collider.com - Goldberg claims not to have an opinion on legalized assisted suicide.  I'm inclined to believe him, based on his somewhat skeptical review of the film:

How to Die in Oregon makes a case for “death with dignity” but that case is weakened by Richardson’s over-reliance on the emotional impact and conducting unnecessary interviews.  If the film wants to sell me on legalizing euthanasia, then I want to know more facts.  I want to know about other options for end-of-life care.  I want to know if the doctor-prescribed death drink ever fails to kill the patient and instead sends them into a persistent vegetative state.  At one point, a title card tells us that Cody is improving under “palliative care”, but it doesn’t tell us what that means or entails.  Rather than take the time to show a broader view of end-of-life care, Richardson shows tangential scenes which don’t benefit the emotional or intellectual impact of the movie.  For example, in one scene he meets with the founder of the “Hemlock Society” (a name I found dreadfully glib), an organization dedicated to legalizing euthanasia.  After the scene, we never see the society’s founder again.

On an emotional level, How to Die in Oregon is a triumph.  It pulls at your heartstrings without feeling manipulative and when we look at Cody, we see our own loved ones, and the thought of losing them slowly and painfully is absolutely gut-wrenching.  But on an intellectual level, the film is unsatisfying.  Euthanasia is a loaded issue and Richardson does his audience a disservice by not providing them with a broader view of the benefits and weaknesses of various options one has when considering their end-of-life care.

It's funny that Goldberg asks about failed assisted suicides in Oregon, because it turns out that there were problems with that in 2010.  Oregon - perhaps to get their report out to coincide with the documentary publicity - published its annual report much earlier this year than in previous years.  I'll share more about the report later, but here is a part relevant to Goldberg's question (pdf):

• Two of the patients who took the medications during 2010 did not die after ingestion, but died later from their underlying illness. Twenty of the patients who received prescriptions in 2010 did not take the medications and died of their underlying illness. Status is pending for 15 patients: two have died but we have not received the follow up questionnaire, and for 13 we have neither the death certificate nor follow up questionnaire (Figure 2).
• One of the two patients who awoke after ingesting the medication regained consciousness within 24 hours after ingestion and died of their underlying illness five days later; the other gained consciousness 3 ½ days after ingestion and died of their underlying illness three months later. Regurgitation was reported in both instances.

Why didn't the two individuals who didn't die not make a second attempt at suicide?  Did the attempt make them sicker and make them unable to make another attempt.  Did the act of staring at the reality of death make them decide they'd just as soon put it off for awhile?

The report provides no answers - to these or other questions.  I'd sure like to know more about the details of the two failed suicides.  I suspect that reviewer Matt Goldberg and any other thinking reviewer might want to know more as well.  Unfortunately, thinking people were in short supply when it came to judging documentaries at Sundance this year.