UK: Pro-Euthanasia Group To Set Up Suicide Assistance "Help Line"

Just a few years ago, this story could have appeared (with a few tweaks) as a satire in The Onion, or as a skit on Saturday Night Live - or the many British comedy shows that exist.

But no, a British pro-euthanasia group has created a partner organization -- which will challenge satire writers, since the truth here already reads like yesterday's parody.  From The Daily Mail, here is a sample of Outrage as 'how-to-die helpline' is launched by euthanasia charity:

A right-to-die pressure group provoked outrage yesterday over plans to sponsor the UK's first helpline aimed at speeding the terminally ill towards 'a good death'.

The free phone line, to be set up by a  charity called Compassion in Dying, will 'promote greater patient choice and control where possible'.

The charity is an offshoot of euthanasia campaign Dignity in Dying and is led by the right-to-die group's chief executive Sarah Wootton, a former sex equality and abortion campaigner.

Its plan to provide the desperately sick with advice on how to end their lives sparked protests from anti-euthanasia activists, who said the helpline would be used to shorten lives.

The charity says it exists to exploit 'existing end-of-life rights' and will pass on information to callers.

However, it comes against a background of growing tolerance of assisted suicide by prosecution authorities, increasing political pressure for the legalisation of assisted dying, and a rising toll of Britons travelling to the Dignitas suicide clinic in Switzerland to end their lives.

It's doubtful there's any real journalistic energy going into this story.  What would real journalism look like in covering this?  Here's a list (not exhaustive) of questions I'd be looking for - directed at Sarah Wootton and others connected to the pro-euthanasia groups:

• What specific types of "advice" will be offered? Will it include instructions on recommended ways to kill yourself?
• Will callers be directed to euthanasia activists who will "help" them commit suicide?
• How will this "helpline" verify that the callers are really terminally ill?  How will they sort them out from non-terminally ill people who want to kill themselves?
• How will they screen for callers who misrepresent themselves so they can get information on "suicide" when their intent is to murder an elderly or disabled relative and pass it off as a suicide?

I won't hold my breath waiting for this kind of inquiry.  I see no evidence that the British press is any more competent at covering this issue than the American press.  --Stephen Drake

Barney Frank Demagogues "End of Life" Policy in Budget Discussion on MSNBC.

I'm probably being more self-disclosing than I would like to here, but it was no accident that we caught this bit of demagoguery by Rep. Barney Frank on MSNBC's "Morning Joe".  The show usually has a good line-up of guests, representing a wide spectrum of political ideologies - and discussion occurs - mostly - with little shouting or talking over each other.  Below is an excerpt from Rep. Barney Frank's appearance on the show today, in which he discussed the possible combination of spending cuts and revenue increases (taxes) that could possibly be worked out between the parties.  As you'll see, Rep. Frank goes off the rails when he talks about "end of life" issues.

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Anyone who wants to see or read the full exchange can go to this link.  The original video has options for both a synced transcript and closed captioning.

In this, Frank makes the outrageous claim that we can save a ton of money by stopping something that isn't actually happening -- medical professional "forcing" medical care to people at the "end of life" who just want to be left alone and die peacefully.

This is demagoguery because the right to refuse treatment - especially in the case of people in the final stages of a terminal illness - is a settled matter.  It is illegal for a hospital to "force" life-saving or life-extending treatment that you don't want.  I give Barney Frank credit for being a pretty intelligent politician and policy wonk - in this case it was the grandstanding politician rather than the policy wonk who was talking.

In short, he offered up a nonexistent "problem" we could "fix" to save money.  It probably hit the right emotional notes with people.  The thing is, there will be same pretty intelligent Republicans he'll have to deal with when negotiating - they won't buy this any more than Frank will be inclined to believe some of the more outrageous stuff coming out of that camp.

Surprise! Compassion & Choices Weighs in on Arizona Final Exit Network Trial Outcome

Not exactly a big surprise, but Compassion and Choices (aka "Conflation & Con Jobs") has weighed in on the disappointing outcome of the trial of Final Exit Network (FEN) members in Arizona. 

I am cynical enough to believe that reporters who use this press release from the organization are too shallow, lazy or generally lacking in critical thinking skills to realize the text doesn't really say anything of substance except to promote the organization and its primary agenda - legalization of phyisician assisted suicide.

Excerpt from the press release:

“This case demonstrates the problem with vague ‘assisted suicide’ statutes such as Arizona’s,” said Barbara Coombs Lee, president of Compassion & Choices. “Terminally ill patients across the nation ask their physicians for aid in dying. Many doctors, in an uncertain legal environment, rebuff such questions and fail to discuss their patients’ concerns about pain and suffering. When patients cannot talk openly with their doctors they may seek assistance from others. Sympathetic family members or friends are usually unequipped to assess a patient’s competence or end-of-life options. No one should have to risk prosecution to help a dying patient end life peacefully.”

Media accounts suggest Van Voorhis was not terminally ill and may have suffered from mental illness impairing her judgment. The trial judge did not allow prosecutors to present evidence of her psychological state. “In today’s legal framework, judges and juries do not distinguish between the choice of a mentally competent, terminally ill patient for a peaceful death via selfadministered medication, and the act of a distraught individual who is not dying, who may be mentally ill and suicidal,” said Coombs Lee. “The
former is a practice known as aid in dying, which has strong and growing support among the public and medical professionals. The latter is suicide. Our nation’s laws should recognize the difference.”

What's most important is what Coombs Lee is not saying:

• She is not saying that FEN members "assisting" the suicides of nonterminally ill people in Oregon or Washington state should be vigorously prosecuted -- even though FEN has made it clear that they do operate in those states to "help" those the law doesn't cover;
• She may be silent regarding prosecution because, while she maintains a highly debatable distinction between "aid in dying" and "assisted suicide," she hasn't really said that assisted suicide is wrong - or something that should be prosecuted;
• She hasn't said that the FEN members have done anything wrong - and as near as I can figure it's the fault of a "vaguely" constructed law that none of us can know if the actions of FEN members were wrong.

Oops.  I guess I was mistaken.  Coombs Lee did say something of importance - her words invite us to believe that it is the law, rather than the actions of FEN members, that was responsible for Jana Van Voorhis's death.

I wonder what she'll say if FEN activities in Oregon or Washington state come to light.  Whose fault will the deaths the group facilitates be then?  --Stephen Drake

Arizona: Jury in Final Exit Network Trial Acquits One, Unable to Reach Verdict with Other

Disappointing, but not entirely unexpected news from Arizona:

Lawrence Egbert, 83, an anesthesiologist from Baltimore, was found not guilty of conspiracy to commit manslaughter by aiding suicide in the April 2007 death of Jana Van Voorhis, 58.

But the jury was unable to reach a unanimous decision as to whether Franklin Langsner, 86, a retired college professor from Scottsdale, had committed manslaughter by aiding suicide as one of Van Voorhis' "exit guides," or whether he was guilty of conspiring with Egbert to help her kill herself.

Langsner had no comment. The Maricopa County Attorney's Office said they would retry his case.

Why was it unsurprising?  For one thing, important information was kept from the jury:

On its website, Final Exit states that "mentally competent adults have a basic human right to end their lives when they suffer from a fatal or irreversible illness or intractable pain, when their quality of life is personally unacceptable, and the future holds only hopelessness and pain."

According to attorneys and her family, Van Voorhis suffered from mental illness but was not suffering from physical illnesses, a fact kept from the jury.

I'll never get this.  Part of the defense claims involved the careful "screening" process that FEN says they use.  The knowledge that Van Voorhis had no serious physical illness would have belied the claim of any kind of "screening" process - and it might have made the jury view other claims of the group more sceptically.  (Personally, it really doesn't matter to NDY if Van Voorhis was "mentally ill" or not.  We're opposed to the facilitation and encouragement of suicide regardless of whatever diagnoses may or may not be involved.)

I can only hope the prosecution in Georgia makes a stronger case in the courtroom.  --Stephen Drake

Final Exit Network Members Await Jury Decision in One State (AZ) and Lose Court Challenge in Another (GA)

The long-awaited trial of two members of the Final Exit Network (FEN) relating to their roles in the death of Jana Van Voorhis is all but over - it's all in the hands of the jury now after a roughly week-long trial at the Maricopa County Superior Court in Arizona.

The only ongoing press coverage of the trial has been published in the Phoenix New Times.  Paul Rubin, writing the reports, has been covering the death of Jana Van Voorhis and the resulting criminal charges against four FEN members for over three and a half years now.  Two FEN members entered into plea agreements and have testified for the prosecution.

Below is a list of Rubin's articles on the trial, from oldest to most recent:

• Final Exit Network Members Going on Trial After 2007 Assisted Suicide of Phoenix Woman
• Final Exit Network Defendant Portrayed Alternately as "The Godfather" and "Great Humanitarian" as Trial Begins
• Final Exit Network Murder Trial Continues This Week -- Prosecution Faces Uphill Struggle
• Final Exit Network Murder Trial: Senior "Exit Guide" Testifies for Prosecution -- Kind of Gets Help From "Right To Die" Group Insider 
• "Right To Die" Case Closing Arguments Scheduled Monday After Defense Calls It a Day
• Final Exit Network Murder Case Should Go to Jury Today 

From the last story, some definitions and omissions that the jury will have to struggle with:

Deputy county attorney Patrick Johnson told the panel that the Final Exit defendants' intent was clear.

"We're not talking about an ignorant organization," the young prosecutor said. "They're smart people. They know know, and they knew they were breaking the law...They knew full well what they were doing."

Don Samuel, a Georgia attorney serving as one of Egbert's lawyers, argued that "this is not a Gambino crime family, like the Maria or something...[Final Exit] is not a group that encourages, actively participates, or advises anybody to commit suicide."

The veteran attorney obviously knows that the word "advises" may come back to haunt the defendant, and he smartly tried to deal with it head-on.

One of Judge McMurdie's jury instructions says that "to aid" means "to assist in the commission of an act." That assistance can include both "active participation" and "advising the person to commit suicide."

The definition of "advice" is fraught with possible interpretation, as the evidence unquestionably showed that both Langsner and his onetime co-defendant Wye Hale-Rowe were intimately involved with Jana Van Voorhis' demise. 

One point worth noting as the jurors begin to deliberate: For legal reasons, they never learned that Van Voorhis was not seriously physically ill when she committed suicide, but was suffering from long-term mental illness.

Personally, I'm not as concerned about the jury not hearing about Van Voorhis' "long term mental illness" as I am about the omission of the very pertinent information that she "was not seriously physically ill." Since FEN claims to screen applicants by reviewing medical records it could cast doubt on both their - to say the least - attention to detail and the veracity of any other claims made on or off the witness stand.

Paul Rubin is writing that he isn't sure that 8 people (the number of jury members in deliberation) can come to a unanimous decision on the charges in this case.

Meanwhile, the AP has news from Georgia:

Intro to article:

A Georgia judge rejected a free-speech challenge to the state's law against assisted suicide, allowing a high-profile case to proceed against four members of a suicide group charged with helping a cancer-stricken man kill himself.

Forsyth County Superior Court Judge David Dickinson said in the opinion released Wednesday that "pure speech is in no way chilled or limited" by the law, siding with prosecutors in the state's case against four Final Exit Network members.

"The court understands that defendants contend that the statute criminalizes only speech," the judge wrote in the 13-page ruling. "However, the court finds that the statute requires both speech and an overt act in furtherance of assisting in the suicide."

There's more in the article, but the upshot is that there will be a trial in Georgia.  Four members face various charges relating to their alleged roles in the death of John Celmer.  --Stephen Drake

Bad Cripple - Assisted Suicide: No Assistance Wanted

On March 21st, the Monterey County Herald published an op-ed by Neil Shapiro, which was, until the last paragraph, a fairly unremarkable and unoriginal promotion of legalized assisted suicide.  The author praised Jack Kevorkian and the states of Oregon and Washington - the two states that have legalized physician-prescribed suicide for people believed to have less than six months to live.

In fact, reading through the bulk of the article, I was hard put to understand the justification for the title given the piece from some newspaper staffer - "Right to die gives dignity to disabled." 

Shapiro didn't mention that most of Kevorkian's body count consisted of people with disabilities or nonterminal chronic conditions, so that wouldn't account for the title.  The statutes in Oregon and Washington claim to limit "eligibility" to "terminally ill" individuals.  So why was the title referring to "disabled" people?

The rationale for the title only became clear when I got to the last paragraph, which reads as a gratuitous jab at California disability rights activists who have been very helpful in fighting legalization efforts in that state.

Here is the closing paragraph from Shapiro's suicide promotion piece:

There is a great irony in all of this. Those who are not incapacitated are physically able to commit suicide, and need no assistance. Those who require, but are routinely denied, that assistance are the disabled. We spend billions of dollars making sure that they have the same right as the rest of us to shop, visit the beach and the like, but we deny them the right to die with dignity. Go figure.

There is so much venom, privilege and bigotry in this one statement, I would hardly know where to begin.  Fortunately, Bill Peace at Bad Cripple took this piece of crap apart in his blog response, Assisted Suicide: No Assistance Wanted.

Here is an excerpt:

Where do I begin? If it were up to my neighbors as Shapiro puts it, I would have been denied an education. I would not be able to get on a bus or plane. I would not have a job or be father. We people with a disability had to fight for these fundamental rights. Even though we people with a disability are supposedly equal I have never felt that way—ever. The idea of equality for people with a disability is illusive at best. As for the billions of dollars spent on access, which Shapiro seems to resent, has saved countless lives, mine included. But just because we spend money on access and inclusion does not mean we value the people who are supposedly equal and included. When it comes to disability rights, as a society we merely pay lip service to these inherent civil rights most take for granted. We do not in reality accept the presence of people with a disability.

 There's more - please read the rest here.

I have nothing to add but my thanks to Bill for writing this.  --Stephen Drake

Ireland: "They asked me why I would want to live" in Irish Times

It's hard to believe it's been about a month since I've written here.  Various health issues have kept me away from the keyboard, although I've been monitoring news and other information sources.  I just haven't had the energy to write.  I'll be doing my best to catch up over the next few weeks - there will probably be days when I publish two posts or more.

This op-ed from the Irish Times is especially appropriate.  As you'll read, it has a lot to do with breathing - and the not-so-shocking feeling that the writer feels it's better to breathe than not breathe - better to be alive than be dead.  We've been appreciating those simple (to us, anyway) truths in our own household.  The author of the piece highlighted below found that his desire to go on breathing met with considerable resistance from the medical team treating him.

From: They asked me why would I want to live

YOU’RE IN A room in Dublin. A man walks in whom you’ve never met. He starts to talk to you. He asks you if you have any children. You say you do. He tells you not to go home tonight. That when you leave the building you must turn right instead of left, head north instead of south. That you must keep going in an unknown direction, knowing only that you will never see anyone from your life again. The journey he is asking you to take is death.

Fitzmaurice describes the "talk" in detail:

I am in a bed in the Beacon Hospital. I came in with pneumonia and three days of no sleep and continuous coughing left me exhausted and unable to breathe. Moved into intensive care, I went into respiratory failure, collapsed unconscious and was put on a ventilator.

I now have a tube up my nose and a tube down my throat. One for feeding, one for breathing. Both of which prevent me from speaking. Motor neurone disease prevents me from moving my arms and legs. I communicate with my family through text messages on my phone.

A man has just walked in the door. I have never met him before and he starts to speak to me. He says his name is John Magner, consultant anaesthetist for the ICU. He tells me he has just got off the phone from Prof Orla Hardiman in Beaumont Hospital, after I requested that he ring them to ensure that I was getting the best care for MND in the Beacon.

He tells me that Prof Hardiman has said that they do not advocate ventilation (see panel) in this country for MND patients. That it is time for me to make the hard choice. He tells me that there have only been two cases of invasive home ventilation, but in both cases the people were extremely wealthy.

My mother and my wife start crying in the corner of the room. I look at him but I cannot reply. He looks at me. “This is it now for you. It is time for you to make the hard choice, Simon.” My mother and my wife are now holding each other, sobbing.

Before I continue with excerpts from Fitzmaurice's essay, people unfamiliar with the Irish health care system might want to know that it's a single-payer system - overseen by the HSE - Health Service Executive. I haven't checked around yet, but I am pretty sure that some conservative bloggers will pick this story up and hold it up as an example of "rationing" imposed by a centralized, single-payer system run by the government.

As you'll see, this is not one of those stories.  The barriers faced by Fitzmaurice had nothing to do with policies of the HSE - but had everything to do with the attitudes of medical professionals regarding "quality of life."  More here:

While he is looking at me, my life force, my soul, the part of me that feels like every part, is unequivocal. I want to live. It infuses my whole body to such an extent that I feel no fear in the face of this man. We find out two days later that the home ventilator is covered by the HSE, while the home care package needed to run it can be funded between my family and the HSE. (Emphasis added.)

 As he makes clear later, Fitzmaurice and his family feel they've gotten terrific support from the HSE - it was the doctors who - to put it mildly - discouraged his choice to live with invasive ventilation. I guess bioethicists would call that encouraging him to make an "end of life" decision - it's anybody's guess what they call the decision they didn't want him to make.

Long story short - Mr. Fitzmaurice is at home, happily enjoying his life with his wife, children and the rest of his family, as this wonderful picture shows:

(The picture above shows Simon Fitzmaurice in bed, attached to his ventilator, with three sons lying beside him)

Read the rest of the article, along with additional material from sources like the Irish Motor Neurone Disease Association, whose spokesperson makes it clear the association doesn't advocate use of trach ventilation.

I'll also add that Mr. Fitzmaurice believes that medical professionals in other countries are more supportive of the choice to use invasive ventilation.  Maybe, but it seems that many of the people I know who use any kind of breathing assistance up had to bring the issue up themselves - mostly, the options weren't offered by their physicians.

And, please, please read the rest of the article here. --Stephen Drake