Legal Analysis of Bill A. 2383-A by Margaret Dore, Esq., MBA: Reject Euthanasia/Assisted Suicide

I.  INTRODUCTION 

For the original pdf version, click the following links for a memo and appendices.  For "quick facts," click here.

I am a lawyer and president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia.[1] The bill, A. 2383-A, seeks to legalize “medical aid in dying,” which is a euphemism for active euthanasia and physician assisted suicide.[2] 

The bill is based on similar statutes in Oregon and Washington State. If enacted, the bill will apply to people with years or decades to live. The bill will also create new paths of elder abuse and exploitation, especially for people with money, meaning the middle class and above. 

Other problems will include family trauma and suicide contagion. I urge you to reject this bill.


II.  DEFINITIONS (TRADITIONAL)

Assisted suicide occurs when a person provides the means or information for another person to commit suicide, for example, by providing a rope or lethal drug.[3] If the assisting person is a
physician, a more precise term is “physician-assisted suicide.”[4]

“Euthanasia” is the direct administration of a lethal agent to cause another person’s death.[5]  Euthanasia is also known as “mercy killing.”[6] 

III. ASSISTING PERSONS CAN HAVE AN AGENDA

Persons assisting a euthanasia or suicide can have an agenda. Consider Tammy Sawyer, trustee for Thomas Middleton, in Oregon. Two days after his death by assisted suicide, she signed documents to sell his home. The property sold for $200,000, which she deposited into accounts for her own benefit.[7]

In other states, reported motives for assisting suicide include: the “thrill” of getting other people to kill themselves; and “wanting to see someone die.”[8] 

Doctors too can have an agenda, for example, to hide malpractice or to obtain an inheritance or other financial gain. An example is Harold Shipman, a doctor in the UK, who directly killed his patients (euthanasia) and also stole from them.[9] One patient, he put himself in her will.[10]

IV.  PUSHBACK AGAINST ASSISTED SUICIDE AND EUTHANASIA

A.  Last Week, a California Judge Overturned California’s Law Allowing Assisted Suicide and Euthanasia 

On May 24, 2018, a Riverside County Superior Court judge overturned California’s law allowing assisted suicide and euthanasia.[11] The law was ruled “void as unconstitutional.”[12]

B.  This Year, Utah Passed a Bill Clarifying That Assisted Suicide Is a Crime

This year, Utah amended its manslaughter statute to clarify that assisting a suicide is a crime.[13]  The bill passed by a more than 2 to 1 margin.[14]  

C.  Last Year, Alabama Passed an Act Banning Assisted Suicide

Last year, Alabama passed the “Assisted Suicide Ban Act,” which renders any person who deliberately assists a suicide, guilty of a felony.[15] The vote to pass was nearly unanimous.[16]

D.  Two Years Ago, the New Mexico Supreme Court Overturned Assisted Suicide; Assisted suicide Is No Longer Legal in New Mexico

Two years ago, the New Mexico Supreme Court overturned a lower court decision recognizing a right to physician aid in dying, meaning physician assisted suicide.[17] Physician-assisted suicide is no longer legal in New Mexico.

E.  In the Last Seven Years, Four Other States Have Strengthened Their Laws Against Assisted Suicide

In the last seven years, Arizona, Georgia, Louisiana and Idaho all strengthened their laws against assisted suicide.[18] This was in 2014, May 2012, April 2012 and 2011, respectively.[19]

V.  THE BILL WILL APPLY TO PEOPLE WITH YEARS OR DECADES TO LIVE   

A.  The Bill Is Based on Statutes in Oregon and Washington State, Which Apply to People with Chronic Conditions

A statute adopted from another jurisdiction is presumed to carry the construction given by the other jurisdiction if the statute adopted is identical or nearly identical to the statute from the other jurisdiction. Consider, Sun Valley Land and Minerals, Inc. v. Burt, 123 Idaho 862, 868, 853 P.2d 607 (1993), which states:

Idaho code § 55–606, describing a bona fide purchaser, was adopted from a nearly identical section of the California Civil code, therefore it is presumed to carry the construction given by the jurisdiction from which the statute was taken. (Emphasis added).

Here, the bill applies to people with a “terminal illness or condition” expected to produce death in less than six months.[20] The bill also states:

"Terminal illness or condition" means an incurable and irreversible illness or condition that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.  (Emphasis added).[21]

The bill is based on statutes in Oregon and Washington State, which have a nearly identical provision. They both state:

“Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months. (Emphasis added).[22]

In Oregon and Washington, this provision is construed to include chronic conditions, such as diabetes and chronic obstructive pulmonary disorder.[23] This is significant because persons with these conditions can have years or decades to live. Oregon doctor, William Toffler, explains:

In Oregon, chronic conditions such as insulin dependent diabetes are sufficient for assisted suicide, if, without treatment, the patient has less than six months to live.

This is significant when you consider that, without insulin, a typical insulin dependent 20 year old will live less than a month. Such persons, with insulin, are likely to have years or decades to live. (Emphasis added).[24]

With this situation, and due to the presumption that a  statute adopted from another jurisdiction carries the construction given by the other jurisdiction, the bill will be construed consistently with Oregon and Washington State to apply to people with chronic conditions. As noted above, such persons can have years or decades to live.

B.  Predictions of Life Expectancy Can Be Wrong

Eligible persons may also have years or decades to live because predictions of life expectancy can be wrong. This is true due to actual mistakes (the test results got switched), and because predicting life expectancy is not an exact science.[25] 

Consider John Norton, who was diagnosed with ALS (Lou Gehrig’s disease) at age 18.[26] He was told that he would get progressively worse (be paralyzed) and die in three to five years.[27] Instead, the disease progression stopped on its own.[28] In a 2012 affidavit, at age 74, he states:

If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.[29]

C.  Treatment Can Lead to Recovery

Consider also Jeanette Hall, who was diagnosed with cancer in 2000 and made a settled decision to use Oregon’s law.[30] Her doctor convinced her to be treated instead.[31] In a recent declaration, she states:

It has now been 18 years since my diagnosis. If [my doctor] had believed in assisted suicide, I would be dead.[32]

VI.  HOW THE BILL WORKS

The bill has an application process to obtain the lethal dose, which includes a lethal dose request form. Once the lethal dose is issued by the pharmacy, there is no oversight. No witness, not even a doctor is required to be present at the death. 

VII.  ELDER ABUSE AND EXPLOITATION

According to statistics from Oregon and Washington State, most people who die under their statutes are elders, aged 65 or older.[33] In New York State, this demographic is already at risk of abuse and financial exploitation. Enacting the proposed bill will make a bad situation worse. See below. 

A.  Elder Abuse and Financial Exploitation Are Already Problems in New York State; Adult Children Are Common Perpetrators

Elder abuse is a problem throughout the United States, including New York State.[34] Philanthropist, Brooke Astor, is arguably New York’s most prominent victim.[35] Her son, Anthony Marshall, plundered millions from her estate.[36]

Perpetrators are often family members.[37] They typically start out with small crimes, such as stealing jewelry and blank checks, before moving on to larger items or to coercing victims to change their wills or to liquidate their assets.[38] Amy Mix, of the AARP Legal Counsel of the Elderly, states:

[Perpetrators] are family members, lots are friends, often people who befriend a senior through church .... We had a senior victim who had given her life savings away to some scammer who told her that she’d won the lottery and would have to pay the taxes ahead of time .... The scammer found the victim using information in her husband’s obituary.[39]

B.  Elder Abuse Is Rarely Reported

The vast majority of elder abuse cases are not reported to the authorities. Victims:

• Do not want their adult child or other family member going to jail or facing        public embarrassment; ... 

• Worry that the perpetrator might harm them even more.[40] 

C. Elder Abuse Is Sometimes Fatal

In some cases, elder abuse is fatal. More notorious cases include California’s “black widow” murders, in which two women took out life insurance policies on homeless men.[41] Their first victim was 73 year old Paul Vados, whose death was staged to look like a hit and run accident.[42] The women collected $589,124.93.[43]

Consider also, People v. Stuart in which an adult child killed her mother with a pillow, allowing the child to inherit. The Court observed:

Financial considerations [are] an all too common motivation for killing someone.[44]

VIII.  THE BILL WILL CREATE A PERFECT CRIME 

A.  “Even If the Patient Struggled, Who Would Know?”

The bill has no oversight over administration of the lethal dose.[45]  In addition, the drugs used are water and alcohol soluble, such that they can be injected into a sleeping or restrained person without consent.[46] Alex Schadenberg, Executive Director for the Euthanasia Prevention Coalition, puts it this way:

With assisted suicide laws in Washington and  Oregon [and with the proposed bill], perpetrators can ... take a “legal” route, by getting an elder to sign a lethal dose request. Once the prescription is filled, there is no supervision over administration. Even if a patient struggled, “who would know?”  (Emphasis added).[47]

B.The Bill Is Based on the Washington State Statute, Which Requires the Death Certificate to List a Natural Death Merely Because the Statute Was Used

The bill states: 

The cause of death listed on a qualified individual's death certificate who dies after self-administering medication under this article will be the underlying terminal illness or condition.[48] [and]

Action taken in accordance with this article shall not be construed for any purpose to constitute suicide, assisted suicide, attempted suicide, promoting a suicide attempt, euthanasia, mercy killing, or homicide under the law, including as an accomplice or accessory. (Emphasis added).[49]

Washington’s statute has similar language, which states:

The attending physician may sign the patient's death certificate which shall list the underlying terminal disease as the cause of death.  [and]

Actions taken in accordance with this chapter do not, for any purpose, constitute suicide, assisted suicide, mercy killing, or homicide, under the law. (Emphasis added).[50]

In Washington, this similar language is interpreted to require the death certificate to list a natural death if Washington’s statute was “used” (not complied with). There must be no language indicating that the actual cause of death was assisted suicide or euthanasia. Washington’s death certificate instructions state:

Washington’s Death with Dignity Act (RCW 70.245) states that “... the patient’s death certificate ... shall list the underlying terminal disease as the cause of death.”  The act also states that, “Actions taken in accordance with this chapter do not, for any purpose, constitute suicide, assisted suicide, mercy killing, or homicide, under the law.”

If you know that the decedent used the Death with Dignity Act, you must comply with the strict requirements of the law when completing the death record:

1.  The underlying terminal disease must be listed as the cause of death.

2.  The manner of death must be marked as “Natural.”

3. The cause of death section may not contain any language that indicates that the Death with Dignity Act was used, such as:

a.  Suicide
b.  Assisted suicide
c.  Physician-assisted suicide
d.  Death with Dignity
e.  I-1000
f.  Mercy killing
g.  Euthanasia
h.  Secobarbital or Seconal
i.  Pentobarbital or Nembutal.[51]

With this situation and due to the presumption that a statute adopted from another jurisdiction will carry the construction given by the other jurisdiction, the New York bill will be construed to require the death certificate to list a natural death. There will no indication that the actual cause of death was assisted suicide or euthanasia.

C.  The Death Certificate Will Prevent Prosecution for Murder

The significance of requiring the death certificate to list a natural death, is that it will create a legal inability to prosecute for murder no matter what the facts. The official legal manner of death will be “natural” (not homicide) as a matter of law.[52] The bill will allow legal murder.

IX.  THERE WILL BE A NEAR COMPLETE LACK OF TRANSPARENCY 

With the presumption that a statute adopted from another jurisdiction carries the construction given by the other jurisdiction, the bill will be construed consistent with Oregon practice to create a near complete lack of transparency and/or an even more perfect crime.  

A.  The Bill Will Follow Oregon’s Data Collection Protocol in Which Patient Identities Are Not Recorded in Any Manner and Source Documentation Is Destroyed And/or Not Maintained

Oregon’s data collection protocol is described on its website, as follows:

[T]he identity of individual patients is not recorded in any manner. Approximately one year from the publication of the Annual Report, all source documentation is destroyed. (Emphasis added).

Alicia Parkman, Mortality Research Analyst for the Oregon Health Authority, makes a similar representation as follows: 

To ensure confidentiality, our office does not maintain source information on participants. (Emphasis added).[54]

B.  The Bill Will Follow Oregon Practice to Insulate the Department of Health from Review and Thereby Create a Government Entity above the Law

The bill charges the Department of Health with issuing an annual report based on information collected pursuant to the bill.[55] The bill also states that the information shall not constitute a public record, except that information “may” be disclosed to a government agency and/or law enforcement (not that it “must” be disclosed). The bill states:

The information collected under this subdivision shall not constitute a public record available for public inspection and shall be confidential and collected and maintained in a manner that protects the privacy of the patient, his or her family, and any health care provider acting in connection with such patient under this article, except that such information may be disclosed to a governmental agency as authorized or required by law relating to professional discipline, protection of public health or law enforcement.  (Emphasis added).

Oregon’s law has a similar, albeit shorter provision, as follows:

Except as otherwise required by law, the information collected shall not be a public record and may not be made available for inspection by the public. (Emphasis added).[57]

In Oregon, this similar provision is interpreted to bar release of information about individual cases, to everyone, including law enforcement. Oregon’s website states:

[T]he Act specifically states that information collected is not a public record and is not available for inspection by the public (ORS 127.865 (2)). The protection of confidentiality conferred by the Death with Dignity Act precludes the Oregon Health Authority [which oversees Oregon’s Department of Health] from releasing information that identifies patients or participants, to the public, media, researchers, students, advocates, or other interested parties.... [58]

Consider also this e-mail from Alicia Parkman, Mortality Research Analyst for the Oregon Health Authority, which states:

We have been contacted by law enforcement ... in the past, but have not provided identifying information of any type. (Emphasis added). 

C.  If New York Follows Oregon, Compassion & Choices, a Non-Governmental Entity, Will Displace the Department of Health to Become the Defacto “Agency” Overseeing the Bill

In 2010, I had client who wanted to know if his father had died under Oregon’s law. I referred him to an Oregon lawyer, Isaac Jackson, who asked the police to investigate. Jackson’s subsequent declaration states: 

2.  I write to inform the court regarding a lack of transparency under Oregon’s assisted suicide act. Even law enforcement is denied access to information collected by the State of Oregon. Moreover, according to the current Oregon State website, this lack of access is official Oregon State Policy.

3.  In 2010, I was retained by a client whose father had apparently died under Oregon’s law. The client wanted to know whether that was true. I therefore made inquiry on his behalf. However and unlike other deaths I have investigated, it was difficult to get information ....

6.  I ... received a copy of the decedent’s death certificate, which is the official death record in Oregon.  A true and correct, but redacted copy, is attached hereto .... The “immediate cause of death” is listed as “cancer.” The “manner of death” is listed as “Natural.”

7.  Per my request, a police officer was assigned to the case. Per the officer’s confidential report, he did not interview my client, but he did interview people who had witnessed the decedent’s death.

8.  The officer’s report describes how he determined that the [father’s] death was under Oregon’s assisted suicide law due to records other than from the State of Oregon. The officer’s report also describes that he was unable to get this information from the Oregon Health Authority, which was not willing to confirm or deny whether the deceased had used the act .... (Emphasis added).[60]

I also read the officer’s report.  According to the report, the former Hemlock Society, now known as  Compassion & Choices, had provided the records necessary for the officer to determine that the decedent had, in fact, died under Oregon’s law. In Oregon, Compassion & Choices, a non-governmental entity, has displaced the Department of Health as the agency overseeing Oregon’s law.

X.  THE BILL WILL ALLOW EUTHANASIA

A.  The Bill Allows Euthanasia When “Appropriate”

[A] legislative act is to be construed as a whole, and all parts of an act are to be read and construed together to determine the legislative intent.[61]

Here, the bill says that another person “shall not” administer the lethal dose to the patient and instructs the attending physician to discuss with the patient the importance of this restriction.[62]  The bill, however, also says that the attending physician may prescribe or order “appropriate” medication. The bill states:

[T]he attending physician ...  may prescribe or order appropriate medication in  accordance with the patient's request under this article ....[63]

The bill dose not define appropriate. Dictionary definitions include:

Suitable for a particular person, condition, occasion, or place; fitting.[64]

B.  Self-administration May Not Be Appropriate

In context of administering medication generally, a patient’s physical condition and other factors can result in a determination that self-administration is not appropriate. Dr. Toffler explains:

If a patient has trouble swallowing, it may be appropriate for a doctor to prescribe  medication to be administered via injection.

Declaration of William Toffler, MD, attached hereto at A-28.

In Oregon, where deaths are generally described as occurring via assisted suicide, official statistics report problems, including trouble regurgitation and seizures.[65]

Consider also the quote below from an article in the New England Journal of Medicine, regarding a study of assisted suicide versus euthanasia. Problems were experienced more frequently with assisted suicide. The article states:

Complications occurred in 7 percent of cases of assisted suicide, and problems with completion (a longer-than-expected time to death, failure to induce coma, or induction of coma followed by awakening of the patient) occurred in 16 percent of cases;

[C]omplications and problems with completion occurred in 3 percent and 6 percent of cases of euthanasia, respectively.  

The physician decided to administer a lethal medication in 21 of the cases of assisted suicide (18 percent), which thus became cases of euthanasia. The reasons for this decision included problems with completion (in 12 cases) and the inability of the patient to take all the medications (in 5). (Spacing changed).[66]

With this situation, and despite the bill’s apparently mandatory language to the contrary, the bill will allow direct administration of the lethal dose when “appropriate,” for example, to reduce the risk of regurgitation, seizures and other problems. The bill will allow euthanasia as traditionally defined.

XI. TRAUMA AND SUICIDE CONTAGION

A.  The Swiss Study:  Physician-Assisted Suicide Can Be Traumatic for Family Members

A European research study addressed trauma suffered by persons who witnessed legal physician-assisted suicide in Switzerland.[67] The study found that one out of five family members or friends present at an assisted suicide was traumatized. These people,

experienced full or sub-threshold PTSD (Post Traumatic Stress Disorder) related to the loss of a close person through assisted suicide.[68]

B.  My Clients Suffered Trauma in Oregon and Washington State

I have had two cases where my clients suffered trauma due to legal assisted suicide. In the first case, one side of my client’s family wanted her father to take the lethal dose, while the other side did not. The father spent the last months of his life caught in the middle and torn over whether or not he should kill himself. My client was severely traumatized. The father did not take the lethal dose and died a natural death. 

In the other case, my client’s father died via the lethal dose at a suicide party. It’s not clear, however, that administration of the lethal dose was voluntary.  A man who was present told my client that his father had refused to take the lethal dose when it was delivered, stating: "You're not killing me.  I'm going to bed."  The man also said that my client’s father took the lethal dose the next night when he (the father) was already intoxicated on alcohol.  The man who told this to my client subsequently changed his story.

My client, although he was not present, was severely  traumatized over the incident, and also by the sudden loss of his father.

C.  Actively Suicidal People Have Contacted Me Seeking “Death With Dignity”

To date, three physically healthy suicidal men have contacted me to commit suicide or be euthanized legally via “death with dignity.” In each case, once they got talking, it came out that they didn’t really want to die; they were depressed. 

The first one was 50. He had recently suffered a traumatic event and blamed himself for a friend’s having been injured. The next one was 27.  He had previously attempted suicide via carbon monoxide. The last one was in his 30's and from what I could tell, was overwhelmed with events in his life.  He contacted me a few months later saying that I had saved his life (by talking to him). Legal assisted suicide encourages other suicide.

XII. CONCLUSION

The bill will legalize euthanasia and assisted suicide for people with years or decades to live. The bill is stacked against the individual with the most obvious problem being a complete lack of oversight at the death. Even if the patient struggled, who would know? 

People are already murdered for their money. Passage of the  bill will make a bad situation worse by creating the perfect crime.  I urge you to say “No” to A. 2383-A.

FOOTNOTES

[1]  I am an elder law/appellate attorney, licensed to practice law in Washington State since 1986. I am also a former Law Clerk to the Washington State Supreme Court and a former Chair of the Elder Law Committee of the American Bar Association. For more information, please see my CV attached hereto in the appendix, at pages A-1 through A-4.  See also www.margaretdore.org and www.choiceillusion.org
[2] Cf. Craig A. Brandt, “Model Aid-in-Dying Act,” Iowa Law Review, 1989 Oct; 75(1): 125-215, (“Subject: Active Euthanasia ....”), at https://repository.library.georgetown.edu/handle/10822/738671 (attached hereto at A-5); and Maria T. CeloCruz, “Aid-in-Dying: Should We Decriminalize Physician-Assisted Suicide and Physician-Committed Euthanasia?,” American Journal of Law and Medicine, 1992; 18(4): 369-394 (“Subject: Active Euthanasia ....”) at https://repository.library.georgetown.edu/handle/10822/744116 (in the appendix at A-6).
[3]  Ben Winslow, “Teen accused of helping friend commit suicide could face trial for murder,” The Salt Lake Tribune, 10/12/17 (The defendant “bought the rope, tied the noose and picked the tree”), in the appendix at A-7 & A-8, https://www.aol.com/article/news/2017/10/12/teen-accused-of-helping-friend-commit-suicide-could-face-trial-for-murder/23241619.
[4]  See e.g., The American Medical Association (AMA) Code of Medical Ethics, Opinion 5.7 (defining physician-assisted suicide).  Attached in the appendix at A-9.
[5]  Id., Opinion 5.8, “Euthanasia,” attached in the appendix at A-9, lower half of the page.
[6]  “Mercy killing” - The Free Legal Dictionary, attached hereto at A-10.
[7]  KTVZ.com, “Sawyer Arraigned on State Fraud Charges,” 07/14/11, at attached hereto at A-1
[8]  AP for Minnesota, “Former nurse helped instruct man on how to commit suicide, court rules,” The Guardian, 12/28/15 (“he told police he did it ‘for the thrill of the chase’”), attached in the appendix at A-12 & A-13; also available at https://www.theguardian.com/us-news/2015/dec/28/minnesota-suicide-conviction-william-melchert-dinkel-mark-drybrough; Ben Winslow, supra.  Doctors too may kill for a thrill, with a New York example being Michael Swango.  See e.g., Charlie Leduff, “Prosecutors Say Doctor Killed to Feel a Thrill,” The New York Times, 09/07/00, attached hereto in the appendix at A-14 to A-17.
[9]  See Steven Rourke & Tricia Ward, Medscape, 12/31/17, at www.medscape.com/viewarticle/884136.  Excerpts attached in the appendix at A-18 to A-20.
[10]  Id.
[11]  Ahn v. Hestrin, Riverside County Case No. RIC 1607135, Judgment, at https://choiceisanillusion.files.wordpress.com/2018/05/2018-0524-judgment.pdf
[12]  Id.
[13]  Enrolled copy here: https://le.utah.gov/~2018/bills/hbillenr/HB0086.pdf
[14]  House, 51 yes, 18 no, 6 absent/abstain; Senate, 19 yes, 5 no, 5 absent/abstain.  See https://le.utah.gov/~2018/bills/static/HB0086.html
[15]  Alabama: Assisted Suicide Ban Act to Go Into Effect,” http://www.choiceillusion.org/2017/07/alabama-assisted-suicide-ban-act-to-go.html 
[16]  See Alabama State website, 2017 Legislative session, HB 96.
[17]  Morris v. Brandenburg, 376 P.3d 836 (2016).  (Excerpt attached in the appendix at A-21)
[18]  See: “Brewer Signs Bill Targeting Assisted Suicide,” Kansas City Star, April 30, 2014, attached hereto in the appendix at A-22; Georgia Legislature Bill Summary, HB 1114, attached hereto in the appendix at A-23; AP, “La. assisted-suicide ban strengthened,” April 24, 2012, attached hereto in the appendix at A-24; and Margaret Dore, “Idaho Strengthens Law Against Assisted-Suicide,” Choice Is an Illusion, Idaho, July 4, 2011, attached hereto in the appendix at A-25.
[19]  Id.
[20]  The bill defines a “qualified individual” as a patient “with a terminal illness or condition.”  See the bill, A-2383.A, § 2899-d.15, attached in the appendix at A-103.
[21]  The bill, § 2899-d.17, attached hereto in the appendix at A-103.
[22]  Or. Rev. Stat. 127.800 s.1.01(12), attached hereto in the appendix at A-29.
[23]  See Oregon report excerpt, attached in the appendix at A-30 (listing diabetes); and Washington’s report excepts, in the appendix at A-51 to A-52 (listing chronic obstructive pulmonary disorder, COPD).
[24]  Declaration of William Toffler, MD, ¶¶ 5-6, attached in the appendix at A-26 to A-31
[25]  See: Jessica Firger, “12 Million Americans Misdiagnosed Each Year,” CBS NEWS, April 17, 2014, attached in the appendix at A-32; and Nina Shapiro, “Terminal Uncertainty — Washington's New 'Death with Dignity' Law Allows Doctors to Help People Commit Suicide — Once They've Determined That the Patient Has Only Six Months to Live.  But What If They're Wrong?,” The Seattle Weekly, 01/14/09, attached hereto at A-33 to A-35.
[26]  Affidavit of John Norton, attached in the appendix at A-36 to A-38.
[27]  Id., ¶ 1.
[28]  Id., ¶ 4.
[29]  Id., ¶ 5.
[30]  Affidavit of Kenneth Stevens, MD, attached in the appendix at A-39 to A-41; Jeanette Hall discussed at A-39 to A-40; Hall declaration attached in the appendix at A-42.
[31]  Id.
[32]  Declaration of Jeanette Hall, May 17, 2018, ¶4, attached in the appendix at A-42.
[33]  See Oregon and Washington report excerpts, attached in the appendix at A-43 & A-43A. A caveat, these statistics cannot be verified due to a lack of transparency.  See “Bad Things Happen in the Dark,” 04/02/17, http://www.choiceillusionalaska.org/2017/07/bill-54-bad-things-happen-in-dark.html
[34]  See e.g., MetLife Mature Market Institute, “Broken Trust: Elders, Family and Finances, A Study on Elder Abuse Prevention,” March 2009, at https://choiceisanillusion.files.wordpress.com/2018/05/broken-trust_-elders-family-and-meaning.pdf and “Elder Abuse in New York: The Most Common Kinds of Financial Scams,” Morgan & Morgan News Blog, 08/22/16, in the appendix at A-44 to A-48
[35]  Carole Fleck, “Brooke Astor’s Grandson Tells Senate Panel of Financial Abuse,” AARP Bulletin Today, 02/05/2015 (“The grandson of socialite Brooke Astor, who blew the whistle on his father for plundering millions from his grandmother’s estate, told the Senate panel Wednesday that his grandmother’s greatest legacy may be the national attention focused on elder financial abuse.”)
[36]  Id. and Robert D. McFadden, “Anthony D. Marshall, Astor Son Who Was Convicted in Swindle, Dies at 90,” New York Times, 12/01/14, at https://www.nytimes.com/2014/12/02/nyregion/anthony-d-marshall-son-of-brooke-astor-convicted-in-swindle-dies-at-90.html
[37]  MetLife Mature Market Institute, supra at note 34
[38]  Id.
[39]  Kathryn Alfisi, “Breaking the Silence on Elder Abuse,” Washington Lawyer, February 2015, available at https://www.dcbar.org/bar-resources/publications/washington-lawyer/articles/february-2015-elder-abuse.cfm
[40]  MetLife Mature Market Institute, supra at note 34, page 21, attached in the appendix at A-49: “The Tip of the Iceberg: Why Victims Do Not Report.”  See also NYS Office of Children and Family Services, “The New York State Cost of Financial Exploitation Study,” June 15, 2016, pp. 20 to 22.
[41]  See People v. Rutterschmidt, 55 Cal.4th 650 (2012).  See also   https://en.wikipedia.org/wiki/Black_Widow_Murders
[42]  Rutterschmidt, at 652-3.
[43]  Id., at 652.
[44]  67 Cal.Rptr.3d 129, 143 (2007), available at https://www.leagle.com/decision/200719667calrptr3d1291182 
[45]  See the bill in its entirety, in the appendix at A-101 to A-114.
[46]  The drugs used include Secobarbital, Pentobarbital and Phenobarbital, which are water and/or alcohol soluble.  See excerpts from Oregon’s and Washington’s annual reports, attached in the appendix at A-53 & A-54 (listing these drugs).  See also http://www.drugs.com/pr/seconal-sodium.html, http://www.drugs.com/pro/nembutal.html and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2977013
[47]  Alex Schadenberg, Letter to the Editor, “Elder abuse a growing problem,” The Advocate, Official Publication of the Idaho State Bar, October 2010, page 14.
[48]  The bill, § 2899-p.2, attached in the appendix at A-113.
[49]  Id., § 2899-n.1.(b), attached in the appendix at A-112.
[50]  RCW 70.245.040(2) and 70.245.180, in the appendix at A-55 & A-56, respecively.
[51]  Washington State Instructions for Medical Examiners, Coroners, and Prosecuting Attorneys: Compliance with the Death with Dignity Act, attached here and in the appendix at A-57.
[52]  Id. and New York State death certificate form attached in the appendix at A-58.
[53]  Oregon Health Authority, Frequently Asked Questions, attached in the appendix at A-59
[54]  E-mail from Alicia Parkman to Margaret Dore, 01/04/12, attached in the appendix at A-63.
[55]  The bill, § 2899-q.2., attached in the appendix at A-114, lines 18 to 20.
[56]  The bill, § 2899-q.1., p. 11, lines 9-17, attached hereto at A-114.
[57]  Oregon Data Release Policy, copy attached in the appendix at A-68.
[58]  ORS 127.865 s.3.11(2)  (Attached in the appendix at A-69)
[59]  E-mail from Alicia Parkman to me, 01/04/12, attached in the appendix at A-60.
[60]  Isaac Jackson, Declaration of Testimony, 09/18/12, in the appendix at A-63 to A-64.
[61]  Kuzmich v. 50 Murray Street Acquisition LLC, 157 A.D.3d 556, 69 N.Y.S.3d 627 (2018).
[62]  The bill states " A health care professional or other person shall not administer the medication [lethal dose] to the patient." (Emphasis added). § 2899-f.3., p. 5, lines 3-4, attached in the appendix at A-106.  See also, the bill 2899-f.1., p. 4, lines 33-35 (saying that no other person may administer the lethal dose to the patient).
[63]  The bill, § 2899-f.1., page 4, lines 1-3, and lines 52-54, attached in the appendix at A-104 and A-105.
[64]  http://www.dictionary.com/browse/appropriate
[65]  Oregon Annual Report for 2017, p. 10, attached in the appendix at A-70.
[66]  Johanna H. Groenewoud, MD, et al., “Clinical Problems with the Performance of Euthanasia and Physician-Assisted Suicide in the Netherlands,” The New England Journal of Medicine, February 24, 2000, excerpts attached in the appendix at A-71 to A-72.  Also available at https://www.nejm.org/doi/full/10.1056/NEJM200002243420805
[67]  “Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide,” B. Wagner, J. Muller, A. Maercker; European Psychiatry 27 (2012) 542-546, available at http://choiceisanillusion.files.wordpress.com/2012/10/family-members-traumatized-eur-psych-2012.pdf  (Cover page attached in the appendix at A-73)
[68]  Id.

Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, P.S.
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