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‘When I use a word,’ Humpty Dumpty said in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’ This quote from Though The Looking Glass by Lewis Carroll, is an apt description of how some groups manage words, and data to express their specific point of view. It came to mind when I read a recent article in the Seattle Times by Robb Miller. Mr Miller is the Executive Director of the Washington chapter of the group called Compassion and Choices which is leading the efforts in Montana to legalize physician assisted suicide (PAS). In a special article for the Times, he was touting a report from Washington State’s Department of Health (DOH) as proof that in Washington, PAS is working very well. He says the results of the recent report confirmed their predictions that the act would be used by a very small segment of the population. “…less than 1/10th of 1%, of terminally ill Washingtonians.” He also notes that “there is no evidence of harm to the elderly, the uninsured, the poor or the disabled.”
It all sounds good but organizations like Compassion and Choices are very good at shaping the message. We need to be wary of the claims they make. For instance, the information in this report is compiled from reports by physicians who provide PAS services, however there is no penalty for a physician who fails to file a report. The DOH claims it will contact the involved party if the report is not filed. But, if no report is filed, how do they know who to contact? The folly of reporting goes one step further as the physician is required to list the cause of death as “natural”, not a drug overdose. The falsified death certificate makes it even more difficult to track those physicians who assist in a patient’s suicide, but fail to report.
The new law also has inherent risks to vulnerable populations. Margaret Dore, a Seattle attorney, has pointed out a few concerns she has with the law.
“The application process to obtain the lethal dose requires two witnesses”, Ms. Dore says, “One of these witnesses can be the patient’s heir. It also allows the patient’s heir to speak for the patient if the patient is unable to speak for themselves. This does not promote patient choice,” she continues, “it invites coercion, especially if the patient has money.”
She also says that under the Washington law, no witnesses need be there when the person dies so someone could administer the lethal dose without the patient’s consent.
Perhaps the most troubling statement Ms Dore made was that by signing the form requesting the lethal drugs for PAS , the patient is taking an official position that if he or she dies suddenly, no questions should be asked. What if the patient changes his or her mind? What if the cause of death is other than the lethal drugs?
It appears the patient gives up all control of when and how they die once they sign the statement. If no witnesses are required to be present and if heirs are able to sign for and speak for the patient, the door seems to be wide open for abuse. Add the lack of reporting and the requirement to falsify death certificates, and we have a recipe for disaster.
In the coming months, you will hear how PAS is the compassionate answer to relieve suffering from proponents of PAS. They won’t tell you about the requirement to falsify death certificates and will down play the potential for abuse. Beware of the Humpty Dumpty’s who report partial facts, and choose them to mean what they want them to mean.
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