NH assisted suicide bill, round 1

For hours yesterday, people spoke up against assisted suicide in New Hampshire, essentially saying “hell, no.” The count was impressive. The only decisive count will come from legislators, though, and the outcome is very much in doubt. Here’s this morning’s Facebook post by a committee member, referring not only to HB 1325 but to a second bill, HB 1226, to set up a committee to study end-of-life decisions

“NH Voters: If you are concerned with end of life decisions and you are against Assisted Suicide, please send e-mails to the House Judiciary Committee, flood our in boxes. We had two public hearings yesterday on the subject and some committee members are actually planning on voting for this to pass. NO ONE spoke in favor of these two horrific bills, but plenty of people spoke out against it. Unfortunately, some of the speakers were from out of town and most e-mails have come from out of town. Their thinking is that since no one is speaking out in NH, it must not be something people are concerned about, so let’s pass it…… The link is HouseJudiciaryCommittee@leg.state.nh.us. Thank you!”

The setting for the hearing

Too much was going on at once yesterday. Two hearings, only a few yards apart in Concord’s Legislative Office Building, and I could only participate in one at a time. After an hour at the first hearing, I hurried to where the House Judiciary Committee was having its hearing on HB 1325.  I hoped I wasn’t too late.

I could barely get in the door.

There was the committee, seated around its big U-shaped table taking up two-thirds of the room, with no one aside from House staff permitted to stand along the walls. This is the standard set-up for New Hampshire House committees. In the remaining third of the room, the two rows of seats were full, with more people standing in clusters at each end of the rows. When I managed to squeeze into the room, I became the de facto doorkeeper as people entered and left.

I was so wedged in that I couldn’t reach my phone or use my tablet, so the world had to get along without my livetweeting (and at last report the world was getting along fine without it). Just as well, since I’d been using the hashtag #hb1325, which someone later pointed out to me was the same hashtag used for a bill in Colorado on a different subject. In the future I’ll use #noPASnh (with PAS standing for physician-assisted suicide).

Some of the testimony

I had earlier provided the committee clerk with the testimony I had prepared on behalf of the New Hampshire nonprofit organization for which I work. The committee members will see this, even though I didn’t testify in person. The core of the testimony is here:

Nothing is more certain to inhibit support for palliative- and supportive-care strategies than to make physician-prescribed death a treatment option. Pain management, respite care, and adaptive technology can require complex, time-consuming effort. Taking a handful of pills is cheap. The negative message to vulnerable, depressed individuals would be unmistakable.

I recognized friendly faces in the crowd, including legislators who have worked for years to resist assisted-suicide legislation. I also saw many people I didn’t know, and I could only hope they were there to protest the bill. I later heard from a committee member that they were indeed opponents – and articulate ones, too. Two of them posted their testimony online via links on PRWeb. They’re worth quoting, but I heartily recommend you go to the PRWeb link to read the statements in full.

From John Kelly, on behalf of Not Dead Yet and Massachusetts Second Thoughts:

We were the progressive voice in Massachusetts that defeated the assisted suicide ballot question.  Our opposition is based in universal principles of social justice that apply to everyone, whether disabled or not….We chose our name Second Thoughts because we find that many people, once they delve below the surface appeal of assisted suicide, have “second thoughts” and oppose it.  In Massachusetts a month before the election, 68% of Massachusetts voters supported the ballot question.  But upon closer look at the real-world threats the legislation posed, voters had serious “second thoughts.”  …

There is nothing in this or any other assisted suicide bill that can protect people who are being abused.  Every year in New Hampshire, it is estimated that there are over 26,000 reported and unreported cases of elder abuse.  No independent, disinterested witness is required when the lethal dosage is taken, which means that the stipulation that someone “must” self-administer the drug is merely a recommendation.  These bills take no notice of how self-interest can motivate family members and caregivers.  Because of the typical provision in these laws that death certificates list the cause of death as the underlying illness, investigations are foreclosed….

HB 1325 uses a definition of “terminal condition” that directly threatens the lives of me and many of my disabled friends.  Section 13 reads:“Terminal condition” means an incurable and irreversible condition, for the end stage for which there is no known treatment which will alter its course to death, and which, in the opinion of the attending physician and consulting physician competent in that disease category, will result in premature death.

The day this bill goes into effect, thousands of people will be instantly made eligible.  For example, my quadriplegia constitutes “an incurable and irreversible condition.”  It has “no known treatment,” and likely “will result in premature death.”  This bill would authorize a New Hampshire doctor, whom I saw “regularly,” to validate temporary feelings of being a burden as being worse than death.  Legalizing assisted suicide sends the wrong message to anyone who depends on caregivers, the message that feeling like a burden is not only an acceptable reason for suicide, but a justification for our health care system to provide the lethal means to end your life.  We are not better off dead.

From Stephen Mendelsohn of Second Thoughts Connecticut:

This bill, with its expansive eligibility targeting a wide range of people with long-term disabilities who are nowhere near death, morphs New Hampshire’s honored state motto, “Live Free or Die” into an ableist obscenity: “Live Nondisabled or Die.”… 

Let us remember that people in Oregon and Washington [where assisted suicide is legal] are killing themselves not because of pain, but because of fear of disability, because they view needing assistance with eating or toileting as a “loss of autonomy,” a “loss of dignity,” and a “burden” on others [according to Oregon’s 2012 report on the Death with Dignity Act]….

As Oregon’s experience shows, death is always the cheapest “treatment.”  Barbara Wagner and Randy Stroup found that out when Oregon Medicaid refused to pay for chemotherapy, but offered to pay for lethal drugs so they could commit suicide under that state’s “Death With Dignity Act.”…

And what message does this legislation send toward those contemplating suicide?  We constantly hear the six-word slogan from proponents, “My Life. My Death. My Choice.”  If “my death” is “my choice,” what message are we sending to an autistic or LGBT teenager who is being mercilessly bullied?  After all, victims of bullying also experience “severe, unrelenting suffering.”  Why even have suicide prevention? … Let us reject HB 1325 and instead work to build a world where no one feels they ought to die merely because they cannot do everything for themselves and instead receive blessing from others, whether they may have days, months, or many years of life ahead.

When I arrived at the hearing, Margaret Dore was speaking, trying vainly to compress extensive testimony into just a few minutes. It’s a fact of life that even when a committee chair goes out of her way to be accommodating, as did Judiciary chair Marjorie Smith (D-Durham) yesterday, all those who testify late in a hearing bear the burden of everyone’s impatience. Dore is an elder-law attorney from Washington state, and she has come to New Hampshire before to fight other assisted suicide bills. Her experience with her own clients has thoroughly schooled her in the risks of abuse inherent in any law that makes physician-prescribed death just another medical option.

The hallway conversations – and what must be done next

Before the hearing began, I spoke with a veteran legislator from the Judiciary committee. He was not optimistic. “Lobby the Senate. Now.” I raised an eyebrow (perhaps two) and asked for his count of the votes on the committee. He declined to elaborate.

Another committee member caught up with me after the hearing and filled me in on what I had missed. She said the turnout by anti-1325 forces had been great. Then this morning, she wrote the warning with which I opened this post. As if the truth changes at the state line … but I appreciate her candor.

Yesterday, a lot of people did a good day’s work. I wish it were enough. Instead, it’s only round one. If this gets through House and Senate – and I concede nothing at this point – it may come down to a veto by Governor Maggie Hassan. Hassan has not addressed this bill directly, but she did veto a bill last year for an end-of-life study committee, introduced by an assisted-suicide supporter. At that time, she said our focus should be “on helping all of those in our society to fully live their lives with the dignity that they deserve.” That sounds promising.

5 thoughts on “NH assisted suicide bill, round 1

  1. My husband had diabetes, congestive heart failure, kidney failure, non healing blisters on legs that had to be wrapped weekly, bladder that did not drain, septic shock (twice), c diff, stroke, unable to stand or walk, some form of parkinson’s, speech difficulties, deep sores from sitting, and more. He had discomfort, yet he was not a complainer. He lived his life bravely and left a wonderful legacy to his children and grandchildren. The time he had was precious even though he had pain, the memorable moments out weight it. That said, if he was of a mind to commit suicide, he could have. Almost all the medicines he took would do the trick. Additionally if he just wanted to let go, all he had to do was refuse treatment. If he stopped his insulin, or his heart medications, or treating the various infections, nature would have taken its course.

    I do not want to make light of your condition, I pray that you get relief, but if you have been sick for 22 years, Physician Assisted Suicide would not have helped you as it is promoted as for people that are dying. Additionally I trust that in those 22 years that you have had some good moments and that you have had some important accomplishments. You did raise a child. You would have thrown all that away. Going forward you do still have options. You could seek a second opinion for pain relief. You could use the methods described for my husband or commit suicide the old fashioned way. What I have a problem with is State Sanctioned Suicide. I do not want the government determining who is eligible to die. That is a very dangerous precedent. I do not want to hear when I or my loved ones go to the doctor, to have suicide suggested as an option. That is abuse. I fear for the elderly, with elder abuse rampant in this country, that this will be another deadly avenue to abuse a senior, especially if they have money. I fear for my friends who have disabilities. They are already treated differently, will their illnesses be treated differently too. And remember, almost all who are eligible, will at that time in their lives have a disability. Healthy people are talked out of suicide, yet the other will be encouraged to suicide. I am sorry, but this is discrimination. Lastly, when Assisted Suicide is a treatment option, medical care is discouraged. Just look at Medicaid in Oregon where Assisted Suicide is legal, patients have been denied treatment, but offered to have lethal doses for suicide paid for. Because the harm to vulnerable populations vastly outweighs the benefit to a handful of individuals, who have other options, we should decline this social experiment to legalize Assisted Suicide.

    1. You are right, physician assisted suicide as it currently exists in several states would not help me, but it is only a first step toward help in dying for whoever needs it. Your husband, apparently, had choices that many of us do not. My mother, at 89 and in severe pain for two years, tried to take her own life with the medications she had, which put her in a coma; ignoring her DNR order she was kept alive by EMS until, finally, after a battle with the hospital where she was taken, NY state law insisted her DNR request be granted and she was taken off life support. We will never know, of course, if she suffered as we fought to have her DNR honored. But it wouldn’t be hard to imagine how she suffered as, all alone, she had to swallow and keep down pills, and, in this condition, try to get a plastic bag over her head. Of course she couldn’t do this by herself….. is this the “old-fashioned way” to which you refer? I have read enough about this subject to know that attempted suicides very often fail, not everyone has the option of just refusing treatment, which is not to take away from everything your husband went through. However, don’t conflate your husband’s circumstances with everyone else who is suffering; often “nature taking its course” only means more intense, torturing, tormenting, unrelenting pain for years on end, with no end/hope in sight.

      You disagree with my viewpoint, but can you possibly think I’m so ignorant I wouldn’t have known to get a “second opinion”? I have probably had more than 20 opinions, I’m in the so-called medical mecca of Boston. I’ve spent thousands of dollars more that I’d want to calculate, and at the expense of my family who would have had a better life, as I had to stop working years ago. Now my husband faces a bleak retirement and I am no help to my daughter and her children – the best I can do is try not to complain, eh? But I certainly can’t help her with her children and no, I have no options, except of course to refuse food and water, which is what I probably will have to do. Thanks to people like you, I am forced to turn to that, which I have read can be a horrific way to die, unless you are already close to death. Perhaps you would have some compassion if you truly understood that you cannot possibly know other peoples’ circumstances, their pain, their feelings, their wishes: why would you “trust that in those 22 years [I] have had some good moments and…important accomplishments?” Since you clearly don’t know anything about this kind of pain, just try to imagine being assaulted and tortured – do you think there would be any “good moments” during that? Luckily, I raised my child before this pain attacked me, I never could have been any real mother while being tormented. What would I have “thrown away” other than years of unrelenting pain? To have wanted that one would have to be a masochist; I was just (stupidly) optimistic enough to think that if I tried hard enough, I’d find an answer and get better; I was so wrong, and so wish I had avoided all these very long, very wasted years of nothing but agonizing pain. So “going forward” can only mean I am somehow able to get and do what I need to leave this world alone, so that no one else is involved, and make sure that I can succeed, not end up brain-dead in an institution using up our life savings – that is the most worrying, that I could, without a doctor’s help, be unable to avoid a situation in which the rest of my husband’s life will be financially wrecked if I don’t succeed. He has been an incredible rock, and doesn’t deserve to have the rest of his life ruined as well as what he’s already lost. There are so many people in my situation: is this what you want for us?

      Where are you getting your information about state sanctioned suicide ? Please provide real evidence that the government is going to determine who is eligible to die – are you referring to Sarah Palin’s lies about “death panels?” There is not a shred of evidence that anyone has been or will be encouraged to end their life in Oregon, nor the Netherlands and Switzerland where all health care is paid for. (Sadly, medicaid is often denied having nothing to do with suicide options.) You write “Lastly, when Assisted Suicide is a treatment option, medical care is discouraged.” On the contrary, many people complain that their elderly parents were convinced to undergo risky surgeries and medications that were at best pointless, and very often caused agony and harm.

      Having a conversation with a doctor about what one does or does not want done to prolong life – just how is that being encouraged to commit suicide? If I were a health care provider, that would be what I needed to know; and if I were a patient who wanted to do everything to prolong my life, that is the conversation I’d welcome having with my doctor, rather than having him/her guess, or decide for me – is that what *you* want?

      My own experience, not only with my mother but with my very sick friends and relatives, is that suicide is not mentioned as an option, while being told to “just live with it” is.
      I don’t know what your experience with doctors has been, but it sounds as if it has been quite negative, if you fear they will be talking people into committing suicide; I have yet to meet this kind of doctor. If you are referring to family members pushing suicide on their elderly relatives, you are ignoring the rules and regulations set up to avoid this, and if you are concerned that those procedures could, somehow, be broken in instances, you might as well decide that we should forget about all laws because there is always – always! – the possibility of circumvention, yet I truly doubt that you are opposed to doing our best, in every situation, to regulate whatever we possibly can to avoid abuse.

      If you feel elder abuse is rampant, that is what you should be working to prevent, not trying to prolong peoples’ suffering; the issue here is only that of letting a doctor help a patient die as they wish, mercifully, in a peaceful, caring way; preventing this is cruel and suggests an utter lack of knowledge and/or compassion. Last year people like you prevented Massachusetts from passing a progressive law enabling help for people suffering at the end of their lives, and now you want to do this in NH.
      I don’t know how you sleep at night. Until you inform and enlighten yourself, you will be promoting suffering, and as I go through every day and night in agony, I’ll be having people like you to thank for doing everything possible to make sure we never have the right to help in getting out of pain.

  2. Asking a physician to violate his oath is just wrong. I watched my mother struggle with pain for years. Some days were better than others. It never diminished her as our mother. She never once asked to die, but for the pain to end. She never stopped searching for pain relief. She passed away after an episode that left her brain dead. We never asked the doctor to help her die. The hospital provided a quiet, peaceful room for her and the family so that she could die with peace and dignity. No machines, no extraordinary measures. Her final minutes were spent with my Dad and their priest beside her. A priest who was suffering himself with Lou Gehrig’s disease and would pass away just a few months later. It was their example I relied upon when having to sit at my friend’s bedside just two months ago, and had to call in the nurse to let the staff know that my friend was prepared to go. The palliative care she received in her final days was a blessing to all of us and allowed her to die with great peace and dignity. The machines were turned off and she left us gracefully, knowing that the family and friends surrounding her would never forget and would continue to carry on her life’s mission and love of life itself. We never asked for a doctor to actively kill her, just to step back and keep her comfortable. Why would you place a burden on any medical professional when we have palliative and hospice care available? That is a burden that none should carry.

    1. As I’m sure you know, there are many physicians who do not consider it a violation of their oath to help someone leave this world, but they do not want to be prosecuted for it. It should not be a burden to help someone out of pain, but for those who do not wish to aid someone in this way, they can certainly choose not to – no one has ever proposed that laws be written so that doctors are *forced* to aid their patients end their lives. I am sure you are well aware of this.

      And I’m also sure you’re aware that every day doctors have the burden of making decisions that can change, even end, a person’s life. At least in the case of assisted suicide, the patient is making the decision, as opposed to all those situations where the doctor has the burden of making a decision about, for example, prescribing a medication or treatment that has the potential for immediate or long term harm to the patient – is this too much of a burden also? If so, this person chose the wrong profession, because it is part of the job; I am not questioning how difficult it must be, but it is one of the many burdens every doctor faces every day.

  3. I am really curious to know how you can justify being opposed to physician assisted suicide. It’s hard for me to believe that you would like those of us who are in unrelenting 24/7 pain to take our own lives without any help; how would you suggest we do it: by jumping in front of a train, drowning ourselves, drinking detergents?
    Is this how you want people to (try to) die? Or do you feel that everyone in pain deserves to be that way? Do you think you would want to live in pain every minute of every day? Do you have no empathy for other human beings?

    It is now impossible to get the drugs (barbiturates) needed to commit suicide. And is this your idea of how people should leave – worried that they may end up in a coma? And they’d better be alone when they attempt to end their misery, or the person helping them may end up in jail.

    Are you so ignorant you believe there is medication for every kind of pain?
    Would you like your loved ones to be in tormenting pain every minute of every day?

    I’ve been in pain for 22 years, I have no life and have derailed my [wonderful] husband’s life as well. (Luckily, my child is an independent adult.) It is incomprehensible to me that anyone other than a sadist would believe people should suffer like this. I doubt you are a sadist, but I do want to know how you
    can possibly be working toward defeating measures that would help people get out of pain.

    Please explain why you think anyone should live in pain unless this is how they want to live: being tortured. Perhaps you want to rethink whether you really want to prolong other people’s misery.

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