Ed. Although I support the right of people to make this choice, I oppose Washington State’s assisted suicide law because of the way it was written. I suspect the cost far exceeds any benefit and worry that this is a slippery slope toward the state over riding medical ethics I treasure. There are better ways, less expensive and more compassionate, of achieving the end of life.
This is a progress report from the group supporting the law.
WASHINGTON STATE ISSUES SECOND ANNUAL REPORT FOR ASSISTED SUICIDE ACT
In its recent Assisted Suicide report, the Department of Health reported that 87 people received lethal doses of medications under the Act and 71 individuals died. 51 people reportedly died after ingesting the lethal dose and 15 died from other causes. The Department of Health does not know if the remaining 6 people died of assisted suicide or not. The Department of Health also has no idea about the status for the 15 remaining people who requested lethal medications—whether they are alive or dead, whether they died from natural causes or from assisted suicide.
There seems to be at least some problem with the accuracy of the reporting (and the timeliness of required documentation) if 15 people out of 87 cannot be accounted for. Of even greater concern is what the numbers don’t, and can’t, reveal. True Compassion Advocates’ President Eileen Geller noted, “The published data from the 2010 report is so limited and unreliable that even some who agree with the policy have qualms regarding the DOH’s inability to determine whether the law operates with the full safety and voluntariness its proponents promised.”
Geller continued, “Washington voters thought they were getting a law to assure choice—what they’ve received is something entirely different, a law which has in some instances has become a recipe for elder abuse and a vehicle for financial coercion.”
Safety and Abuse Risks
According to Ms. Geller, “Over the last year, our office has received many reports from health care professionals, family members, and friends concerned about safety of loved ones at risk for or requesting assisted suicide. Calls from worried and overwhelmed family members have increased in the aftermath of state and federal budget cuts for elder, caregiver, and disability support.”
Examples Geller cited include, among others:
• A concerned nephew worried his uncle’s untreated depression and lack of adequate funding for care led to his request for doctor prescribed suicide under the DWDA,
• A seriously ill paralyzed woman who was discharged prematurely from a Seattle-area hospital and worried about being a burden to her family. The woman did not have financial resources for adequate care—she requested doctor prescribed death via the DWDA because she felt she did not have any other real choices,
• An elderly gentleman whose young wife (and financial heir) hosted a suicide party after encouraging him to die via doctor prescribed suicide, despite the objections of other family members who wanted to care for him,
• A depressed man with no health insurance requested DWDA because of financial worries and pressure from family members.
Data is Limited, Incomplete, and Incorrect
Geller notes that the Department of Health did not ask about potential cases of abuse and did not tell about the safety risks associated with this law.
The report, for instance, relies on a very few forms to collect the data—and these forms are supposed to include information about the circumstances when the lethal dose was ingested, and how long it took for the person to die. The data for that section of the report comes from an “After Death Reporting Form,” which is completed by the prescribing physician. But according to the report, the prescribing physician is rarely present when the lethal dose is ingested (only 4% of the time, to be precise). One wonders how he or she might give an accurate account of a death via lethal ingestion if he or she wasn’t in fact present at the time of death.
The report purports to describe “concerns” of the people who died under the act, which led to their requesting the lethal dose. The data for these concerns comes from a “check-the-box” question on the “After Death Reporting Form,” a form which gives the prescribing doctor seven choices. The limited options on this menu do not include virtually any options that might express ambivalence about assisted suicide or might indicate pressure from relatives—a phenomenon known to occur in elder abuse.
The report, which doesn’t even address whether the administration of the lethal dose was voluntary, has significant gaps. Instead, Washington’s 2010 report on doctor-prescribed death focuses on the “ingestion” of the lethal dose. “Ingestion” as described in the report does not require a patient’s consent, competency, or even awareness.
“What the numbers in the report don’t show is what really needs reporting,” said Geller. “Assisted suicide in Washington is neither safe nor voluntary for those who feel coerced, can’t afford proper health care, or are victims of unreported elder abuse.”