A Deadly Campaign Masked as a Personal Decision

Imagine that you are standing in line at your supermarket pharmacy. As you wait to pick up your prescription, the pharmacist hands the person ahead of you a bottle filled with capsules. The prescription bottle contains a strong barbiturate sometimes used to temporarily treat insomnia or to calm a person for surgery. But this bottle doesn't contain the usual instructions to take one capsule. Instead it directs that person to take the entire bottle of capsules, all at the same time.

Then, you overhear the pharmacist explaining, "Open each of these capsules. Put the powder from them into a glass, Then, mix it all into a sweet beverage and drink it very quickly to cause death." 

Unimaginable?  No. That type of prescription has been available in Oregon since 1997.

In early October, Brittany Maynard, a beautiful 29-year-old with terminal brain cancer, announced plans to end her life by taking a massive, lethal dose of drugs prescribed by an Oregon physician. She selected November 1 as the day she would die, although, she said, that could change.

If she does carry out her plan, she will become one of the more than 40,000 people who commit suicide each year in the United States. 

However, unlike the others, she has reached national and international celebrity status, starting with an October cover story in People magazine. This explosion of coverage was due to a public campaign facilitated by Compassion & Choices (the former Hemlock Society) to legalize Oregon-style doctor-prescribed suicide in every state. 

The organization has established the Brittany Maynard Fund to raise money for political campaigns to legalize doctor-prescribed suicide in targeted states across the country. And, to strengthen the resolve of the young woman for whom the campaign is named, Compassion & Choices has posted "Britanny's Card" on its website. "Let's get 1 million people to sign Britanny's card," states the message, adding, "Sign the card and let Brittany know you support her bravery in this very tough time."

But sending a message comes with a catch. In a startling note of hucksterism, the site states that "By signing Brittany's Card, you agree to receive periodic communication from Compassion & Choices."   

Assisted-suicide advocates have come out swinging against those who voice concern over Maynard's tragic story, claiming that hers is a personal decision that should be respected. But they fail to acknowledge that all the media coverage is really not about a personal choice.  Instead, it's about the orchestrated public campaign aimed at changing laws that would personally affect everyone. And so this does raise concern and call for discussion.

The campaign uses assisted-suicide advocates' poll-driven language to claim that her death will not be a suicide, but will be "death with dignity". That’s a perfect example of using verbal engineering to accomplish social engineering. Another part of the campaign claims that Oregon’s "death with dignity" law works well, is abuse free, and contains rigorous patient safeguards. 

Yet the facts tell a different story. 

Laws such as Oregon's, give health-insurance companies a surefire way to lower health care costs:  tell the patient you'll pay for drugs that will end her life, but not those which would extend her life.  That's what happened to some Oregonians who had health insurance. 

One of those people was Barbara Wagner, a 64-year-old retired school bus driver. When her doctor diagnosed her with cancer, she was hopeful when he gave her a prescription for a drug that would likely slow the cancer's growth and make her more comfortable. However it didn't take long for her hopes to be dashed. Shortly thereafter she was notified by letter that her insurance wouldn't cover her life-extending prescription but that it would cover assisted suicide.  

Certainly, spending a few hundred dollars for deadly drugs is the least expensive treatment for cancer.

As the cofounder of the Hemlock Society has written, "In the final analysis, economics, not the quest for broadened individual liberties or increased autonomy, will drive assisted suicide to the plateau of acceptable practice."

Then there's the claim that Oregon's law has careful safeguards to protect patients, including the requirement that a patient must knowingly and willingly request the drugs. However, once the lethal prescription is provided, there are no safeguards. There's no requirement that the patient knowingly and willingly takes the deadly overdose. There's no way to know if the patient was tricked or forced into taking them.

Nonetheless, assisted-suicide activists say the state’s annual reports -- based on information from doctors who prescribed the fatal drugs -- show that there have been no problems with the law.  This, too, is a claim, not evidence. 

According to the American Medical News, Oregon officials in charge of issuing the annual reports have acknowledged that "there's no way to know if additional deaths went unreported." Indeed, the official summary accompanying one annual report noted that there is no way to know if information provided by the prescribing physicians was accurate or complete.  

Without doubt, there is much to consider before jumping on the Compassion and Choices public-relations bandwagon.

What if you found out your elderly mother's doctor prescribed assisted-suicide drugs for her, even though she didn't have serious physical symptoms but wanted to die because she was worried about being a burden on you? Oregon's official reports indicate that fear of being burden is a major reason many people give for wanting assisted suicide, while few people reportedly request the lethal drugs because of pain or fear of pain.

What if your daughter who had cancer and a history of mental illness was given a prescription for assisted suicide after a psychiatrist evaluated her mental status by a brief telephone conversation? In Oregon, a "psychiatric evaluation" by phone was considered sufficient in at least one of the very few cases where an evaluation was even reported. 

Or, what if your son's long-time doctor refused to prescribe assisted suicide for him, but an assisted-suicide advocacy group referred him to a doctor he had never seen before, and that doctor prescribed the lethal drugs? In Oregon, most assisted-suicide deaths are facilitated by Compassion and Choices or its affinity groups.

When all is said and done, the debate is not about Brittany Maynard and how she will die. It is about whether the laws will be changed to affect how you and your loved ones could be pressured into taking a deadly overdose under the label "death with dignity."

Rita L. Marker is an attorney and executive director or the Patients Rights Council.

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