International Task Force Update on & Assisted Year 2009 Vol. 23, No. 3

More charges filed against Washington State: First deaths Network under new assisted-suicide law revealed

ew charges have been filed in Arizona ince Washington‟s “Death with Dignity Act” took effect on March 5, N against the (FEN), S 2009, there have been two known assisted-suicide deaths. a national network of volunteers who The announcements of the deaths came from the assisted-suicide advo- around the country to assist the of cacy group Compassion & Choices (C&C), formerly the . its members. Earlier this year, four FEN sui- C&C was the main force behind the passage last year of the assisted-suicide cide facilitators were arrested in Georgia in ballot measure, Initiative 1000, and considers itself the “steward” of the new connection with the death of a non- law—the same role it has assumed in Oregon in regards to that state‟s as- terminally ill man and charged with felony sisted-suicide law. C&C readily admits that, in 2008 alone, it facilitated assisted-suicide, tampering with evidence, 88% of Oregon‟s assisted suicides. [Oregonian, 3/4/09] and violating the Georgia RICO Act. (For more on this case, see Update, 2009, no. 2.) According to C&C‟s press release, Washington‟s first death was that of Linda Fleming, 66. She had been diagnosed with stage IV pancreatic cancer The new Arizona indictments center on only a month before her induced death, and the “disease progressed rapidly the (by helium asphyxiation) and her pain worsened.” She said that pain medications were “making it dif- of Jana Van Voorhis, 58, in April 2007. Van ficult to maintain the state of mind I wanted to have at my death.” Fleming Voorhis had a long history of mental illness died on May 21, 2009, after ingesting the lethal drug overdose her doctor dating back to her high school days when she prescribed. Present at the time were her daughter, her dog, her doctor, and a was admitted to a psychiatric hospital. The C&C Client Support volunteer. [C&C of WA, Press Release, 5/22/09] year before she died, her psychiatrist, Dr. Michael Fermo, wrote in her medical record C&C of Washington‟s executive director, Robb Miller, called Fleming‟s that Van Voorhis was “increasingly becom- assisted death “a form of comfort care.” [Peninsula Daily News, 5/24/09] ing psychotic, claiming the roof rats have When asked if he knew that Fleming—who was divorced—had had finan- been overtaking her home, sneaking into her cial problems, that she had been unable to work due to a disability, and house and attacking her.” According to her was forced to declare bankruptcy in 2007, Miller said he was unaware of sister, Viki Thomas, any physical ailments all that, but that her case presented “none of the red flags” that would Van Voorhis had were more imaginary than cause C&C to reconsider supporting her suicide request. [New York Times, real. “She called her doctors constantly with 5/23/09] lists of aches and pains,” Thomas said. One The second known assisted-suicide death was also announced by C&C doctor even “fired” her as his patient and of Washington, but, this time, the person was not identified. The group wrote in his notes that she “believes she has told Associated Press that the family wished to remain anonymous, and no holes in her belly, feet, and liver.” [Phoenix further details would be released. [AP, 6/3/09] New Times, 8/23/07] C&C often issues press releases as a tactic to make the public and health But, the two FEN volunteer “exit guides” care professionals more comfortable with assisted-suicide practice and to charged with facilitating Van Voorhis‟ (continued on page 3) death were not troubled by her state of mind. Senior exit guide Wye Hale-Rowe, from Colorado, told a reporter shortly after Also in this Update: the suicide that she didn‟t think Van Voorhis was seriously mentally ill. “Jana was in the  Overview: Attempts to legalize euthanasia/PAS in U.S...... 2 throes of what we call existential suffering,”  ITF submits brief in Montana Supreme Court appeal ...... 3 she explained. “Even though their physical  Assisted-suicide debate rages in the U.K...... 4 pain may be managed, just being alive is a burden.” The other exit guide indicted for  Petition to close Dignitas after healthy man dies ...... 4 Van Voorhis‟ death is Frank Langsner from  News briefs from home & aboard ...... 5 (continued on page 2) Update Year 2009—Vol. 23, No. 3 Page 2 Overview: Attempts to legalize euthanasia/assisted suicide in the U.S. hen Oregon became the first state in the U.S. to But, since Oregon legalized PAS in 1994, other states W legalize physician-assisted suicide (PAS), advocates have rejected assisted-suicide measures, many multiple predicted that there would be a rapid “domino effect,” and times. In fact, between January 1994 and June 2009, there other states would soon follow Oregon‟s lead. But that were 113 legislative proposals to legalize assisted suicide didn‟t happen. introduced in 24 states. All were either defeated, tabled for the session, or languished with no action taken. It took 14 years before another state legalized the practice, and, even then, only after advocates spent more Moreover, of the six ballot initiatives to legalize assisted than a year preparing for the campaign and eventually suicide and/or euthanasia—Washington State (1991), raising almost five million dollars to insure the victory they California (1992), Oregon (1994), Michigan (1998), Maine so desperately wanted. Paid consultants determined that (2000), and Washington State (2008)—only the Oregon Washington State offered assisted-suicide advocates the best initiative and the 2008 Washington initiative passed. chance of success. It was demographically most like Oregon For a complete listing, by state, of all the U.S. ballot and, therefore, most likely to favor assisted suicide. Their initiatives and legislative measures, see: prediction proved correct. http://www.internationaltaskforce.org/usa.htm ■

More charges filed against Final Exit Network, continued from page 1 Scottsdale, Arizona. Apparently, he manslaughter. Massey and medical voice it for them.” [Quotes from AP, believed Van Voorhis when she director Egbert face only the conspir- 4/22/09] claimed to have serious physical con- acy charge. Langsner made a somewhat similar ditions. He told police in 2007 that her According to Maricopa County At- comment after Voorhis‟ death. He told “illnesses” included a lesion on her torney Andrew Thomas, when the two police that to help people end their liver, possible breast cancer, and other exit guides arrived the night of Van lives successfully, “You help get them serious problems. [Phoenix New Voorhis‟ death, “they made sure to in a frame of mind that they want to do Times, 8/23/07] park their vehicle in the garage and not it.” [Phoenix New Times, 8/23/07] The two other FEN officials indicted on the street” to avoid detection. Then, After obtaining data from FEN‟s in the case are regional coordinator after she was dead, they “arranged the computers, the FBI, the Georgia Bu- Roberta Massey and FEN medical di- victim in a sleeping position” and put reau of Investigation, and local police rector Dr. Lawrence Egbert, who is the equipment used to kill her (helium departments are also investigating pos- also charged in the Georgia case. Eg- tanks, exit bag, tubing, and valve) in sible FEN deaths in Connecticut, Ohio, bert has approved all of the estimated three trash bags that they dropped in and other states. [AP, 5/29/09; Hart- 200 FEN suicide deaths since the group three different, “pre-selected office ford Courant, 5/30/09; Columbus Dis- formed in 2004. In the Van Voorhis trash sites in the area.” [Press Release, patch, 6/15/09] case, Egbert approved her suicide assis- Maricopa County Attorney, 5/14/09] tance request after speaking with her on According to Derek Humphry, co- the phone, not in person. [Phoenix New It was a procedure straight out of founder of the Hemlock Society and Times, 8/23/07, 2/25/09] FEN‟s step-by-step exit guide training chairman of FEN‟s advisory board, manual. The manual—confiscated by defense lawyers will argue that FEN Commenting on the Van Voorhis Arizona police during their investiga- volunteers merely provided case, FEN‟s president, Jerry Dincin, tion—also tells would-be guides that “information and moral support,” and said, “We didn‟t even know she had a they are “special” people, and they that their activities are protected by the mental illness. She gave us the medical should “keep a sense of celebration” First Amendment‟s free speech clause. records that indicated that she had se- about the deaths they help bring about. [Humphry, Assisted Suicide Blog, vere enough problems that she didn‟t The manual suggests that, after the 6/14/09] But ITF Associate Director want to live anymore, and our medical suicidal member is dead, the two exit Wesley J. Smith disagrees. “The alle- director agreed.” Dincin, a retired psy- guides assigned to the case should “go gations are that these defendants did chologist, added that those medical to a to quietly celebrate.” more, such as hold down the hands of records indicated that she had a physi- Exit guides, the manual states, are the person dying and clean up the cal illness, but did not disclose what it “attracted” to FEN‟s suicide service scene to cover up the induced death,” was. [Arizona Republic, 5/15/09] “because of a compassionate interest.” he explained. “If either—or both—of FEN exit guides Langsner and Hale- “Sometimes that means to „hear‟ a des- the allegations are true, then the FEN Rowe have been indicted for man- peration that the member does not defendants went way beyond mere slaughter and conspiracy to commit know how to communicate and softly speech into the realm of action.” ■ Update Year 2009—Vol. 23, No. 3 Page 3 ITF submits “friend of the court” brief in Montana Supreme Court appeal he Montana Supreme Court will ITF, specialist unreported” because the Oregon T hear an appeal later this year on Herbert Hendin, M.D., and Department of Human Services “has the decision handed down by District constitutional law expert Professor no regulatory authority or resources Court Judge Dorothy McCarter that Yale Kamisar. The brief addresses to ensure compliance with the single-handedly legalized physician- claims McCarter made in her ruling law.” [p. 6] assisted suicide (PAS). Her December that PAS practice in Oregon is  Oregon Department of Human 5, 2008, ruling took effect immediately, working well, abuse free, and has Services admits that “approximately putting patients at risk. When the state improved the quality of health care in one year from publication of the attorney general‟s office appealed the Oregon. Here are some excerpts: Annual Report, all source decision, McCarter refused to stay her documentation is destroyed.”  The District Court mistakenly ruling until after the state‟s highest Therefore, even if investigations were declared that “abuses can be provided for under the law, there court ruled on the matter. The result is controlled by state law,” citing the that PAS is currently legal in would be no way to check on “numerous requirements to avoid information that had been submitted Montana—at least until the supreme such potential abuses” in Oregon‟s after one year had elapsed. [p. 11] court rules otherwise. law. Oregon‟s “laboratory” results are  When assisted suicide is a legally- The case, Baxter v. Montana, was inconclusive, at best, since what takes place in that laboratory is shrouded in accepted, inexpensive medical spearheaded by Compassion & Choices treatment, the force of economic (C&C) and challenged Montana‟s law secrecy, precluding the possibility of knowing whether there are individuals gravity can lead to increased pressure banning assisted suicide. McCarter whose lives have ended mistakenly or on patients to request, and doctors to sided with C&C, finding that the law under pressure. [ITF Brief, p. 4] prescribe, assisted suicide. [p. 16] violated the rights to privacy and  Among the claims made by those who  Oregon‟s annual official reports dignity guaranteed in the Montana support Oregon‟s law is that a high convey the notion that assisted Constitution. (For more on this case, percentage of patients are in hospice suicide in the state has not resulted in see Update, 2009, no. 1.) care and that pain control has been any problems or abuses. However, enhanced… Since Oregon‟s law went The ITF has submitted an amicus information in those reports is into effect, effective pain curiae (friend of the court) brief to the questionable at best since it is based management has actually decreased Montana Supreme Court in support of on self-reports by the same doctors due, at least in part, to understaffing overturning McCarter‟s ruling. The who carry out assisted suicide… and underfunding for effective brief—submitted by attorneys Rita Furthermore, Oregon officials in symptom management. [pp. 9-10] Marker, ITF‟s executive director, and charge of formulating annual reports Nickolas Murnion, a Montana have conceded “there‟s no way to The complete brief is available at lawyer—was written on behalf of the know if additional deaths went www.internationaltaskforce.org. ■

Washington State: First deaths under new assisted-suicide law revealed, continued from page 1 encourage more doctors to write lethal drug prescriptions. In tions for life-ending drugs have been written for 14 death- Washington, most physicians and health-care facilities have requesting patients, after their attending physicians and con- refused to participate in assisted suicide due to ethical and sulting physicians deemed them qualified for assisted sui- other reasons. [AP, 3/2/09; Yakima Herald-Republic, 3/3/09] cide. The drugs have been dispensed to 13 of the patients. Washington State‟s Department of Health (DOH), the While five “after death” report forms have been submit- agency responsible for compiling annual assisted-suicide ted, there is no way to know whether those deaths were all reports, maintains a count on its web site of the number of assisted suicides, since the form is also used to report the official reporting forms it has received relative to the various natural deaths of patients who had received lethal drugs, but steps involved in the assisted-suicide process. [DOH web opted not to take them. site: www.doh.wa.gov/dwda/formsreceived.htm] In addition, the DOH reports that it has received two “Psychiatric/Psychological Consultant‟s Compliance” forms, As of June 22, 2009, 14 patients have submitted forms which means that two patients were referred for a psycho- requesting assisted suicide. In addition, the DOH has re- logical consultation before receiving their lethal prescription. ceived 14 “Attending Physician‟s Compliance” forms, 14 “Consulting Physician‟s Compliance” forms, 13 “Pharmacy The DOH is barred by the new law from revealing the Dispensing Record” forms, and five “Attending Physician's names of patients, doctors, pharmacists, and other health after Death Reporting‟ forms. In other words, 14 prescrip- care workers involved in assisted-suicide deaths. ■ Update Year 2009—Vol. 23, No. 3 Page 4 Assisted suicide debate rages is the United Kingdom he U.K. is currently embroiled in Coroners & Justice Bill But Dr. Peter Saunders, the head of heated debate over assisted the Alliance, accused T Some high-profile parliament suicide—a debate fueled by assisted- Lord Falconer of hijacking the members want to change the law to suicide proponents who use the media to Coroners & Justice Bill. “Lord remove any threat of prosecution for personalize the issue with compelling Falconer‟s amendment is a recipe for those who accompany loved ones “hard cases.” The goal is to pressure the abuse and exploitation of abroad to die in countries where parliament to define and change the vulnerable people,” he warned. “It is assisted suicide is legal. They are existing law prohibiting assisted suicide. dangerously naïve to suppose that attempting to add an amendment to people who are helped to commit The British House of Lords is an already proposed amendment to the suicide are always „loved currently considering two assisted- Suicide Act. The Coroners & Justice ones.‟” [Daily Mail, 6/3/09, 6/6/09] suicide proposals. Both deal with Bill Amendment was originally clarifications of and/or amendments to crafted to put a stop to web sites that Dignitas Britain‟s Suicide Act of 1961, which encourage vulnerable people to According to British pro-assisted prohibits aiding, abetting, and procuring commit suicide. Now Lord Charlie suicide group , another‟s suicide. Violators could face up Falconer, the former lord chancellor decriminalization of suicide is to 14 years in prison. and justice secretary, has authored an needed because Dignitas has already Debbie Purdy case additional provision that would assisted the suicides of 113 British exonerate those who accompany an ill citizens. (Another two deaths were The first issue before the House of person to other jurisdictions to die if facilitated by EX International, a new Lords is a petition by 46-year-old two “medical practitioners” have Swiss suicide group.) Almost 800 multiple sclerosis patient Debbie Purdy, certified that the person is terminally Britons are members of Dignitas a member of the Swiss assisted-suicide ill and has the mental capacity to (indicating an intent to end their lives group Dignitas. Purdy wants firm choose to die. In addition, the person sometime in the future). Thirty-four assurance that her husband will not be must have made a written declaration are already approved by Dignitas for prosecuted if he accompanies her to that he or she wants to die, and that an imminent death. [Dignity in Dying, Dignitas to die. She was unsuccessful in declaration must be witnessed by an “Report: A law out of step,” 6/1/09] previous attempts before Britain‟s High “independent witness” who is Dignitas‟ records reveal that some of Court and Court of Appeal. The courts “unlikely to benefit in any way from those who died had non-terminal ruled that only parliament could give the death.” [Falconer, “A More conditions such as Crohn‟s disease, her the assurance she wants since the civilized approach to suicide,” London rheumatoid arthritis, and paralysis. existing law would have to be changed. Times, 6/3/09] [Guardian, 6/21/09] ■ Purdy, a very charismatic woman and well liked by the public and the media, Petition to close Dignitas after healthy man dies presented her case before a five-member House of Lord‟s panel on June 2, 2009. ore than 17,000 Swiss protesters have signed petitions to close down Her lawyer, Lord David Pannick, argued M Dignitas and tighten Switzerland‟s assisted-suicide law. Organizers hope that unless Purdy knows that her that putting Dignitas out of business will also put an end to the country‟s husband will not be prosecuted, she will reputation for being the capitol of the world. Authorities in be forced to go to Switzerland alone Zurich are backing the call for the federal government to change the law, but while she still has the capacity to travel. neither the Zurich officials nor the protesters want assisted suicide to be made That would force her to die sooner than illegal. Instead, they want the practice available to only those who have lived in she would want. [London Times, 6/2/09; the country for one year. [Austrian Times, 5/27/09] But the Federal Cabinet is Telegraph, 6/2/09; Reuters, 6/2/09] divided on the issue and has called for the public to submit comments on the matter. The government is deliberating two options: a stricter assisted-suicide law ITF Associate Director Wesley J. Smith called the lawyer‟s argument or an outright ban on suicide clinics. [World Radio Switzerland, 6/18/09] “nonsense.” “Nobody is forcing Purdy to The controversy over Dignitas escalated after the March 14, 2009, death of fly to Switzerland to kill herself,” he said. Andrei Haber, 62, a physically healthy Swiss man who was severely depressed “That she might wish to do it someday over a series of failed relationships and an unpleasant divorce. When shocked does not make it a „necessity.‟ Indeed, relatives and friends complained to authorities, Judge Philippe Barboni accede to this sophistic argument and the investigated the case and determined that Dignitas committed no crime, since whole potential for suicide prevention Swiss law allows assisted suicide as long as it is done without selfish motives. flies out the window.” [National Post, 5/16/09] ■ Update Year 2009—Vol. 23, No. 3 Page 5

News briefs from home & abroad . . .

 If Canadian MP Francine Lalonde gets her way, both posing.” The final version of her bill, “The End of Life euthanasia and assisted suicide will be legal in Canada. Choices (Scotland) Bill,” has yet to be drafted. The next Her third attempt to legalize both practices is Bill C-384, step is to consult with parliament officials for help in which would amend the country‟s Criminal Code to al- writing the final draft. The bill would likely then go the low doctors to aid “a person to die with dignity.” To Health Committee later this year. [The Scotsman, qualify for this death service, a person needs to be 18 or 4/24/09; The Herald, 4/25/09] MacDonald, who has older and either terminally ill or, “after trying or ex- Parkinson’s disease, has indicated that her bill will pressly refusing the appropriate treatments available,” have three categories of patients who would be eligi- continues “to experience severe physical or mental pain ble for assisted suicide: (1) those who are terminally without any prospect of relief.” Regarding mental ca- ill; (2) those with progressive or degenerative condi- pacity, the person isn‟t required to be competent, only tions, such as Parkinson‟s disease; and (3) those who to “appear to be lucid” at the time he or she requests are totally dependent on others as a result of trauma death. [Bill C-384, § 222 (7)] from crashes or sports injuries. [The Scotsman 3/25/09; BBC, 3/25/09] The wording of the bill leaves qualification for the kill- ing option wide open. The person need not even be  In May, Tasmania Parliament Member Nick McKim physically ill. Mental illness will suffice. Even if there introduced his “Dying with Dignity Bill 2009,” a measure are appropriate, effective treatments available that the to legalize assisted suicide. At the time, he was ex- person has refused, the individual is still eligible for an tremely optimistic that the bill would easily pass the induced death. And there is no definition of “terminally House of Assembly. “The Upper House,” he said, “will ill.” It could be interpreted to mean a projected life ex- be a little bit more difficult.” But, in June, it became pectancy of six months, a year, five years, or longer— apparent that his bill wouldn‟t have the clear sailing he or, as defined it, having “any disease that had hoped. Instead, it will be referred to a select com- curtails life for even a day.” [Kevorkian, speech to Na- mittee for study. “What I am worried about is this tional Press Club, USA Today, 10/28/92] committee giving weak-minded Lower House mem- When Lalonde officially introduced her bill on May 13, bers an excuse to vote against my bill,” he told report- 2009, she told the House of Commons, “The time has ers, “and I am also worried it will not report in any come for this Parliament to find a way to decriminalize timely way.” [ABC, 5/26/09; The Mercury, 6/8/09] A medical assistance in dying, which is of such vital im- poll of state politicians, conducted by the Sunday Ex- portance to those whose suffering can no longer be re- aminer newspaper, found that McKim‟s bill would lieved except by this ultimate compassion.” Her state- likely be defeated by a slim margin. [Sunday Exam- ment prompted one Canadian commentator to write, iner, 5/31/09] “But when you read the small print, her bill includes depressed 18-year-olds who refuse „appropriate treat-  Amelie Van Esbeen, a 93-year-old Belgian woman, ments‟ like say, refusing to take their Prozac. So killing was not ill, but wanted to die. Her doctors in Belgium off depressed teens who refuse their meds is now refused her request for euthanasia because she wasn‟t „ultimate compassion.‟ The euphemism is nauseat- qualified under the country‟s 2002 euthanasia law that ing.” [Licia Corbella, “Legalized euthanasia leads to no requires the patient to be suffering from a “serious ter- choice, ever,” Calgary Herald, 5/16/09] minal illness” or “constant and unbearable pain that cannot be relieved.” So the woman went on a hunger  Independent Scottish Parliament Member Margo Mac- strike. After 10 days of not eating, Van Esbeen again Donald has gotten the required number of her peers to requested euthanasia. This time a different doctor back her proposed assisted-suicide bill. She needed 18, granted her written request and helped her die on but managed to get 21 fellow parliament members to March 24, 2009. Apparently, being on a hunger strike sign on. “I‟m not claiming everyone who signed it qualifies as a terminal condition. Her death has added agrees with me because the whole purpose of having to the controversy in Belgium over euthanasia and as- the bill is to take one step at a time—getting the bill, sisted suicide (both legal) for minors, people with de- having it investigated, analysed and decided on,” she mentia, and those not terminally ill. A recent survey told the press. “That‟s quite a long process and it found that 76 children had been euthanized in the past should be because it‟s a very serious new law I‟m pro- (continued on page 6) Update Year 2009—Vol. 23, No. 3 Page 6

News briefs from home & abroad, continued from page 5

two years—22 of them were babies.  Australia‟s Dr. Death, Dr. Philip The International Task Force on [Expatica Belgium, 4/4/09] Nitschke, has been on the road proffer- Euthanasia & Assisted Suicide is a human rights group formed in 1987 to ing his latest invention, a do-it-yourself meet the urgent need for individuals and  In the Netherlands, the number of re- kit to test the quality and potency of the organizations who oppose euthanasia to ported euthanasia and assisted-suicide work together to: provide information barbiturate Nembutal. Used primarily on euthanasia and related issues; deaths in 2008 rose by nearly ten per- for putting down animals, Nembutal is promote and defend the right of all cent over the previous year. The 2008 Nitschke‟s drug of choice for human persons to be treated with respect, reported death toll was 2,331 as op- dignity and compassion; resist attitudes, euthanasia. But the drug is banned for programs and policies which threaten posed to 2,120 induced deaths in human use in many countries, includ- the lives of those who are medically vulnerable. 2007. According to Jan Suyver, head ing Australia. So Nitschke tells the eld- of the Dutch committee overseeing The Update is available to the erly and not-so-elderly that the drug is general public; suggested minimum euthanasia practice, there will likely both available and cheap in Mexico. donation is $25.00 [U.S.] a year. Add $3.00 for foreign postage. be a twenty percent rise in reported But not all Mexican vendors are reputa- cases in 2009. “Five months into ble, so his euthanasia test kit is needed Executive Director: Rita Marker, J.D. 2009, the rise in reported cases is dou- Assoc. Director: Wesley J. Smith, J.D. to make sure that people have the real Editor: Kathi Hamlon ble that of last year,” he said. thing and the potency is truly deadly. [Expatica, 5/30/09; German Press “People want reassurance they‟ve not International Task Force Agency, 5/29/09] The Netherlands just bought a bottle of water,” he said. P.O. Box 760 formally legalized euthanasia and as- Steubenville, OH 43952 USA Nitschke launched his kit in the U.K. 1-800-958-5678 sisted suicide in 2001, but had al- and is planning to bring it to the U.S. in www.internationaltaskforce.org lowed both practices to occur since

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