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Testimony on Maine H.B. 948, Regarding Physician-Prescribed Suicide

Written Testimony of Catherine Glenn Foster, M.A., J.D.

On H.B. 948

Submitted to the Joint Committee
on Health and Human Providers

April 9, 2019

Pricey
Chair Gratwick, Chair Hymanson, and Members of the Committee:

My identify is Catherine Glenn Foster and I function President
and CEO of People United for Life (AUL), the oldest and most lively pro-life
non-profit advocacy group. Established in
1971, AUL has devoted almost 50 years to advocating for everyone to be
welcomed in life and protected in regulation. In my follow I focus on
life-related laws, and am testifying as an professional in constitutional regulation
usually and in the constitutionality of end of life-related laws
specifically. I’ve additionally written extensively on the end-of-life difficulty, most
lately in The Human Life Evaluate. I recognize the opportunity to
provide written testimony towards H.B. 948, which might legalize suicide by
medical means in Maine.

I have
completely reviewed H.B. 948, and it’s my opinion that the Act goes towards
the prevailing consensus that states have a duty to protect life, places
already weak individuals at higher danger, and fails to protect the integrity
and ethics of the medical career.

The
Majority of States Affirmatively Prohibit Medical Suicide

Presently, the overwhelming majority of states—a minimum of 39 states—affirmatively prohibit assisted suicide and impose felony penalties on anybody who helps one other individual end his or her life. And since Oregon first legalized the apply in 1996, “about 200 assisted-suicide bills have failed in more than half the states.”[1] In Washington v. Glucksberg, america Supreme Courtroom summed up the consensus of the states: “In almost every State—indeed, in almost every western democracy—it is a crime to assist a suicide. The States’ assisted-suicide bans are not innovations. Rather, they are longstanding expressions of the States’ commitment to the protection and preservation of all human life.”[2]

This longstanding consensus amongst
the overwhelming majority of states is unsurprising when one considers, because the Courtroom
did, that “opposition to and condemnation of suicide—and, subsequently, of
aiding suicide—are consistent and enduring themes of our philosophical,
authorized and cultural heritages.”[3] Certainly, over twenty years in the past, the Courtroom in Glucksberg held there isn’t a elementary
proper to assisted suicide in the U.S. Structure, finding as an alternative that there
exists for the states “an ‘unqualified curiosity within the preservation of human
life[,]’ … in preventing suicide, and in learning, identifying, and treating
its causes.”[4]

Only
by rejecting H.B. 948 can this committee additional Maine’s necessary state
curiosity in preserving human life, in addition to its obligation to protect the lives of
her residents, particularly the lives of probably the most weak individuals in our
society.

Suicide
by Doctor Locations Already Weak Persons at Higher Danger

Additionally it is
essential to protect weak individuals—including the poor, the elderly, and
disabled—from abuse, neglect, and coercion. When considering the danger posed to
these weak individuals, legalizing suicide might be thought-about neither a
“compassionate” nor an applicable answer for many who might endure melancholy
or loss of hope at the end of life. Many within the bioethics, authorized, and medical
fields have raised vital questions relating to the existence of abuses and
failures in jurisdictions which have accepted prescription suicide, together with a
lack of reporting and accountability, coercion, and failure to guarantee the
competency of the requesting affected person.[5] America’s most weak citizens, including the elderly, the terminally sick,
the disabled, and the depressed, are worthy of life and equal safety underneath
the regulation, and state prohibitions on selling or enabling suicide mirror and
reinforce the well-supported policy “that the lives of the terminally ailing,
disabled and aged individuals have to be no much less valued than the lives of the young
and healthy.”[6]

Suicide
by Doctor Erodes the Integrity and Ethics of the Medical Career

Prohibitions on physician enabled suicide also
shield the integrity and ethics of the medical career, including its
obligation to serve its sufferers as healers, in addition to to the rules
articulated in the Hippocratic Oath to “keep the sick from harm and injustice”
and to “chorus from giving anyone a deadly drug if requested for it, nor make a
suggestion to this impact.”[7] Likewise, the American Medical
Affiliation (AMA) doesn’t help physician-assisted suicide, even for
individuals dealing with the top of life. The AMA states that “permitting physicians
to interact in assisted suicide would finally trigger extra hurt than good.
Physician-assisted suicide is basically incompatible with the doctor’s
position as healer, can be troublesome or inconceivable to regulate, and would pose
critical societal risks.”[8] In truth, the AMA states the doctor should “aggressively reply to the wants
of the patients” and “respect affected person autonomy [and] provide applicable
consolation care and enough pain control.”[9]

As well as, the U.S. Supreme Courtroom has said,

medical career.”[10] In Justice Antonin Scalia’s dissent to another Supreme Courtroom case involving a
ban on using managed substances for physician-assisted suicide, he
identified: “Nearly each relevant source of authoritative which means confirms
that the phrase ‘legitimate medical purpose’ doesn’t embrace intentionally
aiding suicide. ‘Medicine’ refers to ‘
prevention, remedy, or alleviation of disease’ . . . . [T]he
AMA has determined that ‘[p]hysician-assisted suicide is basically
incompatible with the physician’s position as healer.’”[11]

“Safeguards” Do Not All the time Work in Follow

Despite the so-called “safeguards,” opening the
door for suicide by way of prescriptive means also opens the door to real abuse. For
example, the Act requires
there be no less than two witnesses to the request for life-ending medicine, however
just one have to be a disinterested celebration, no less than in principle. There isn’t a
requirement that the second witness be utterly disinterested, which means an
inheritor and his greatest good friend would fulfill the two-witness requirement, simply
circumventing the alleged safeguard designed to protect the affected person from
strain, coercion, or abuse.

One need only look to the Netherlands and
Belgium to see how this plays out. A report commissioned by the Dutch
government demonstrated that greater than half of assisted suicide- and
euthanasia-related deaths have been involuntary within the yr studied.[12] At the least half of Dutch physicians actively recommend euthanasia to their
sufferers.[13] One other research showed that out of 1,265 nurses questioned, 120 of them (virtually
10 %) reported that their final patient was involuntarily euthanized.[14] However solely 4 % of nurses involved in involuntary euthanasia reported
that the patient had ever expressed his or her wishes about euthanasia. Most of
the patients euthanized with out consent have been over 80 years previous, reaffirming the
incontrovertible fact that assisted suicide and euthanasia shortly lead to elder abuse.

One other example of the unreliability of these
“safeguards” is the requirement for mental health assessments. The Act requires
the doctor to refer the person for counseling if, in his or her opinion,
the individual “could also be suffering from a psychiatric or psychological disorder
or melancholy inflicting impaired judgment.” There isn’t a definition of what
constitutes “impaired judgment,” and actually, one research from Oregon discovered that “[o]nly 6% of psychiatrists have been very
assured that in a single evaluation they might adequately assess whether or not a
psychiatric disorder was impairing the judgment of a affected person requesting
assisted suicide.”[15] As the newest statistics from Oregon show, only three of the 168 sufferers who
died from ingesting end-of-life medicine in 2018 have been ever referred for a
psychiatric analysis.[16] Equally, in Washington, solely 4 of the 196 sufferers who died in 2017 have been
referred for a psychiatric analysis.[17] Even with this “safeguard” in place, it’s troublesome to argue this “safeguard”
in H.B. 948 will accurately safeguard mental health considerations.

In
conclusion, Maine ought to reject H.B. 948, thereby continuing to uphold its obligation to protect the
lives of all its citizens—especially weak individuals such because the sick,
elderly, and disabled—and keep the integrity and ethics of the medical
career. Thanks.

Sincerely,

Catherine Glenn Foster
President & CEO
People United for Life


[1] Catherine Glenn Foster, The
Fatal Flaws of Assisted Suicide, 44 HUMAN LIFE REV. 51, 53 (2018).

[2]

521 U.S. 702, 710 (1997).

[3] Id. at 711.

[4] Id. at 729–30.

[5]

J. Pereira, Legalizing Euthanasia or
Assisted Suicide: The Illusion of Safeguards and Controls, 18 Current Oncology e38 (2011) (finding
that “laws and safeguards are
recurrently ignored and transgressed in all of the jurisdictions and that
transgressions are usually not prosecuted”); see
additionally Wash.
State Dep’t of Health, Washington
State Dying with Dignity Act Report (2018), https://www.doh.wa.gov/Portals/1/Documents/Pubs/422-109-DeathWithDignityAct2017.pdf (In 2017, 56% of patients who died
after ingesting a deadly dose of drugs in Washington did so, a minimum of in
part, because they didn’t need to be a “burden” on relations, elevating the
concern that sufferers have been pushed to suicide.).

[6] Glucksberg, 521 U.S. at 731–32.

[7]

The Supreme Courtroom has acknowledged the enduring value of the Hippocratic Oath: “[The
Hippocratic Oath] represents the apex of the development of strict moral
ideas in drugs, and its influence endures to this
day. . . . [W]ith the top of antiquity …
nucleus of all medical ethics’ and ‘was applauded as the embodiment of truth’” Roe v. Wade, 410 U.S. 113, 131-132
(1973).

[8]AMA
Code of Medical Ethics Op. 5.7 (Physician–AssistedSuicide),
https://www.ama-assn.org/sites/default/files/media-browser/code-of-medical-ethics-chapter-5.pdf.

[9] Id.

[10] Glucksberg, 521 U.S. at 731.

[11]

Gonzales v. Oregon, 546 U.S. 243, 285–86
(2006) (Scalia, J., dissenting) (third inner citation citing Glucksberg 521 U.S. at 731).

[12]See W.J.
Smith, Pressured Exit: The Slippery Slope from Assisted
Suicide to Legalized Homicide 118–19 (2003) (citing the Dutch authorities’s
Remmelink Report documenting
euthanasia leads to the Netherlands).

[13] See id. at 119 (citing R. Fenigsen, Report of the Dutch Authorities Committee on
Euthanasia, 7 Points Regulation & Med.
239 (Nov. 1991); Special Report from the
Netherlands, N.E.J.M. 1699-711 (1996)).

[14]

E. Inghelbrecht et al., The Position of Nurses
in Doctor-Assisted Deaths in Belgium, Can.
Med. Assn. J. (June 15, 2010).

[15]

Linda Ganzini et al., Evaluation of
Competence to Consent to Assisted Suicide: Views of Forensic Psychiatrists,
Am. J. Psychiatry 157:four, 595 (2000) https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.157.4.595.

[16] Or. Health Auth. Pub.
Health Div., Oregon Dying with Dignity
Act 2018 Knowledge Summary (Feb. 15, 2019) https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year21.pdf (last visited Apr. eight,
2019).

[17] Wash. State Dept. of
Well being Disease Management and Health Statistics Div., Washington State Demise with Dignity Act Report (Mar. 2018) https://www.doh.wa.gov/Portals/1/Documents/Pubs/422-109-DeathWithDignityAct2017.pdf (final visited Apr. 8,
2019).