Selling Assisted Suicide, State by State

Wheelchair-bound disabled protesters against physician-assisted suicide are silhouetted as they hold up a banner outside the U.S. Supreme Court in 2005 on the day of the Gonzales v. Oregon case. The Supreme Court revisited the emotionally charged issue of physician-assisted suicide in a test of the federal government's power to block doctors from helping terminally ill patients and end their lives.
Wheelchair-bound disabled protesters against physician-assisted suicide are silhouetted as they hold up a banner outside the U.S. Supreme Court in 2005 on the day of the Gonzales v. Oregon case. The Supreme Court revisited the emotionally charged issue of physician-assisted suicide in a test of the federal government's power to block doctors from helping terminally ill patients and end their lives. (photo: REUTERS/Staff)

DENVER — Kathryn Tucker has been busy the past few years. As director of legal affairs for Compassion & Choices, she peruses state constitutions and laws to see if they address assisted suicide, which she refers to euphemistically as “aid in dying.”

So far, Washington and Oregon are the only states that have legalized assisted suicide in this country. Some believe that Montana has also, but a legal analysis of two court decisions which supposedly legalize assisted suicide in the state questions that assumption.

For all its efforts, Compassion & Choices, which was once known as the Hemlock Society, has seen more setbacks than successes. But that hasn’t stopped its latest campaign from revving up in Idaho.

It started in the local press with a column Tucker wrote in the June 25 issue of the Coeur d’Alene Press.

Tucker writes that “Idaho does not have a statute specifically addressing aid in dying, either to permit or prohibit the practice. It does not have [a statute making it] a crime of assisting another to ‘commit suicide.’ Accordingly, in Idaho, physicians can provide aid in dying.”

Margaret Dore, an attorney in Seattle who specializes in elder law, wrote a rebuttal to Tucker’s column for the Idaho Medical Association.

Dore stated that Tucker’s claim that there were no statutes dealing with assisted suicide “is untrue.”

“Idaho does have a statute prohibiting assisted suicide. Moreover, it has been in effect since 1994. Prior to that time, assisted suicide was prohibited solely by common law,” Dore emphasized.

“With assisted suicide prohibited by common law and not subsequently made legal, a doctor who causes a suicide with ‘deliberate intention’ is guilty of an unlawful killing … [and] can be statutorily charged with murder,” Dore explained.

Dr. Robert Ancker, an Idaho physician, board certified in hospice and palliative medicine, wrote a response to Tucker’s column as well.

He attacked her “factually untrue” reading of Idaho statutory law, which states that it “does not make legal, and in no way condones, euthanasia, mercy killing or assisted suicide or permit an affirmative or deliberate act or omission to end life, other than to allow the natural process of dying.”

“Any coroner in Idaho will classify any ‘aid in dying’ death as an assisted suicide, thus making it illegal [according to] Idaho code,” Ancker emphasized.

He concluded that this is “a dangerous game that Ms. Tucker is playing with Idaho citizens. Worst of all, it takes away from meaningful conversations regarding death, dying, advanced directives, and comfort, palliative and hospice care.”

Ancker gave a rebuttal of Tucker’s comments July 17 at an event sponsored by the Idaho Medical Association. Margaret Keeler, a nurse who was present at the event, recalled that Tucker started her talk “by showing statistics about how many people have significant pain at the end of life and stressing a person’s right to have pain and symptom relief.” Ironically, later in her talk, Tucker gave a slide presentation on why people chose assisted suicide. The statistics showed that “91% of those surveyed gave ‘a loss of autonomy’” as their reason for asking for a lethal overdose, followed by “the patients’ inability to engage in life fully,” Keeler remembered.

She added: “Far down on the list was the issue of ‘unrelieved pain.’”  In other words, Keeler noted, “pain was not the chief reason, or even the more prominent reason, that people asked for help in dying.”

Keeler mentioned that Tucker was trying to convince attendees that “because they had three adjoining states [with] legalized assisted suicide [Oregon, Washington and Montana ], it lent support to a standard of care [for legalizing] the practice in Idaho.”

At one point in his rebuttal, Ancker asked the medical professionals in the room how many supported assisted suicide. No hands went up, Keeler recalled.

Connecticut Case

Tucker’s attempt to switch terminology in a Connecticut case last year failed as well. The murder-suicide of an elderly couple in North Haven, Conn., led to a lawsuit filed last October, Blick v. Connecticut, which was represented by local counsel and lawyers from Compassion & Choices.

Dr. Gary Blick, an HIV/AIDS specialist in Norwalk, Conn., and Dr. Ronald Levine, an internist in Greenwich, Conn., filed a legal challenge to the state’s assisted-suicide statute, saying that the threat of punishment prevents them from prescribing lethal doses of medication for their patients.

But in June, a Superior Court judge said that the lawyers failed to make their case by insisting that the issue was a case of “aid in dying” rather than “assisted suicide.” The judge ruled that the change in terminology would make no difference in prosecuting the plaintiffs.

Unbowed, Tucker said she would not rule out lobbying the Connecticut Legislature to take up the issue of legalizing assisted suicide.

Meanwhile, in Montana, there has been a groundswell of activity to fight assisted suicide in the state, according to Mo Wosepka, executive director of the Montana Catholic Conference. He spoke to the Register in July about the formation of a broad-based coalition to stop legalized assisted suicide following last year’s State Supreme Court ruling in Baxter v. Montana: that nothing in state law or the court’s precedent indicated assisted suicide was against public policy. The court did not determine whether the Montana Constitution guarantees a right to assisted suicide.

Montanans United consists of “physicians, health-care professionals, disability-rights advocates, faith communities, seniors, people who are seriously ill and their caregivers, and many other Montanans in communities across the state.” He is confident, he says, that this group will be successful in “getting the truth out” on assisted suicide and the proposed legislation. “With good information, people can make good decisions,” he said.

On May 30, state Sen. Greg Hinkle introduced “the Montana Patient Protection Act, prohibiting physician-homicide and physician-assisted suicide, based on Montana’s public policy to prevent elder abuse and to value all citizens.”

State Rep. Dick Barrett issued a formal request for a draft bill in favor of physician-assisted suicide, ensuring that terminally ill patients in Montana can elect to choose assisted suicide, while providing physicians protection from civil liability.

As Sen. Hinkle recently said, “[Compassion & Choices talks] about choice, but in many cases, there is no choice made. … They put the decision in the hands of other people — the doctor and the family.”

Legalizing physician-assisted suicide “opens a Pandora’s box,” Hinkle said. “I don’t believe the people of Montana want to go there.”


Bob Liston is disabled and has problems with the idea that those advocating for assisted suicide are really doing so out of a true concern for the suffering.

Liston is an organizer for Not Dead Yet in Montana, a group officially opposed to assisted suicide and euthanasia, and works for Adapt, a national disability-rights organization. He told the Register, “I think that in Montana it is unnecessary for an assisted suicide law to be written because we already have laws on the books that allow a physician to provide palliative care up to and including efforts that might hasten death.” He added: “So, I have a really hard time seeing why we need to go beyond this.”

It is the faulty assumptions about those whose lives it will affect that he finds upsetting. “Compassion & Choices … seems to think that taking one’s own life is dignified, often using the example of [a disabled person’s need for assistance with personal care and hygiene] as a reason to not go on living.” But he adds that some disabled people need this kind of total assistance on a daily basis “and are grateful for it.”

Compassion & Choices “puts forth the argument that so few people in Oregon have chosen assisted suicide [because] the guidelines are so strict. Nothing could be further from the truth,” he insisted, adding: “We have no idea what is really going on in Oregon because recordkeeping is not required.”

Liston stated: “As a person with a disability, I would say that not only is this the wrong law [favoring assisted suicide] to pass — it is definitely the wrong message.”

“If [the citizens of Montana] put as much effort into suicide prevention for people wanting this, or services for people with disabilities to live in their communities, not just have a life in a nursing home,” Liston concludes, “we would be a much greater nation.”

Elenor Schoen writes from Shoreline, Washington.