Full disclosure: I am the Online Community Coordinator with Compassion & Choices-Montana, working to keep aid in dying legal in Montana.
Yesterday in the Senate Judiciary Committee, a bipartisan group of Montana Senators rejected SB 116--an assault against the right of terminally-ill, mentally competent Montanans to obtain a prescription to achieve a peaceful and dignified death. So, first things first. A heartfelt thank you to Sens. Augare (D), Blewett (D), Jent (D), Larsen (D), Moss (D), Peterson (R) and Vincent (R). Their vote leaves responsibility to develop the standard of care for aid in dying with Montana's medical community.
Senator Hinkle attempted today to blast the bill out of committee and to the floor, but it failed spectacularly, 35-15.
Another thank you goes to Bob Baxter and his family. Mr. Baxter fought valiantly for his right to die with dignity. His daughter Roberta has an eloquent and touching series of blog posts about her father, which you can read here.
Additionally, Missoula activist Dustin Hankinson has penned an extremely important piece on why aid in dying should be legal and end-of-life choice must be extended to those living with disabilities. It's called My Right To Choose. I hope you'll take a moment to read it and to watch the video from Oregonians who have embraced Death With Dignity.
Citizens, doctors, attorneys and religious leaders seemed evenly split between Hinkle and Blewetts' proposals during testimony. Opponents to aid in dying called on the Judiciary Committee to pass SB 116 and defend them from state-sanctioned suicide. Proponents of SB 167 stepped forward with personal accounts and statistics from Oregon and Washington, where Death with Dignity Acts passed by citizen initiative.
"I'm here in support of Senate Bill 167," said the Reverend John C. Board of Helena, an ordained deacon in the Episcopal Diocese of Montana. "I am not here to convert you to my personal religious belief. But I am here to ask you not to impose the perspective of one faith upon all Montanans."
Thank you to all those who've supported freedom and dignity for Montana.
A number of great opportunities to learn more about Death With Dignity are on tap this week in Glendive, Miles City and Havre.
The State of Oregon has had a Death with Dignity law for 12 years. Throughout that time, Barbara Glidewell has been studying how the law works for dying patients and their families in Oregon. Ms. Glidewell wears many hats:among them nurse, bioethicist, patient advocate, and ombudsman.
There are few people in the nation that understand Death With Dignity and its impact in Oregon better than Barbara Glidewell.
This week, Ms Glidwell is visiting eastern Montana to discuss her experiences with Oregon's law. In many ways, Oregon's experience shows what Montanans can expect under the state's new aid-in-dying policy.
Someone get Senator Greg Hinkle a chalkboard. In his elaborate proof that physician aid in dying is the same thing as euthanasia, he has to dig up 30 year old law school papers and a failed bill from 20 years ago, both of which come from other states. All of this is to advance his bill to criminalize a physician giving an individual pharmaceuticals they want in order to self-administer and end their own life on their own terms.
Here's what we might call the nut graf (it's a double entendre):
More recently, the Montana Supreme Court gave doctors who participate in aid in dying a potential defense to criminal prosecution. When doing so, the Court described aid in dying in terms of a doctor providing the means for a patient's death, but not directly participating in that death. This is physician-assisted suicide, not euthanasia. But how long will that distinction be remembered? The term "aid in dying" also means euthanasia. (Emphasis added.)
The Supreme Court merely ruled that there is currently no law against physician aid in dying. There is a law against euthanasia. In addition to being called "aid in dying," euthanasia is called "homicide."
Senator Hinkle also provides a single link to prove that aid-in-dying laws are "a recipe for abuse." That link is to an article that has absolutely no data about any indication of abuse in Washington or Oregon. It is simply meaningless speculation.
In his defense, though, he is clearly just not very smart.
Full disclosure: I am the Online Community Coordinator for Compassion & Choices.
This week in townsacross Montana, Compassion & Choices-Washington's Medical Director Dr. Tom Preston has been conducting town hall style meetings to provide information and answer questions about Death With Dignity for Montana.
From Helena to Bozeman, Dr. Preston's events are providing opportunities for citizens to gain a full understanding of how physician aid in dying is working in Oregon and Washington, and how it can work for Montana. The presentations have included details on how physicians manage Death With Dignity in Oregon and Washington as well as statistics on use of the laws in those states.
Dr. Preston is in a unique position to comment on Death With Dignity. As a physician, Dr. Preston understands the need for doctors to be healers, but also to end suffering for dying patients. Preston notes that more and more physicians are realizing that "death with dignity" is a humane part of medical practice.
By participating in physician aid in dying, physicians are helping patients gain release from the agonies of extended dying. They are staying with their patients and giving good end-of-life care. Patients then that know they can talk with their doctors about obtaining a peaceful and dignified death and are able to have conversations about all the options available to them. The conversations help patients to better direct their end-of-life care and gain peace of mind knowing they will not have to suffer unbearably.
Dr. Preston also discusses Death With Dignity from the perspective of families, who express overwhelming gratitude for the support their loved one recevies. Patients and survivors have a chance to be together and to reconcile any past differences and say goodbye before the patient dies. The death is peaceful, allowing the patient to escape the agony that often takes over the last days or hours of life.
Dr. Preston's next presentation will be on Friday, September 24 at noon, Silver Bow Library, Butte.
Death With Dignity (also known as aid in dying) is generally an issue that folks feel strongly about, one way or the other. It's also an issue that can bring up a bunch of questions. Next week in Havre, Great Falls, Bozeman and Butte, Montanans will have an opportunity to have those questions answered by a physician expert on Death With Dignity: Dr. Tom Preston.
[Full disclosure: I am the Online Community Builder for Compassion & Choices]
Montana is preparing to have an important public policy discussion about the rights of terminally-ill citizens to request medication from their physician to achieve a peaceful and dignified death at the time of their choosing.
Compassion & Choices-Montana believes its extremely important to provide the public with accurate information on this issue. Thankfully, so does the Missoula Independent:
Legislators on both sides are eager to clarify the Montana Supreme Court's December ruling that gave physicians a legal defense in prescribing life-ending medication to terminally ill, mentally competent patients. Proponents point to legislation already on the books in Oregon and Washington that provides strict criteria for the practice-psychiatric evaluations, written consent observed by an impartial witness, etc.-as a good starting point for building on the court's decision.
Hinkle's talking points are, shall we say, less researched. He's claimed for weeks that physician-assisted suicide will wrongfully endanger patients who might actually survive their illness. Even patients with stable HIV and years to live could receive a prescription, he says, and he's gone on record stating that once medication is prescribed, a patient's life is out of his or her hands. Death is under the control, he says, of a doctor or family member.
Hinkle couldn't be more wrong. Physician-assisted suicide is a voluntary alternative for those suffering extreme pain or indignity at the end of life. In 2009, doctors in Oregon prescribed life-ending medication to 95 patients, only 53 of whom elected to take it. The majority of those were already in hospice care.
Terminally ill, mentally competent adults are very capable of making informed decisions about their care. They don't need the government telling them how to live and they definitely don't need the government telling them how to die.
Get more information on Death With Dignity and keep track of the latest on the issue, join us on Facebook.
In addition, a community conversation on end-of-life choice is set to take place at Carroll College on Saturday, April 10. Hosted by the ACLU of Montana, the event will feature both proponents and opponents of aid in dying, including representatives from the legal, civil liberties, faith, medical and disability rights communities as well as patients and families.
This conversation is a great opportunity to hear the full scope of opinions on Death With Dignity.
When people are terminally ill and death is near, they should be free to decide whether to prolong life as long as possible or to end their suffering more quickly. Terminally ill patients want the right to have some measure of control over their lives. The right to request aid in dying places the power to choose solely in the hands of the patient.
Carla's post the other day reminded me of a prediction I made after Montana's Supreme Court decided that physician-aided death with dignity was not against Montana state law that state social conservatives would rush to pass a bill that make it illegal.
The rush is on, led by Republican state Senator Greg Hinkle.
Now, no one ever claimed Hinkle was the sharpest tool in the toolbox, but check out his statement on physician-assisted suicide, and why he's passing a bill outlawing it:
On top of working on drafting a bill for stricter DUI laws, Hinkle currently introduced a bill to illegalize physician-assisted suicide, which was made legal in a Supreme Court decision this past year.
Hinkle explained that physician assisted suicide does not deal with someone who is terminally ill or on a life support system where their family members can decide turn it off. Hinkle used the example of going into diabetic shock, which is under the terminally ill category and something a person can recover from. However, now that this bill has passed, a doctor can say that a person is permanently ill and can decide to kill that person, even if they could have the potential to recover.
"You no longer have control of your own life," said Hinkle. "I'm laying the groundwork, the bill has just been drafted and will get really big as time goes on."
Er...what? Senator Hinkle's obviously confusing a "living will" with "physician-aided suicide."
This is such a bone-headed "understanding" of what physician-aided suicide is that it makes me wish the state legislature had a penalty box for legislators, where the worst incompetents could be stashed away for the session and allowed to do no harm to the body politic.
Doctors sometimes encounter terminally ill patients who have no chance of recovery. In these cases medicine cannot offer any hope other than to ease a patient's suffering. Occasionally one of these patients will request a prescription for medication they can take to bring an end to a dying process has become unbearable. Now doctors in Montana can provide such a prescription to these patients without fear of prosecution.
Suffering near the end of life can come from a number of places. Relentless pain, progressive and inexorable loss of bodily function and control, loss of dignity, inability to engage in meaningful activities or interact with loved ones are all contributing factors. Excellent medical care, including state-of-the-art palliative care, often controls most symptoms. This care is always a physician's first course of treatment. But sometimes severe suffering persists and the only course of relief could require a patient to surrender all consciousness.
Some patients confronting this type dying process ask for a prescription for medication they can ingest to bring about a peaceful death. Bob Baxter wanted to have this option. A Marine veteran with 49 years behind the wheel as a long-haul truck driver, Bob was suffering from terminal lymphocytic leukemia, with no hope of cure or recovery. With a good long life behind him he had no desire to die early. But knowing death approached from his disease, Bob wanted an option for a peaceful death on his own terms.
This set the stage for Baxter v. Montana, in which Baxter, four physicians and Compassion & Choices sought a ruling on this intensely private and personal choice.
Physicians can now feel safe providing aid in dying to mentally competent terminally ill Montanans. Doctors in Montana should understand they are not governed by the statutory schemes that control care in Oregon and Washington. While those states enacted statutes with specific requirements, Montana has not done so.
However, certain boundaries recognized by the court are similar to the Oregon and Washington requirements. All three states maintain that the patient be terminally ill and mentally competent, and that the physician involvement be limited to providing a prescription that the patient can self-administer.
The Montana Supreme Court just issued a decision that public policy of Montana does not criminalize, and much in current public policy affirmatively supports, aid in dying. The court did not reach the question of whether the Montana constitution specifically protects aid in dying.
A panel will be held Nov. 9 at the University of Montana to discuss the ethical implications of Baxter v. Montana, the case in which a lower court recognized the right of terminally ill, mentally competent adult Montanans to choose aid in dying.
The Montana Supreme Court will consider whether to uphold the landmark decision made last December by First Judicial Court Judge Dorothy McCarter.
"Aid in Dying: A panel discussion on the ethical implications of Baxter v. Montana" will take place at 7 p.m. in Gallagher Business Building Room 123. The event is free and open to the public.
This morning in a Helena courtroom, the Montana Supreme Court heard oral arguments on Baxter v. Montana. This case will decide whether terminally-ill, mentally competent adults have the right to choose aid in dying.
The Montana State Constitution contains broad clauses for dignity and privacy. The question before the court is whether those clauses protect the right to aid in dying.
Below is Montana attorney Mark Connell, arguing the case for legalized aid-in-dying:
In December, District Court Judge Dorothy McCarter ruled in a summary judgment that aid in dying is indeed a protected right under the Montana Constitution. The case heard today will give the higher court an opportunity to affirm that decision.
A diverse array of individuals and groups have provided friend of the court briefs in support of aid in dying. Human rights groups, women's groups, people of faith, legal scholars and many others contributed to these briefs. You can view those briefs here.
Compassion & Choices Legal Director Kathryn Tucker, co-counsel to the plaintiffs/respondents said, "This case is about the right of mentally-competent, terminally-ill patients to request a prescription for medication from their doctors which they can ingest to bring about a peaceful death. This is a choice the Constitution entrusts in them, not the government."
Montana's First Judicial Court has issued a landmark decision in a lawsuit brought by a terminally ill Montana man, four Montana physicians and Compassion & Choices, a national nonprofit organization advocating for better care and choices at the end of life.
Judge Dorothy McCarter held that mentally
competent terminally ill Montanans have a right to a dignified death protected by the Montana Constitution's guarantees of privacy and individual dignity.
Accordingly, plaintiff Robert Baxter has the right to obtain medications he can self-administer to bring about a peaceful death, if he finds his suffering intolerable. The physician plaintiffs can write prescriptions for their mentally competent, terminally ill patients who want to control the time and manner of their deaths without the fear of criminal prosecution.
Compassion & Choices Legal Director Kathryn Tucker, lead counsel in the two federal cases asserting a right of this nature under the U.S. Constitution, teamed with Montana litigator, Mark Connell, in arguing for Bob Baxter and the
The ruling by McCarter is consistent with a long line of Montana cases which recognize the decision making power of the individual in the most personal and intimate decisions of their lives. The court found that the decision of a dying patient whether to endure suffering is intensely personal and private. And it should remain with them.
Montana's State Constitution contains exceptional rights to privacy and dignity. The court's result is consistent with the belief that government should have a limited role in such matters.
Montana is now the third state to legally affirm aid in dying along with Oregon and Washington.
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