Many people know that CDR is active in advocacy on the national level, and provides support and technical assistance in other states. That is also true of Not Dead Yet, which now has its national headquarters in CDR’s Rochester offices. Today, February 19, 2009, the House Judiciary Committee in New Hampshire held a hearing on HB 304 (http://www.gencourt.state.nh.us/legislation/2009/HB0304.html), which is titled “AN ACT relative to death with dignity for certain persons suffering from a terminal condition.” In case the wording leaves you in doubt, this is a bill to legalize assisted suicide.

This particular bill is broader in terms of who would be eligible for assisted suicide than any similar bill introduced in the U.S. so far. Other bills limit “eligibility” to people diagnosed to have less than 6 months to live, but the NH bill actually expands the definition of “terminal” in a way that makes virtually anyone with a significant disability or chronic condition “eligible” for legal help in killing themselves. You can find an analysis of this element of the bill at the Not Dead Yet blog at http://notdeadyetnewscommentary.blogspot.com/2009/01/new-hampshire-poised-to-redefine.html.

If pro-assisted suicide advocates were hoping to dominate the testimony today, they are in for disappointment. New Hampshire activists Bunny McLeod and Tom Cagle offered personal testimony. The Disability Rights Education and Defense Fund (DREDF) submitted written testimony by Marilyn Golden. Dr. Ira Byock, Director of Palliative Medicine at Dartmouth-Hitchcock Medical Center submitted written testimony in opposition to the bill based on his extensive experience as a palliative care physician. I prepared testimony submitted on behalf of Not Dead Yet (NDY).

This is an excerpt from Marilyn Golden’s testimony on behalf of DREDF:

Disability rights organizations overwhelmingly oppose assisted suicide because we see it as worsening the damaging stereotypes society has about disability. The widespread view of disability as a fate worse than death – which is a stereotype that most people with actual disabilities do not agree with – has justified making a deadly exception to public policy on suicide. Most people are given suicide prevention – but people like us would receive suicide assistance, due solely to our disability or health status. People with disabilities in the hospital are often urged to sign Do Not Resuscitate Orders, even when they actively want aggressive medical treatment. And let’s not forget that Derek Humphry, who founded the Hemlock Society, has written clearly that this change is needed to save resources for society – as if we are expendable.

Now the New Hampshire bill has the loosest definition of any assisted suicide proposal in years: no “six months to live;” no “one year to live;” simply any condition that may shorten one’s life span. People with disabilities are clearly included, and there are no protections in the bill for depressed individuals who may have new disabilities, and have not yet adjusted to life with a disability — who may make a “choice” that is irrevocable because they are unaware of the good options available to them.

Read the rest of the DREDF testimony at: http://www.cdrnys.org/index.php?option=com_content&view=article&id=189&Itemid=157

Ira Byock offered a different set of arguments, but came to the same conclusion – that legalization of assisted suicide is bad policy and bad medicine:

It is not surprising that most graduating medical students and licensed physicians have never been taught to assess and treat cancer pain, know little about hospice care and have not been trained in ways to counsel a person with advanced illness who worries about the future or has begun to feel that life is not worth living. Today’s young doctors are bright, caring, committed and generally well-trained professionals, but most are never taught the aforementioned skills, so it is no mystery that they don’t have them.

If these are the real problems facing patients and their families, then real solutions are needed – solutions not offered in this bill:

If HB 304 were to pass, the day after it became law, medical education would still be seriously lacking in attention to communication, pain assessment and management, counseling of patients and families during this difficult time of life, medical and social services would still be woefully inadequate, Medicaid and insurance payments would still reward doctors and hospitals for providing aggressive treatments, while not supporting access to palliative and hospice care.

You can read the rest of Ira Byock’s testimony at: http://www.cdrnys.org/index.php?option=com_content&view=article&id=190&Itemid=158

Written testimony was submitted on behalf of both the national and state chapters of Not Dead Yet. Here’s an excerpt:

In other states, assisted suicide proponents have used a door opener strategy to push their bills, claiming that they would limit the availability of assisted suicide to people who are diagnosed as terminally ill, defined as someone who is predicted to die within six months from their illness. If assisted suicide is about actual terminal illness, not disability, then many have questioned disability groups “meddling” and trying to “take away” what they see as the general public’s right to choose physician assisted suicide.

At this point, we don’t have that problem here in New Hampshire. Disabled people don’t have to explain our presence in the debate. The New Hampshire proponents have leaped past the door opener strategy and abandoned the pretence that assisted suicide will be limited to people who are going to die soon anyway. The New Hampshire bill expressly applies to anyone whose condition is incurable, irreversible and will eventually shorten their life span. That includes . . . . pretty much everyone with a permanent disability, as well as people with chronic conditions like diabetes and heart disease.

The rest of the Not Dead Yet testimony is available at: http://www.cdrnys.org/index.php?option=com_content&view=article&id=191&Itemid=159

More on this the New Hampshire story as it develops.

Diane Coleman, JD

1 Diane Coleman, “Not Dead Yet,” in Kathleen Foley, MD, and Herbert Hendin, MD, (eds.), The Case Against Assisted Suicide: For the Right to End of Life Care, (2002, Johns Hopkins University Press, Baltimore, MD), p. 221.