Massachusetts Voters Deny Rights to Terminally-Ill People

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Massachusetts Question 2 election results: 49% (yes) to 51% (no)

Despite strong early support for Death with Dignity in Massachusetts the final vote tally didn’t give more Americans another end-of-life option. In the end, the opponents’ enormous smear campaign based on fear and misinformation won the day. But the foundation for support has been built, and we’ll keep working to make sure voters in Massachusetts and other states get the facts they need for an open and honest debate about Death with Dignity.

Together, we’ve changed the entire conversation around end-of-life care policy reform. A little over a year ago, many people in Massachusetts and throughout New England started hearing about Death with Dignity laws for the first time, and since that time, the need for these carefully crafted laws has been a hot topic on television programs, news publications, blogs, editorial columns, and countless letters to editors.

Polls showed people were ready for a Death with Dignity law in Massachusetts, and many shared their stories with the public at an unprecedented level. One such person is Jim Carberry.  He, like so many of you who’ve come to support Death with Dignity, watched a loved one die a long, painful, and protracted death. His wife, Margie didn’t have the option to die on her own terms in the final stages of her terminal illness—something she so desperately wanted after her tumor aggressively returned in 2007.

She wanted to survive long enough to see their daughters graduate from high school and endured many invasive medical procedures to keep her body functional through those milestones. She was out of curative treatment options. Even after chemotherapy was no longer helping, she worked with her medical team to keep her body going.

Margie lived to see both of their daughters graduate, and through both graduations she was radiant, a proud mother who celebrated her daughters’ achievements. A week after graduation, she spoke with her family, clergy, and medical team and decided to remove her feeding tube and meet death on her terms.

Though she was ready, she suffered another five weeks before her body gave out. Margie wanted the option to shorten her suffering, but that option doesn’t yet exist in her state.

Margie wasn’t alone in her support for a Massachusetts Death with Dignity Act. Polls before the election showed a strong majority of peop

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Two-Thirds of Likely Voters Support Massachusetts Death with Dignity

Suffolk University logo
Suffolk University logo

Another independent poll released this week showed winning support for the Massachusetts Death with Dignity initiative which will appear on the state’s November ballot. Tuesday’s poll conducted by Suffolk University and 7News, demonstrated 2/3 of likely voters would vote yes on the Death with Dignity initiative. The poll question had the same wording as what will appear on the November ballot:

Question #2 is the Prescribing Medication to End Life Proposed Law. A YES VOTE would enact the proposed law allowing a physician licensed in Massachusetts to prescribe medication, at the request of a terminally-ill patient meeting certain conditions, to end that person’s life. A NO VOTE would make no change in existing laws. At this point would you vote yes or no?

Yes………………………………….. 64%
No ………………………………….. 27%
Undecided…………………………. 10%

With just seven weeks before the general election, this poll echoes others indicating Bay Staters want more legal and safe options at the end of their lives. Learn more about what’s going on in Massachusetts from Dignity 2012 the coalition working in support of Death with Dignity. Most of us around the country don’t have the opportunity to vote on this issue, but but all eyes are on Massachusetts.

After all, the key to new Death with Dignity laws is an informed public. Your tax-deductible donation will help people in all states learn more about this critical end-of-life option. Please consider a gift today.

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Boston Public Radio Discussion of Massachusetts Death with Dignity

Vote Aqui care of Boston Public Radio
Vote Aqui care of Boston Public Radio

Boston Public Radio hosted a vibrant dialogue this week around the Massachusetts Death with Dignity ballot measure Bay Staters will vote on this November. Several key discussion points were addressed by radio host Callie Crossley as she engaged Dr. Marcia Angell, supporter of the proposed Massachusetts Death with Dignity Act, physician, former editor-in-chief of the New England Journal of Medicine, and Dr. Lynda Young, an opponent of the proposed law.

From this short 30-minute broadcast I’ve extracted a handful of gems I think you’ll enjoy. And I encourage you to take a little break from your day to listen and tell us your favorite quotes in the comments below, on Facebook, and through Twitter.

From the start, Dr. Angell helped listeners understand what the initiative is and described her confusion about how anyone would oppose it:

In my mind the real question is “why would anyone oppose it?” This Act merely permits dying patients, ones who find their suffering unendurable and who can’t find the relief that they want, permits such patients to ask their physician for a medication that would allow them to end their lives somewhat earlier. These people are dying; remember that. Allow these patients to die a little more peacefully.

I don’t see how this can be a threat to anyone. It’s their choice—they don’t have to ask for the medication—and it’s the doctor’s choice as to whether he or she wants to comply. Why would anyone—the state, organized medicine—why would anyone want to tell someone else how much suffering they have to endure as they face death?

Dr. Angell also explained how physician-assisted dying is completely separate and different from suicide (a word opponents inaccurately use to scare people). With suicide “someone—usually a younger person—with a normal life expectancy chooses death over life. Here, unfortunately, these patients don’t have that choice. They are dying. They are just choosing the manner of their death.”

So often opponents try to put palliative care in conflict with physician-assisted dying. Dr. Angel helped explain how this is a false dichotomy; rather, it’s about more options instead of limiting a person to only one option:

To say you can’t permit physician-assisted dying because we have good palliative care is as though you’ve said you can’t have heart transplantation because we have good heart drugs. This is for when the patient decides that good palliative care has not worked. This is the patient’s decision.

On the argument of the Hippocratic Oath:

This is not about physicians. This is about patients. We have to remember this. Yes, physicians should heal, but this isn’t when healing is possible. Healing is not possible for these patients. So then, what physicians should be doing is concentrating on relieving their suffering as they wish.

After listing the medical associations which do respect patient autonomy and support patient-centered care, Dr. Angell explained what is often the core of some of the other medical organizations’ opposition:

They are too engaged in their own self-image. They say “This is what we do. We have hope. We heal.” And medicine should be more specific—less abstract, less one size fits all. It should be an individual doctor dealing with the individual circumstances of that patient, what that patient needs and desires. And it’s about patients.

When asked about who’s used the law in Oregon and Washington, Dr. Angell put forth a scenario to help illustrate the sense of control people regain under a Death with Dignity Act:

We celebrate when people are healthy. We say, “Oh, this person is in control of his life, he’s independent.” And why should we, when they are dying, suddenly say, “No we don’t value that. We don’t want you have control, we don’t want you to be independent, we don’t want you to make up your own mind?” It’s sort of an odd thing.

Something I found very telling throughout the interview: Dr. Angell and Crossley at different times reiterated all of the safeguards written into the initiative which have kept people safe under the Oregon and Washington Death with Dignity Acts, Dr. Young even admitted fears put forward by opponents haven’t happened in the 15 years of Oregon’s law, and Crossley suggested to Dr. Young to consider amendments to the text of the proposed law to add additional requirements the opponents say are missing. After all this, when asked if opponents could support the initiative, Dr. Young still said no, they would still oppose.

This isn’t new. During Oregon’s long struggle to defend their groundbreaking law, opponents just kept coming up with new roadblocks. When in fact, no matter what, they could never support the law because of their own religious beliefs.

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Majority of Massachusetts Voters Support Death with Dignity

Public Policy Polling logo
Public Policy Polling logo

If Massachusetts voters had their say today, they’d approve of their Death with Dignity initiative by a winning margin. A new independent Public Policy Poll showed 58% of Bay Staters would vote yes for Death with Dignity. The poll question had the same wording as what will appear on the November ballot:

Question 2 would allow a physician licensed in Massachusetts to prescribe medication, at the request of a terminally ill patient meeting certain conditions, to end that person’s life. If the election was today, would you vote yes or no on Question 2?

Yes………………………………….. 58%
No ………………………………….. 24%
Undecided…………………………. 18%

This is an excellent sign; however, the race is far from over. With 77 days left until the election, opponents who object to Death with Dignity based on their own moral beliefs will waste no time in firing up their lie machine in an effort to mislead voters.

The key to new Death with Dignity laws is an informed public. Will you help people in all states learn more about this critical end-of-life option with a tax-deductible donation today?

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Massachusetts Media Round-Up

With the exciting announcement that Death with Dignity is now officially certified for the November Massachusetts ballot, there’s been a flurry of excitement about the measure in the news. Something refreshing I’ve noticed in these reports is the reliance on facts about these important laws which have been in effect in Oregon and Washington for years. All too often, people get distracted by misinformation and scare tactics put forward by opponents of additional end-of-life options.

A consistent theme throughout these articles about the proposed law is to outline what would and would not be allowed under the Massachusetts Death with Dignity Act. An example from the Albert Einstein College of Medicine Bioethics Blog:

Two doctors—the patient’s own physician and an additional consulting physician—must confirm that the patient is expected to die within six months. The patient must file two requests, spaced 15 days apart, in the presence of two witnesses, one of whom cannot be a relation. The patient must wait an additional 48 hours to fill the prescription. Violation of the law, including coercion and forgery, would result in the physician’s imprisonment. Under the law, active euthanasia is illegal; the drugs must be self-administered by the patient. Physicians who are opposed to the practice would be in no way obligated to write a lethal prescription for a patient.

Some articles dug into the Oregon and Washington state-issued reports for statistics about the effectiveness of the safeguards stipulated in these Death with Dignity Acts. As MetroWest Daily News found, by looking at the state reports it’s undeniable “prescriptions often don’t get used but still provide solace.”

As Jim Carberry explained in his interview with MetroWest Daily News, “The real crux of the situation is giving people the right to control” their end-of-life care.

And as Dignity 2012 spokesperson Steve Crawford explained for the American Medical Association blog, “this statute has worked as intended in both Oregon and Washington. The scare tactics the opposition uses simply haven’t come to life.”

Another commonality found among the articles was how the Massachusetts initiative got to the ballot:

“The “Death with Dignity” campaign started with signatures from the former head of the New England Journal of Medicine, several other Harvard Medical School doctors, and respected lawyers and academics.” (MetroWest Daily News)

“Last year, volunteers from across the state began a petition drive to collect the 68,911 signatures needed to introduce the act for consideration by the state legislature; by the time they were done, they’d gotten more than 86,000 voters to sign on to show their support. Lawmakers had until the beginning of May to address the issue, but they declined to do so. In response, volunteers fanned out for a second wave of signature gathering. An additional 21,000 people from the state’s 14 counties signed on to support the Act. That’s nearly double the number needed to bypass the statehouse and bring the issue directly to voters via ballot measure.” (the Atlantic)

…and how strongly Bay Staters support this initiative and why:

“Sixty percent of Massachusetts voters support “allowing people who are dying to legally obtain medication that they could use to end their lives,” according to a Western New England University Polling Institute survey of 504 voters conducted at the end of May. Twenty-nine percent said they opposed the idea, and 11% declined to answer the question.” (American Medical Association blog)

“Palliative and hospice care are available to help patients find peace and comfort in their final days. But there are some people who want another option, which is the right to end suffering by taking their own life at a time and place of their choosing.” (the Atlantic)

All the articles agree the Massachusetts initiative will lead to an open and lively debate about end-of-life options throughout the US. “But this November, it’s up to the people of Massachusetts to decide: near the end of life, should we have the ability to choose exactly when the time comes?” (Albert Einstein College of Medicine Bioethics Blog)

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Death with Dignity Qualifies for Massachusetts November Ballot

“The initiative petition will be printed on the November 6, 2012, state election ballot.”

-from the Massachusetts Secretary of the Commonwealth to Dignity 2012

After a long, winding road, the Massachusetts Death with Dignity initiative completed the final step of the process to appear on the November ballot! After collecting nearly double the number of signatures necessary for the second and final signature-gathering phase, the Secretary of the Commonwealth certified that the citizen petition will be put before voters this fall during the presidential election.

This final round of signature gathering proved to be another demonstration of strong support for the measure from all over Massachusetts; signatures were certified from all 14 counties in order to qualify the Death with Dignity initiative for the November ballot. Michael from Dignity 2012 shared the great news with supporters in an email earlier today. He summarized the path to the ballot in his message:

Our long journey to the ballot started nearly one year ago.

Last August, a group of citizens joined to propose the law. The team included two former Editors of the New England Journal of Medicine, two Professors of Medical Ethics at Harvard Medical School, and leaders in the legal, civil rights, disabilities, and faith based communities. The proposed law was approved by the Attorney General.

During the fall, hundreds of volunteers helped to submit 86,000 certified petition signatures to complete the first step towards the ballot, which introduced the petition as a bill before the Legislature.

Starting in April, we collected 21,000 additional petition signatures to finally put the Death with Dignity Act on the statewide November ballot.

Throughout the course of the qualification process, the initiative has caught the attention of many media outlets. Michael mentioned one such insightful article in today’s email:

Growing attention led several newspapers to look into the law and write about the many safeguards of the proposed law. Among them was Boston Magazine, which reported that the Death with Dignity Act is “a measured proposal loaded with safeguards, and it reflects the wisdom and experience of a diverse group of experts.”

After what’s felt like a long, circuitous journey to get to this point, this final step to qualify for the ballot sparks beginning of what now becomes a dash to the election. Support throughout the state is strong—a recent poll showed Bay Staters support Death with Dignity by a margin of two to one; as part of our partnership with Dignity 2012 we’ll keep working to make sure the people of Massachusetts continue to get the facts about this important end-of-life option. Please support our efforts with a tax-deductible donation today.

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The Boston Globe on the Massachusetts Death with Dignity Initiative

Photo by Ryan Huddle of Globe staff
Photo by Ryan Huddle of Globe staff

Last Sunday, the Boston Globe Magazine helped many Bay Staters learn more about the proposed Death with Dignity Act in Massachusetts. The magazine’s feature, “Dying wishes”, by Scott Helman contains a personal story about why two Massachusetts advocates are volunteering their time in support of the ballot measure, outlines the facts of the measure, and highlights the history of Death with Dignity laws in other states.

Perhaps the most touching story from the article is that of Heather Clish. When her parents were visiting Heather in Massachusetts, her father was diagnosed with a terminal brain tumor—the same type of cancer Senator Ted Kennedy had. An Oregonian, Heather’s father knew of his state’s Death with Dignity Act, and chose to request the prescribed medication while he received palliative care and his family enrolled him in hospice care.

When his pain and suffering became too great for the doctors to relieve, he decided to take the medication. Heather and her sisters were able to travel to Oregon to be with her dad in his final moments:

Clish and her two sisters filled his ears with pleasant images. Mary Lou lay in his arms, as he’d wanted. He had earlier told her, “I hope I will be holding you when I take my last breath.” Johnson slipped into what looked like a deep sleep. After about 15 minutes, his pulse stopped.

Massachusetts’ proposed law emulates the time-tested and safe Oregon and Washington laws. All too often, inaccuracies are put forth about Death with Dignity Acts, but to reduce confusion, Helman does an outstanding job of explaining the facts about law:

Under the Massachusetts proposal, which is virtually identical to the laws in Oregon and Washington, terminally ill, mentally competent adults deemed to have six months or less to live would have the freedom to obtain a fatal prescription. They could qualify only after going through a process designed to ensure that they are not being coerced and that they fully understand what they’re doing. They would administer the drugs themselves. Any doctor opposed to the practice could opt out of writing the prescription.

In recapping the long history of Oregon’s law—which went into effect in 1997—and the extensive research that’s been done over the years. An especially poignant paragraph demonstrates that even researchers opposed to the Death with Dignity Act have found concerns about the law unfounded:

Even some personally opposed to assisted suicide agree Oregon has proved many of the concerns to be overblown. “When all things are considered, the arguments in favor of continued prohibition of physician-assisted suicide are not particularly compelling,” Daniel E. Lee, an ethicist and professor at Augustana College in Rock Island, Illinois, wrote in a 2003 essay for the Hastings Center Report, a prominent ethics journal. Lee wrote that it’s perfectly appropriate to maintain moral reservations, as he does. But he said that was not enough to “stand in the way” of those who want to make a different choice.

Included in the article is the perspective of another prominent supporter of Massachusetts’ efforts, Dr. Marcia Angell, former editor of the New England Journal of Medicine and senior lecturer at the Harvard Medical School. Her father suffered greatly with incurable prostate cancer, and killed himself. Dr. Angell firmly believes her father would have wanted the option, and all terminally ill individuals should be able to decide when or whether to shorten their suffering as death draws near:

Is ingesting a lethal prescription morally distinct from removing a ventilator or a feeding tube? Terminally ill patients and their proxies make those decisions every day.

Doctors can’t always alleviate suffering for the dying, she says, and patients should have the option to end it themselves. That, she argues, is consistent with the greatest obligation of doctors—to care for people as best they can, in accordance with their wishes.

Besides, Angell argues, top-flight end-of-life care and the choice of taking a lethal drug can coexist. “Good comfort care and the availability of physician-assisted suicide are no more mutually exclusive than good cardiologic care and the availability of heart transplantation,” Angell wrote in a 1997 Journal editorial. In fact, studies suggest that Oregon’s Death with Dignity Act has only improved end-of-life care in the state.

Heather Clish, drawing from her experience with her father’s peaceful death explained why this should be an option in every state:

This is not a choice that is right for everybody. But for each of the people who have chosen it, no matter how small the number, it is of immeasurable value.

Read the full article on the Boston Globe Magazine’s website, and if you’d like to learn more about how you can help, visit Dignity2012.org.

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An Interview with Massachusetts Dignity 2012

Massachusetts State House by notafish on Flickr
Massachusetts State House by notafish on Flickr

There have been a number of recent developments in the Death with Dignity movement. When I was in Massachusetts last week, I took a moment to sit down and chat with Michael Clarke, the Campaign Director at Dignity 2012, to get the latest news on their efforts. Read more about the work they’re doing and what you can do to help citizens of a third state learn more about important end-of-life options proposed in the Death with Dignity Act initiative.

Peg Sandeen from Death with Dignity National Center: What’s the goal of Dignity 2012?

Dignity 2012: Dignity 2012 is working to pass a Death with Dignity law, similar to the laws in Oregon and Washington. We’re focused on a ballot initiative effort to present the question to the voters on the November ballot. As you know, this is the same process which was used to pass the laws in Oregon in 1994 and Washington in 2008.

PS: How has the reception been so far?

Dignity 2012: We’ve received an overwhelmingly positive response from people across Massachusetts who believe terminally ill patients deserve greater control over their end-of-life care. Hundreds of volunteers and donors have signed up to help with the effort. These decisions are deeply intimate and personal, and belong in the hands of individuals, not the government.

The proposed initiative gathered more than 84,000 signatures from voters for the initial qualification phase for which we only needed about 69,000 to move forward. After achieving that first step, the initiative was then put before the State Legislature for consideration and received a hearing. The next step in this process started yesterday when we filed the documents to request the petitions to put Dignity on the ballot.

PS: What’s the next step?

Dignity 2012: The state constitution requires the petition to travel through the legislature where it is today. They had until May 1st to act on the petition but that didn’t happen. Now the petition has entered its next phase when we’ll need to collect about 20,000 more signatures by the end of June to put the question on the ballot in November.

PS: You mentioned more than 84,000 voters signed the petition. Why do you need to collect more signatures?

Dignity 2012: Massachusetts has two rounds of required petition collection: one in the fall to qualify the petition to be delivered to the Legislature and the second in the spring to place the initiative on the ballot as a question.

PS:How much time do you have to gather signatures? When is the deadline?

Dignity 2012: It’s a very short timeline. We’ll have fewer than 6 weeks to collect 20,000 signatures. The deadline to file all of the signatures is June 20.

PS:What’s the process for collecting signatures?

Dignity 2012: The process is complicated. Petitions must be hand signed by voters and a different petition sheet must be used for each town. So, people who live in different towns have to sign different sheets. Each of those sheets will have to filed with the local town Clerk’s office. The Town Clerk will check every signature and disqualify anyone who isn’t registered to vote in that town. The petitions then have to be picked up by the campaign and filed with the Secretary of State. Consider the state has 351 towns and cities, this requires a lot of work.

Collecting the signatures takes a lot more than a couple hundred people standing on street corners. We have to mail out thousands of petition sheets, provide return postage, get the petitions to the 351 Clerks, pick up the petitions, and file them with the Secretary of State, all in just 39 days. Because volunteers only have so much time to give over a 6 week period, we also have to hire workers to help collect signatures. All together, we estimate this process will cost somewhere between $85,000 and $100,000.

PS: How can people help?

Dignity 2012: Please visit our site, www.Dignity2012.org, for details. There are several ways people from all over the US can help, and here is how you can make the biggest difference:

  1. Donate – Without generous gifts from people who want to see Death with Dignity laws enacted, we wouldn’t even be able to mail out a single petition.
  2. Volunteer – If you live in Massachusetts or know someone who does please help Dignity 2012 with this huge signature-gathering stage. After you make a donation (hey it’s going to cost us money to get you the supplies) dedicate time to collect signatures from your family, friends, and coworkers.

Thank you so much, Michael, for helping our readers learn so much about everything Dignity 2012 is doing to allow Bay Staters the possibility to decide what’s best for them in their final days.

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