There’s been a lot of conjecture around these parts over whether doctors in Washington support I-1000. Carol Ostrom provides some hard data:
In July, the Washington State Medical Association (WSMA), which represents nearly 7,000 doctors in Washington, said it opposes the measure and that its “opposition was emphatically voted on” at last year’s meeting.
In fact, WSMA members never voted on the initiative.
And a survey WSMA commissioned last year actually found slightly more doctors approved of the provisions of I-1000 than opposed them.
In the survey, completed by Elway Research, 50 percent of doctors responding said they would support a measure like I-1000 while 42 percent would oppose it. Female physicians were more likely to support such a law.
In addition, I-1000 does not force dissenting doctors to certify patients under the law if they have moral objections to it. This is an initiative that respects choice for both doctors and patients. And this is why the similar law in Oregon has been so effective.
As long as you’re doing the reseearch here, how do disability rights activists feel about how the same law has been implemented in Oregon?
@1
The law in Oregon doesn’t pertain to disabled people, only the terminally ill, so I have no idea why that would be relevant.
Hey Lee,
Are you paid staff for the Yes on I-1000 initiative? If you aren’t, you should be, they have the money.
Yup – the PI also had that false dichotomy. That somehow, this law would affect the disabled. The proposed law only applies to the terminally ill. Guess some people cannot actually read the law as written in Oregon or as proposed here.
So all you right wing trolls on this site need not worry. Your mentally diabled status will not be affected by this law. I’m sure you will all rest easy tonight, especially cynical, TRM and Rick D.
@3
Nope, I’m not paid by them. I don’t need the money. I just believe very strongly in not having the government tell me what choices I can and can’t make.
So for you, it’s more about government than health care. That makes sense.
How many millions are being spent on this campaign by both sides? And how many people have been helped (I’ll presume their position) by the similar legislation in Oregon?
The whole thing seems weird to me, some kind of a death fixation. There are plenty of good fights to be fought when it comes to government and health care (I’d like to see more government involvement in many respects), and I don’t like the way this issue is sucking the air out of the political landscape. I’ll vote no.
@6: I just fail to see how letting terminally ill people decide to go is sucking the air out of anything. I will vote yes to give people a choice. Having seen the agony of a painful death due to cancer, how could I vote otherwise. If someone doesn’t want the option, then they don’t need to use it.
I am all for healthcare – but this issue really has no impact on healthcare except to help out people who want it.
@6
It’s not a death fixation. It’s a freedom fixation. To me (and I don’t expect everyone in the world to agree with me), issues that involve the freedom to establish one’s own morality are the top priority of making laws.
I certainly think that fixing our health care problems in this country is important, but one of the biggest dangers that we face in making that happen politically is convincing many people that government-run health care will not make these kinds of health choices for people.
If progressives more forcefully assert that individuals have the right to make these kinds of choices, then the population as a whole will be less likely to perceive these various nightmare scenarios about progressive government-run health care.
Why do Republicans hate freedom? Why do they want the government making choices for individuals at every stage of life? I shake my head, I just don’t get it.
I posted a comment twice including a link from a “duty to die” proponent from the UK. Guess you didn’t like it…so it never made it.
What a shame
Interesting article from across the pond. Especially the wording ” a duty to die”. I bet she would be a proponent of I-1000 as well
“http://www.telegraph.co.uk/news/uknews/2983652/Baroness-Warnock-Dementia-sufferers-may-have-a-duty-to-die.html?source=EMC-new_19092008”
#5
Then go kill your self at a time place and method of your choice.
Called suicide.
Leave the govt. out of the choice completely.
Wealthy white people like this law – I guess it is the “ask permission” their mommies and dads always demanded. Still children inside.
I fear changes of mind, peer pressure and $$$$ cost of last years. Voting no, again. This has lost once.
I’m neither Catholic nor Mormon. Just this law is not needed at all, and the potential for abuse is obvious.
Lee and other proponents of I-1000 do have a peculiar focus on a very rare group of patients .
About 30 year Oregonians choose this option each year. So perhaps this legislation is just a wasted effort.
Actually, the real number maybe a lot less than 30. Under current law, without the intrusions of a second opinion and a psychologist as required by I-1000, a physician may offer a patient relief from pain and suffering, even if that relief entails death!. This scenario happens all the time. I suspect that some of those people now register their choice under the Oregon law.
I worry, that, as written, I-1000 may decrease freedom by inserting law where we do not need it.
Surveys and Devils
I am not a memeber of WMSA so I do not know what Elway poll Lee or Carol Ostrom is describing,
I wonder if we can obtain it? My hunch is that the poll did not specifically address I-1000.
The UW Opinion
I thought folks here might like to get some of the flavor of the current teaching on physician assisted suicide at UW.
This very well written and balanced material reflects my own experience with the subject. It may help Lee and other proponents realize how carefullyt this subject is delat with now. I worry that I-1000, wile meeting the needs of very few people, may screw up what is already a difficult process.
Do Oregon Docs Use the Law?
from an internal email at Kaiser:
This was 2002. I wonder if this has changed? BTW, I read that the average cost to kaiser of terminal care over six moths is $40,000. Since th prescription is less than $50, the incentive for profit is obvious. To the credit of Kaiser, how3ever, they are obviously not using their I-1000 to increase profits.
Has Oregon’s Lw worked?
The answer is not clear. What is clear is that a few physicians now seem t have become suicide specialists, that is people choose them when they want this option. It is also clear that noone is making a rigorous effort to be sure the plan is not abused.
To characterize physicians as a homogeneous group either voting for or against I-1000 would be like saying all women were Hillary supporters and now Sarah Palin supporters.
As for me, the one with the prescription pad, I still have great reservations about this. If this passes will there be a slippery slope to try and pressure all physicians to prescribing as is being done with emergency contraception?
I-1000 also seems to completely discredit the many successes of palliative care and hospice. Death can be dignified through comforting as supporting someone as their disease takes its natural course.
@18 Country Doc
Good post. I have been in this slot as a family member and have sat with many friends as they dealt with patients in the same position.
I think part of the problem here is that the proponents of !-1000 have very little trust in the system. They assume the worst. That is why I posted the link to the UW teaching materials.
Nothing else is dignified in our present day culture, why should death be?
@20 kirk
a FAR bigger issue in re dignity ad the end of life is impoverishment. I have had many friends and even family members from relatively affluent backgrounds meet with the geriatrics social worker and plan how to bleed themselves dry so as to provide terminal palliative care.
One thing that really frightens me about I-1000 is that ignores the likelihood that many will choose suicide over impoverishing themselves, their spouses or their family.
@15 Great link. I didn’t see a rebuttal to the “freedom” argument for PAS. That one tips the scale for me, leaving me pro I-1000. They also didn’t acknowledge, pro or con, that the Hypocratic oath has changed through the millinia. What would be today’s argument against changing it again?
http://www.scienceweek.com/2004/sa040917-6.htm
The hippocratic oath has NOT changed since it began being used in Med Schools around 150 yrs ago.
The argument against changing it is that is now a very good oath.
As you can see from the UW site there is no prohibition under WALAW or the oath against a doc using drugs to relieve pain and suffering, even if those drugs kill.
The ONLY folks I-1000 might help would be people told they have 6 months to live who are not depressed by this, who are not willing to have palliative care to re leave their symptoms.
Even then, under I-1000 these folks need to find two docs willing to prescribe the hemlock and be able to pass a psychiatric exam to show they are dying but not depressed by dying. Thse criteria may well be why so few folks in Oregon have used the mechanism.
@22 on freedom
I agree with you on this and if the thing were written better i would vote for it for that reason. But, to get my vote, the elgislation would need to
1. assure that the cost of terminal care is not an issue in making this decision.
2. take the doc out of the loop. The key issues here are not medical. It seems to me the best person to make this decision would be a judge. The law could require a person to demonstrate they have 6 months to live, have passed a psych evaluation, and have no legal entanglements such as terminal debts. Under the law, the judge would be required to certify a person a person meeting those criteria.
Another important website in re I-1000.
This is a real story about a physician who was jailed for TREATING a terminal patient in a way that accelerated their death.
The question in re I-1000 is whether it would have prevented Dr. Wetzels’ unfair prosecution (and conviction) or made it more likely?
I wold argue that I-1000 would make such suits MORE likely because,as is the case in Oregon, I-1000 makes what is now a tacit, personal matter into an affair of the public record.
Remember under I-1000 the Doc cannot write the script unless he can satisfy certain rules and even then he can not administer himself no matter the patient’s condition. Wouldn’t this law have implicitly criminalized what Dr. Wetzel did unless he got either:
a. proved that he had no intent of shortening life.
b. had gotten a second doc to agree on the pain meds even though they likely would shorten life.
c. had obtained a psychiatric consult from some person with the mysterious skill required to distinguish between depression and situational affect (depression due to the situation).
Dr. Wetzel’s conviction was over turned and it is my understanding that under current law he would no longer be charged.
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BOTTOM LINE:
Not all problems are improved by making our legal system more complex.
In this case no one has shown a demand for the service or that the current informal procedures by family and physician are not working.
The rule in medicine of “First do not harm” should apply to law as well!
@1 eridani
As I am sure lee knows at least some disabilities organizations oppose I-1000 for many of the same reasons I have stated already. They are concerned that I-1000 offers an incentive to shorten life rather than provide terminal care.
@24 “take the doc out of the loop” “best person to make this decision would be a judge”
Interesting. But who would provide the prescription? The court? Would a pharmacist realize the intent of the prescription and possibly refuse to fill it based on personal morals? It really is a can of worms. I’m glad I’m not dealing with this for myself or a loved one. Yet.
I reckon it might be better to be free under a poorly written law than to not be free under well written law. How is this law so badly written that it requires further relinquishment of this particular freedom?
@26 “They are concerned that I-1000 offers an incentive to shorten life rather than provide terminal care.”
Meanwhile, others are concerned for those who desire the freedom to choose and that, without passage of I-1000, there will not be access to humane means to terminate one’s life. Perhaps consensus can never be reached. If not all can be satisfied, consider erring on the side of freedom.
@13
I worry, that, as written, I-1000 may decrease freedom by inserting law where we do not need it.
Then why don’t you look to Oregon to find out if this is happening, Einstein?
@25
I wold argue that I-1000 would make such suits MORE likely because,as is the case in Oregon, I-1000 makes what is now a tacit, personal matter into an affair of the public record.
Then why don’t you look to Oregon to find out if this is happening, Einstein?
@26
They are concerned that I-1000 offers an incentive to shorten life rather than provide terminal care.
Then why don’t you look to Oregon to find out if this is happening, Einstein?
@15
I worry that I-1000, wile meeting the needs of very few people, may screw up what is already a difficult process.
Then why don’t you look to Oregon to find out if this is happening, Einstein?
Lee
Why I do not look into what is happening in Oregon?
Actually I did. What I found was somewhat disturbing. On the one hand a very small number of people are opting for this choice. The last estimate I saw was 30 but that is hard to evaluate since this may include people who would have achieved the same end w/o using the government program. So one would conclude either that I-1000 has had very little impact and therefore is harmless or that it simply is not needed.
On the other hand, I read a concern from some of the opponents that Oregon has not kept records. It is not even clear that there is a way of knowing whether the 30 prescriptions were ever used. I note that I-1000 does not require records either .. making the supposed safeguards dubious.
Another problem, contrary to your headline, is that apparently few Oregon physicians are willing to participate because there seem to be a very few doctors who actually write this and at least some of them are sponsored by the pro-PAS organizers.
I would, however. like to put this into context. I do not think I-1000 will do much harm in WASTATE because I feel my colleagues are too good to take the financial incentives implicit in the law.
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What bothers me most is not I-1000 itself but the unneeded cultural polarization when in-your-face legislation of any kind is proposed by the right or the left. Joel righlty complains about anticatholic bigotry of the pro-1000 forces. Is that sort of thing worht the small benefit I-1000 might offer?
This remonds me of Obama’s comment on right to life. Rather than fighting over choice v. right to life, BHO proposes that good people should work together to minimize the need for abortions and to assure good adoptions.
In the same spirit, it seems to me that a more meaningfil issue is terminal impoverishment. This is so common that there are people who make a profession of counseling end-of-life patients how best to work the system while hospitals employ social workers to squeeze those last few bucks out of people.
This odious practice is not limited to the “poor.” My own grandmothers and my wife’s father went through this process in their last days. Talk about cruelty!
So, Lee .. maybe we cna join together on part of this issue. Esp. if I-1000 passes, don’t you think we need legislation to isolate those ;ast six months of hell from insurance companies or social workers who make it worse?
Such legislation would seem to me be one of the first bebefits of health care reform. If we socialize the costs of health care, the at least this part of the picture would be a bit brighter!
No?
FWIW I visited he town of Albert’s birth. Ulm.
The town is, of course, now judenfrei. There was, however, a small monument to is most famous citizen near to where his home was.
As for any resemblance to Albert .. there is only my hairstyle.
Given the long fight we have had over this issue, how about betting a beer? I actually think it is going to pass but I will take even odds.
Lee
a good summary of the pro I-1000 POV appeared in Crosscut.
The issues I raised are not addressed but it does say that .. as one proponent said, the law has done more good than bad.
Worth reading.
21–the present financial crisis will finish bleeding what’s left of the middle class dry.