Yesterday marked the six month anniversary of our state’s Death With Dignity Act. Compassion & Choices of Washington, a group that works to make sure the law works for both patients and doctors, announced that 16 Washington residents have passed away since taking advantage of the new law, 11 of whom actually used the prescription to control the time and manner of their passing. None of these events are cause for celebration, but merely a recognition that the terminally ill in this state have more choices than the residents of 48 other states, and that’s something that we should be proud of here.

Claudia Rowe covered the milestone nicely for the PI, but as she points out, opponents of the new law still aren’t doing a very good job of dealing with reality:

But no number of physician-assisted deaths — however small it may be — is small enough for opponents of the law. Eileen Geller, a hospice nurse and spokeswoman for True Compassion Advocates, believes that merely discussing the issue implies that hastening death is a valid option for the sick and vulnerable.

“It’s not just the few who have used this, but all the other Washingtonians who are receiving the message that they should die prematurely and unnaturally,” Geller said. “I’ve received calls from people who are worried and wondering, ‘Maybe I shouldn’t receive treatment. Maybe I should give up.'”

I have a very simple suggestion for Geller. Tell these people the truth. Tell them that giving people choices is in no way forcing them into a particular choice. Tell them that the law is not meant in any way to encourage people to die prematurely and unnaturally. Tell them that the law is meant for people who have very strong feelings about being able to control the time and place of their passing.

What’s most frustrating about this is that the reason that Washingtonians are “receiving the message that they should die prematurely and unnaturally” is not because of the law, but because people like Eileen Geller spent much of last year misleading people into thinking that that’s what the law was meant to do. It’s as if we pass health care reform this year, and then next year Sarah Palin finds that people keep telling her they’re worried about imaginary “Death Panels” and blames that phenomenon on Obama.

It’s one thing to be – like Palin – dishonest for the sake of your political prospects and potential income streams. It’s another thing altogether to be dishonest out of pure paranoia. If there are large numbers of people in this state having sleepless nights about the Death With Dignity law, it’s not the fault of the law. It’s the fault of those like Geller who act as if they’ll break out into hives if they simply tell the truth about what this law does and doesn’t do.

In the comments from Sunday morning’s post, commenter Roger Rabbit posted a link to another tragic drug war story that I haven’t covered here. It comes out of Kansas, where in late 2007 a pain doctor named Stephen Schneider and his wife Linda (a nurse) were rung up on a 34-count indictment related to prescribing more pain medication than the DEA allows. As Harvey Silverglate explains, this is an all-too-common occurrence:

When pain doctors administer too much of a controlled substance, or do so knowing that they will be diverted to narcotic addicts, they are deemed no longer engaged in the legitimate practice of medicine. But the dividing line is far from clear and not subject to universal agreement even within the profession. Any patient in need of relief can, over time, develop a chemical dependence on a lawful drug–much like a diabetic becomes dependent on insulin. And, once a treatment regimen begins, many patients’ tolerance to the drug increases. Thus, to produce the same analgesic effect, doctors sometimes need to increase the prescribed amount, and that amount varies from person to person.

It is notoriously difficult even for trained physicians to distinguish an addict’s abuse from a patient’s dependence. Nonetheless, federal narcotics officers have increasingly terrorized physicians, wielding the criminal law and harsh prison terms to punish perceived violators. Since 2003, over 400 doctors have been criminally prosecuted by the federal government, according to the DEA. One result is that chronic pain patients in this country are routinely under-medicated.

One notorious case along these lines was the prosecution of Richard Paey, a wheelchair-bound attorney in Florida who was originally given a 25-year prison sentence for forging prescriptions (he was pardoned by Governor Crist in 2007). Prosecutors tried to paint him as a drug dealer, but could never prove that he sold any of the drugs he obtained. Ironically, in prison, he was finally given the amount of pain medication he’d been trying to obtain for himself all that time.

Another person affected by this crusade against pain doctors is Siobhan Reynolds, whose husband died after spending years trying to find a doctor willing to treat his pain. Reynolds founded the Pain Relief Network in 2003. She’s been heavily involved in trying to raise awareness of the prosecution of Dr. Schneider, and because of that she found herself a target of the Kansas prosecutors as well. Silverglate writes:

When Reynolds wrote op-eds in local newspapers and granted interviews to other media outlets, Assistant U.S. Attorney Tanya Treadway attempted to impose a gag order on her public advocacy. The district judge correctly denied this extraordinary request.

Undeterred, Treadway filed on March 27 a subpoena demanding a broad range of documents and records, obviously hoping to deter the peripatetic pain relief advocate, or even target her for a criminal trial of her own. Just what was Reynolds’ suspected criminal activity?

“Obstruction of justice” is the subpoena’s listed offense being investigated, but some of the requested records could, in no possible way, prove such a crime. The prosecutor has demanded copies of an ominous-sounding “movie,” which, in reality, is a PRN-produced documentary showing the plight of pain physicians. Also requested were records relating to a billboard Reynolds paid to have erected over a busy Wichita highway. It read: “Dr. Schneider never killed anyone.” Suddenly, a rather ordinary exercise in free speech and political activism became evidence of an obstruction of justice.

Last Friday, after Silverglate’s editorial was printed, the judge in the case fined Reynolds for refusing to turn over the documents. She plans to appeal the ruling.

A few weeks back, I posted about my skepticism of what’s been happening with the investigation of Michael Jackson’s death and the attempts to charge his doctor with manslaughter. Cases like the one in Kansas are what formed my initial reaction to that news. The circumstances of the Michael Jackson case are quite different and bizarrely unique, but they also boil down to a prosecutor deciding that a doctor has done something so improper that it’s not only bad medical practice, but is actually a criminal act. And as this case out of Kansas has shown, it’s often the prosecutors who are a greater threat to the general public.

In the spirit of this post at EffU, I’d like to see who can come up with the funniest set of hypocritical statements from a wingnut blogger when it comes to the “George Bush is our President and we should respect him and everyone should shut up” and “Barack Obama should not be telling our schoolchildren to work hard” brain malfunction.

I generally don’t write about every single drug war tragedy that I come across, especially ones from outside of the northwest. They happen so routinely – whether it’s a botched drug raid against an innocent suspect, a police officer dying in the line of duty, or innocent people getting caught in the crossfire of competing drug gangs – that it would dominate this blog if I wrote about them all. But one that just happened in northeastern Georgia caught my attention for a couple of reasons and I feel like sharing some thoughts on this.

On September 1, a 28-year-old pastor named Jonathan Ayers was shot and killed by undercover police officers in the town of Toccoa, Georgia. The pastor had been seen driving a car with an alleged drug dealer as a passenger. After Ayers dropped off the suspect (a woman who has not been identified) at a gas station, the officers quickly pulled up in an Escalade and drew their guns (the CNN page has a good video from the convenience store surveillance camera). Ayers sped off as the plain-clothed officers discharged their guns at him. He was wounded from the gunshots and later died at a hospital.

If anyone is convinced that there was some dark side to this pastor, his blog should cast serious doubt on that notion. Reading his recent entries just made my heart sink. Ayers left behind a pregnant wife and was where I was a little less than a year ago, looking forward to ultrasounds and having those “oh shit, I’m going to be a dad” moments. It’s not clear why he had allegedly given this drug suspect a ride, but according to his friends, he considered it his Christian mission to help people, so it wasn’t uncharacteristic for him to be doing favors for strangers.

One post in particular, from only three weeks before the shooting, really struck me as well:

Scared as Crap

I got pulled over today for no insurance. I was like are you kidding? The deputy told me “no I am not kidding you have no insurance”. We both got on the phone and called the insurance company to figure this whole thing out. They told the deputy that I had a policy but no vehicle’s was on the policy. I was like what kind of policy do I have? So we finaly got it fixed.

I left there and I wandered how many people go through life and think they are ok because they are a good person, have done some good deeds, and they aren’t as bad as some other people. Here’s the thing they don’t know Christ! They have never started a relationship with Jesus. One day they will stand before God and He will say “depart from I never knew you”. They are going to be in for the sadest day of their life. Don’t miss Jesus because you think you are good enough!

I’ve seen several comments to the articles I’ve read about this incident saying things like “well, why did he speed off if he was innocent?” The post above should answer that question completely. Only three weeks before he was killed, he was this rattled from a routine traffic stop. It shouldn’t surprise anyone that the sight of several non-uniformed individuals getting out of an Escalade with guns would have scared him enough that he’d choose to drive away as fast as possible.

It’s not likely that an atheist from the Pacific Northwest is going to change the way the drug war is fought in rural Georgia, but every tragedy in this war weighs on me and hardens my determination to start the dominoes falling where they’re most likely to tip over. This one in particular. While religion has never been a part of my life, I couldn’t help but notice that Ayers’ determination as a Christian mirrors my own determination in this battle. And our underlying motivations are largely the same, to build a better society and to promote peace. I hope that Jonathan’s family can find peace in this tragedy and that Americans of all stripes will take a long look at what this war is doing to us.

Last week’s contest was won by ‘waguy’. It was Long Island MacArthur Airport in Ronkonkoma, NY. If you want to keep up with what areas are being added to the Bird’s Eye View image server, you can check out this page, where the Bing team is releasing monthly updates.

Here’s this week’s, good luck!

Earlier this week, the Montana Supreme Court heard oral arguments in the Death With Dignity case that is expected to uphold a District Court ruling from last December that found that patients have a right under the Montana State Constitution to request medication that aids in dying.

Washington’s law has been in effect for six months now, and the main issue in that time has been the question of whether Washingtonians in certain areas can find doctors who will allow them to exercise their rights. In Montana, which is even more vast and rural, this will almost certainly be an issue as well. I touched on that issue very briefly here and had some back and forth in the comments, but Jacob M. Appel covers it far more extensively here at Huffington Post:

Janet Murdock learned this awful lesson the hard way. The sixty-seven year old Missoula woman, who suffered from advanced ovarian cancer, initially believed that Judge McCarter’s ruling would guarantee her the death that she desired. Instead, she spent her final months trying to find a local doctor willing to help her die — eventually giving up food and water when no physician in the entire state proved willing to supply her with a lethal dose of medication. Her desperate efforts certainly were not aided by the Montana Medical Association, which issued a policy documented declaring aid in dying a violation of professional ethics, or that group’s president, Kirk Stoner, who has championed an absolutist, anti-assistance position on the issue. In response, before her death in June, Murdock released a statement that read: “I feel as though my doctors do not feel able to respect my decision to choose aid in dying…Access to physician aid in dying would restore my hope for a peaceful, dignified death in keeping with my values and beliefs.” The challenge for those on both sides of this issue is how to balance the “values and beliefs” of desperate patients like Murdock and Baxter with those of medical professionals who are personally opposed to easing their deaths. Our society will soon be forced to adjudicate these competing claims: Which right trumps? The patient’s right to die or the doctor’s right to follow her conscience?

The ongoing public debate over “conscience” clauses, which permit individual health care providers to opt out of medical practices to which they are morally opposed, has until now been confined primarily to issues of reproductive freedom. Pharmacists who refuse to fill prescriptions for emergency contraceptives have become lighting rods in the debate over religious freedom and women’s health. A critical shortage of abortion providers has led some progressive commentators, including myself, to call for mandatory abortion training in obstetrics residency programs. However, even those policy-makers who support conscience exemptions in these areas should be able to recognize the fundamental difference between pharmacists who refuse to fill birth-control prescriptions and the physicians who would not help Janet Murdock to die. A handful of rogue druggists may certainly impede access to contraception — but all pharmacists do not oppose RU-486. A shortage of abortion providers, while deeply troublesome, is not the same as a complete, state-wide absence of abortion providers. If Montana doctors can act on their consciences, patients wishing to die will not merely have to endure additional burdens to vindicate their rights. Rather, they will have absolutely no means to effectuate them. Much as constitutional guarantees of press freedom do little good for prospective publishers if they do not have access to paper or ink, the right to aid in dying is strikingly useless if nobody is willing to help.

The legal profession long ago recognized that if our judicial system is to function meaningfully, all criminal defendants — even the most distasteful — should be entitled to representation. As a result, states provide attorneys for those who cannot find them on their own, and judges occasionally compel individual members of the bar to represent the interests of unpopular defendants. In contrast, doctors have rather stubbornly clung to historic notions of professional autonomy. These arguments might hold more sway if physicians operated in an open marketplace and if anyone with the appropriate knowledge and skills could practice medicine in the United States. In reality, medical licenses are a limited commodity, reflecting an artificial shortage created by a partnership between Congress and organizations representing physicians — with medical school seats and residency positions effectively allotted by the government, much like radio frequencies. Physicians benefit from this arrangement in that a smaller number of physicians inevitably leads to increased rates of reimbursements. There’s nothing inherently wrong with this arrangement. However, it belies any claim that doctors should have the same right to choose their customers as barbers or babysitters. Much as the government has been willing to impose duties on radio stations (eg. indecency codes, equal time rules) that would be impermissible if applied to newspapers, Montana might reasonably consider requiring physicians, in return for the privilege of a medical license, to prescribe medication to the dying without regard to the patient’s intent.

Mandating that physicians aid in dying should be a last resort. First, Montana should explore other, less-invasive means of ensuring that all citizens are guaranteed their constitutional right to die. One solution might be hiring a handful of publicly-salaried physicians, recruited from out-of-state, whose primary responsibility would be to offer palliative services, including lethal prescriptions, to the terminally ill. Another possibility would be easing licensure requirements for out-of-state physicians, particularly those from Washington or Oregon, who come to Montana on a short-term basis solely for the purpose of helping the terminally ill to die. Finally, the state might simply scrap its general requirement for physician-issued prescriptions in cases of terminal illness, instead providing both drugs and instructions directly to dying individuals or their families. In short, the state should think creatively about ways to ensure that the terminally ill do not suffer without taking the drastic step of forcing doctors to assist in dying.

The right to die is not an abstract principle. This right — or its absence — has a profound effect on the fundamental welfare of nearly every individual and family in the nation during the most vulnerable moments of their lives. If the Montana Supreme Court guarantees citizens the right to aid in dying, and I am both hopeful and confident that the court will do so, then it is also incumbent upon the justices to ensure a mechanism by which patients can exercise their rights. To do otherwise — to offer a theoretical right to die that cannot be meaningfully exercised — will be both a hollow gesture and a cruel taunt to the terminally ill.

The Cannabis Defense Coalition has adopted a highway (SR 169 in Maple Valley):

Their court calendar is pretty busy as well. Here are the upcoming court dates they’re observing:

Tuesday, September 8 – 9am
Douglas County vs. Hubert Mangum

Wednesday, September 9 – 9am
Grant County vs. David Hagar

Monday, September 14 – 9am
Mason County vs. John Reed & Karen Mower

Monday, September 21 – 9am
Kitsap County vs. Lloyd Stillson

Some background on two of the cases here. Please contact the CDC if you’d like to be an observer for any of these court dates.

– Radley Balko discusses the lawsuits against Seattle-area police agencies by Somali immigrants who were targeted in an effort to crack down on the use of khat, a mild plant-based stimulant popular in East Africa and the Middle East. Charles Mudede wrote about the war on khat back in 2007.

– The Spokesman-Review writes about the legal troubles that two medical marijuana providers from the Spokane area are facing. These two men are openly defying the one-patient-per-provider statute of the medical marijuana law, but this restriction can make it very difficult for new patients to obtain marijuana (as Dale Rogers put it at the patient Hempfest panel, if you’re 70 and you’re diagnosed with cancer, you don’t have time to learn how to be a gardener). And not everyone can find someone willing and able to grow for them. People who are told by their doctors that marijuana might be beneficial still have to resort to the black market – especially when the people who are willing and able to provide for multiple patients are arrested.

Despite the arrests in Spokane, a group in Richland is requesting the ability to open up a dispensary, but were told by the City Attorney to take it to the Legislature, which failed miserably in its attempt to improve the law in 2008.

– Gene Johnson from the AP writes about the world of helicopter smuggling along the Washington-British Columbia border.

– John H. Richardson from Esquire talks to a member of Law Enforcement Against Prohibition and outlines the argument for legalizing drugs from the standpoint of saving lives and keeping communities safe. Predictably, Mark Kleiman takes the bait and makes a fool of himself. Pete Guither hammers him pretty good here, but Kleiman responds with an update where he writes:

My objection is to the claim that there’s a hideous monster out there called “prohibition,” and that the main drug policy task is to slay that monster with the magic sword of “taxation and regulation.” That claim is just as stupid as the drug-warrior claim that there’s a hideous monster out there called “drugs” and that the main drug-policy task is to slay that monster with the magic sword of a “a drug-free society.”

First of all, both “prohibition” and “drug abuse” are “hideous monsters”. Prohibition is such because it takes a commodity that has significant demand from both responsible adults and people with addictions and hands it to criminals who have significant income with which to fight over their share of the marketplace. Drug abuse is a “hideous monster” because human beings are flawed creatures who often make mistakes and end up without the control to help themselves overcome an addiction. Both are things that we need to deal with as problems in our society, but the important difference is that one of the two is a basic human tendency that we can’t stop while the other is a creation of government that we most certainly can stop.

Second, one only needs to look at the example of alcohol prohibition to see where the “magic sword of taxation and regulation” has slayed the monster of prohibition. No one is arguing that people will never die from overdoses or from driving while intoxicated if we end prohibitions on other recreational drugs. What’s being argued is that the collateral damage of the cat and mouse games we play with the criminal enterprises who distribute and sell them (our massive murder rates and our unsustainable and self-perpetuating prison overcrowding problems) far outweigh mild upticks in drug addiction rates. And there’s absolutely no clear evidence that drug addiction rates would even go up, especially if you enact smart regulations.

Yes, alcohol kills many, many people every year – from drunk driving accidents to liver diseases – but liquor distributors don’t get shot by the police or by competing liquor distributors, and law enforcement officers don’t get shot while raiding speakeasies and backwoods stills. This is because of the magic sword of “taxation and regulation”.

And finally, the latter part of the analogy doesn’t even make sense. “Taxation and regulation” is a means for achieving an end, while “a drug-free society” is an end with no realistic means for achieving it. Mark can keep pretending that the people who advocate for drug legalization collectively envision some spiritual nirvana that can only be achieved by legalizing drugs, but the reality is that the people who advocate for legalizing the use and regulating the distribution of currently illegal drugs – whether they be law enforcers like the folks in LEAP or computer geeks like me – do so because it appears to be the most progressive, most cost-effective, and most humane solution to the problem of drug abuse in our society. All of us recognize that even when you do it, people will still have drug problems and people will still die of drug overdoses. But as we’ve already seen in places that have taken incremental steps toward legalization – especially in places that have stopped treating heroin addicts as criminals – we tend to see fewer deaths from overdoses, not more. And the collateral damage from people who decide to buck the regulations tends to be negligible, and don’t usually end with people being shot.

At this point, I don’t know if anyone still considers Kleiman an authoritative source on this subject. I’d be curious to know how the panel he was on at Netroots Nation ended up, but it’s just sad to see him repeatedly breaking out this obnoxious strawman in order to belittle those who have come to a very reasoned and very rational conclusion that prohibition is an ineffective government solution for drugs that have an established level of popular demand.

Carl and I met up with Demo Kid last night and made it out to the big event. So did Eli Sanders.

I have some family in town this weekend, so I haven’t had any time to blog, but something happened today while driving out to Snoqualmie Falls that just baffled me. We were driving south on I-5 past the 45th/50th St exit when an SDOT-type vehicle (the ones with the big flashing signs on top) got on the freeway and immediately started to swerve wildly across the four lanes of traffic back and forth. Somehow, the vehicle didn’t crash into anyone, but the cars on I-5 were all slowed to well below the speed limit. I quickly got over to the left lane and took 520 instead of 90 so I don’t know if there was anything ahead on the freeway. Does anyone know what the fuck was going on?

UPDATE: Response from SDOT here.

Last week’s contest was won by Deathfrogg. It was the transplanted London Bridge in Lake Havasu City, Arizona.

Here’s this week’s, good luck!

– I just finished reading David Neiwert’s new book The Eliminationists. It’s a very timely book, especially with all of the ridiculous comparisons people are making to Nazi Germany these days. Very few people seem to know the reality of what fascism was and how it came to power. At its core, it was a movement about cultural purity and national renewal. It was fed largely by a militant opposition to modern democratic ideals, civil liberties, and multiculturalism. The idea that it’s comparable to modern American liberalism is a notion so absurd that it really doesn’t even warrant serious discussion, yet it remains a constant theme on talk radio and even cable news. David is careful not to use the term fascist too broadly to describe the elements in our society that tend to exhibit traits similar to what bubbled to the surface in Italy and Germany in the early 20th century, but his book is a must-read for Americans who really want to understand that time in history and to be mindful of what could happen here.

– The idea of boycotting Whole Foods over CEO John Mackey’s somewhat clueless op-ed is probably the dumbest thing I’ve heard from progressives since they confused Don Imus with David Duke. For a good rebuttal to Mackey, Ezra Klein has a nice analogy here comparing markets for food with how we should approach health care by integrating public assistance with free market competition. But even though I don’t agree with Mackey’s ideas, he really wasn’t being an ass. If I boycotted every company with a CEO who bought into goofy libertarian groupthink, I’d quickly die of either starvation or boredom.

– On Sunday, The Seattle Times’ Ryan Blethen wrote the following:

Journalists have the right to write pointed critiques or damaging stories. This is never done lightly and must be backed up with fact. What we do can alter somebody’s life for better or worse. Almost every professional journalist is careful not to abuse this right of free speech.

There is nothing wrong with pushing the limits of the First Amendment, but there is a line where free speech can go too far and real damage is done. Bloggers are writing past this line and finding themselves in trouble.

I’m surprised that Goldy hasn’t responded to this yet (and maybe he still will), but I wanted to point out one thing. Everyone – not just journalists – have the right to write pointed critiques or damaging stories. For some reason, though, I always thought that journalists had an obligation to do it. I’d always thought that journalists exist to expose the corrupt, to explain the elusive, and to tell the truth in a world where many powerful people find comfort in lies. Journalists are supposed to be unpopular to the powerful, not their spokespersons. Maybe if the Times actually understood how profoundly they’re failing in their role as journalists, it would be easier to understand why so many bloggers are trying to fill the gap.

– Argentina’s Supreme Court ruled that it’s against their Constitution to arrest people for the personal use of cannabis. This is following the long-awaited decriminalization of drugs in Mexico, something that Bush Administration officials had actively prevented them from doing in the past.

– I haven’t written about it much, but I’m very concerned about the overuse of Tasers in what should be normal law enforcement activities. That said, I have no problem with repeatedly Tasering the people at TLC who brought us Police Women of Broward County.

Here are some drug war items I’ve wanted to write full posts about but haven’t had the time:

– Anthony Citrano writes about the latest wave of medical marijuana raids in Los Angeles. According to Attorney General Holder’s previous statements, federal authorities wouldn’t be targeting any establishments that are complying with state law. Unfortunately, many of these raids are happening without any disclosure of what state law the establishments are being accused of violating. For Obama’s policy to provide any real protection for legal dispensaries, there needs to be that level of transparency to ensure that the DEA isn’t violating it.

– The saddest part of the attempts to raid medical marijuana dispensaries is the fact that California is desperately trying to figure out how to fix the problem of its overcrowded prisons. Even worse, Governor Schwarzenegger is still trying to increase funding to anti-drug units. I just remember back in 2003, when I was in Belgium and I told a group of people I was having drinks with that Arnold Schwarzenegger might be the next governor of California, and they were all shocked. At the time, I wasn’t as alarmed as they were that a brain-dead action movie star would be running the largest state in the country. Maybe I should have been.

– I was never much of a Michael Jackson fan, so I didn’t pay much attention to the news surrounding his death, but the fact that they may charge one of his doctors with manslaughter certainly has my attention now. How doctors treat people with chemical dependencies or how they subscribe potentially addictive opioid medications is a very touchy subject where prosecutors and judges often decide that they have better judgment than a physician. It’s still way too early to know what the doctor in this case was doing, but I have trouble believing that he could have been doing anything that warrants a manslaughter charge.

– This week’s drug war outrage comes from Florida, where a man named Donald May spent three months in jail for being in possession of breath mints. The arresting officer claimed the breath mints were crack-cocaine. The officer involved also lied in his report, claiming that the man admitted to buying crack. In the three months he was in jail, they auctioned off his car. He’s now suing. [h/t to the Crackpiper]

– Toby Nixon and Jeanne Kohl-Welles write in the Seattle Times in support the State Senate bill to decriminalize marijuana.

– In Bolivia, where President Evo Morales kicked out the DEA but still claims to oppose cocaine trafficking, there’s a new bar gaining some worldwide notoriety.

Last week’s contest was won by mlc1us in an impressive 19 minutes. The view was of Tokyo, and the link is here.

Here’s this week’s contest, good luck!