Yesterday’s testimony before the Health and Welfare and Judiciary Committees ended with Margaret Battin, a philosopher from the University of Utah who concluded in a 2007 study that “vulnerable groups” had not been harmed by the Oregon law or by the legality of assisted suicide and euthanasia in the Netherlands. The assisted suicide lobby has been touting that study ever since as proof that all is just fine in Oregon, and the study was what Battin produced yesterday to make the same point.
Senator Richard Sears asked Battin if there had been any work challenging her conclusions, and she admitted that there had been. She said the challenge had been to her not having been more concerned that depressed people are being given the lethal doses in Oregon and proceeded to say that depression does not necessarily make a person unable to make a rational decision about committing suicide. Until about a year ago, we thought that depression was a thought-distorting illness marked by suicidal ideation that should be treated. Since then, we have been hearing constantly that depression and rational decision-making on the very symptom of depression, the desire to commit suicide, can co-exist. We heard it in testimony from several speakers, not just Battin.
The article to which Battin referred did indeed assert that Battin had given too little attention to depression as a criterion of vulnerability, but it said far more. Here is a brief summary of it. The full article, “Legal physician-assisted suicide in Oregon and the Netherlands: evidence concerning the impact on patients in vulnerable groups: another perspective of Oregon’s data”, by G. Finlay and R. George of Cardiff University Velindre Hospital in Wales, UK, published in 2011 in the Journal of Medical Ethics, is available online for a charge from www.jme.bmj.org. Use the search engine on the site to find the article.
Finlay and George state that they disagree with the conclusions of the Battin study on four grounds:
- Battin defines the elderly as people over 85 and finds that those people are not at heightened risk as compared to people aged 18-64. Finley and George point out that people over 65 are generally defined as elderly in our society and note that Battin’s study does not mention at all the age group between 65 and 85. Finlay and George also quarrel with Battin’s comparison of natural death rates of people 85 and older with assisted suicide rates in that age cohort, pointing out that, “Since the death rates from non-PAS causes among persons aged 85 years or over are naturally very high, it follows that almost any rate of PAS in this age bracket is likely to show up as proportionately less than the rate of death from other causes.” In fact, they write, 68% of PAS deaths are among people over 65. The elderly do seem to be vulnerable to PAS.
- Finlay and George quarrel with Battin’s choice of which groups to investigate for vulnerability. For example, she investigates whether women are more vulnerable to PAS than men and finds that they are not. Finlay and George find her discovery unimpressive, since studies done all over the world have shown men are more likely to commit suicide than women. Battin cites the affluence and high educational level of PAS users as proof that the poor are not vulnerable. Finlay and George ask whether Battin has overlooked the possibility that there is a particular vulnerability among the affluent and educated, a vulnerability marked by an aversion to suffering, an isolating individualism seen as “dignity”, and a need for control. They believe Battin’s work may have been distorted by her seeing “the concept of vulnerability from one perspective only, as something to which only less educated or less wealthy persons might succumb.” They also suggest the possibility that Compassion and Dying, now Compassion and Choices, represented at the hearings by George Eighmey, may exert an unintended coercion on individuals they guide through the PAS process. Finally, they point to the coercive influence among the affluent of fashion and political correctness.
- Finlay and George question Battin’s conclusion that only the terminally ill are receiving PAS in Oregon, pointing out, as Dr. Bentz did in his testimony to Health and Welfare, that the Oregon reports are based on “voluntary” reporting by doctors who are motivated to state that they acted within the law; those same doctors label their patients as terminal. They note that one patient lived for three years after getting a PAS prescription; he was clearly not terminally ill when he got it. They point to the difficulty of prognosticating and also to the blurring, purposeful or not, of the boundaries between chronic illness and terminal illness; for example they note that “…illnesses such as multiple sclerosis, Parkinson’s disease and cardiopulmonary disease pretty well universally have a chronic and disabling prelude before they become predictably terminal as defined by less than 6 months to live.” Battin , they point out, discusses chronic and disabling terminal illness in a way that blurs the lines, if they can be drawn at all.
- Lastly, Finlay and George do point out, as Battin said, that some depressed patients seem to have received PAS.
It was clear from watching the members of Judiciary and Health and Welfare listen to the testimony of one expert after another that the committee members’ opinions on PAS had been formed and set in stone long before they heard that testimony. All of the members of both committees have strong and deeply held convictions on the issue. Health and Welfare did what it was expected to; it made the bill less safe than in any previous legislature and unanimously voted to send it to the floor of the Senate with a recommendation to approve. Judiciary will accede to the proponents’ desire to grant the measure a floor vote, but it will recommend, by a vote of 3-2, that the Senate reject it.
That Finlay and George disagree with Margaret Battin on the safety of assisted suicide seems worth pointing out, since Battin herself glossed over it in her testimony and since the Senate members who have declared themselves undecided may take the time to read her testimony. If they do, we hope they also take the time to read Finlay and George’s article.
The Burlington Free Press lists the following undecided senators: Sens. John Rodgers, D-Essex/Orleans; Don Collins, D-Franklin; Chris Bray, D-Addison; and Peter Galbraith, D-Windham. We have also heard from Senator Bob Hartwell, D-Bennington, that he has not decided how to vote.
These undecided senators will decide whether Vermont becomes only the third state in the country with legal assisted suicide. We elected them to represent us. Please, if you live in their districts, contact them. Make sure they read Finlay and George, not just Margaret Battin. Most of all, make sure they know what you think, so that they are able to act as your representatives. Tell them the elderly, the affluent, the depressed, the chronically ill and disabled, and everyone will be vulnerable and threatened if assisted suicide becomes legal. Ask them to vote against this dangerous bill.