The End for ‘Brittany’s Bill’? Legislators Balk at Doctor-Assisted Suicide for the Terminally Ill

By Katherine Seligman

Brittany Maynard’s battle with virulent brain cancer was compelling and heartbreaking, but today it wasn’t enough to sway key California lawmakers. Her decision to end her life last year at age 29 galvanized a campaign to make it legal for doctors to prescribe lethal drugs for terminally ill patients, but this morning the sponsors of the End of Life Option Act shelved the bill until next year, acknowledging that for now, they lacked the votes to secure passage in the Assembly Health Committee.

“I am not deterred,” says Brittany’s husband, Daniel Diaz, who was in Sacramento for the hearing. “This makes me more determined. I have faith in this bill.” 

Sponsors Democratic Sens. Lois Wolk of Davis and Bill Monning of Carmel released a statement saying they would “continue to work with Assembly members to ensure they are comfortable with the bill.” But supporters also haven’t ruled out the possibility of resorting to a ballot initiative if the Legislature fails to act. “All options are open,” says Diaz. “In the end, polls show the public support is there.”

Among opponents warning that the bill would have detrimental, even if unintended, consequences: the California Catholic Conference and the disabilities rights group Not Dead Yet.

Maynard, a Cal graduate, became the very public face of the debate after she moved to Oregon, one of five states allowing physicians to help the terminally ill end their lives. “I did this,’’ she said, ‘’because I want to see a world where everyone has access to death with dignity, as I have had.”

Her story—how she was diagnosed shortly after marrying fellow UC Berkeley alum Diaz, painstakingly researched the disease, and ultimately decided to end her life in November when her suffering was unbearable—made the cover of People magazine and traveled around the world.

“It’s the prom­ise I made to Brit­tany be­cause I also be­lieve that no one should have to go through what she went through. To have to up and move, in the middle of the chaos of be­ing told you are ter­min­ally ill, no one should have to do that.”

“She opened the eyes of Californians and opened the conversation,” says Patricia Gonzalez-Portillo, a spokeswoman for Compassion and Choices, a nonprofit orchestrating the fight to pass the bill. “She left a legacy for us and I’m sure she would be proud to see the progress.”

Diaz had been getting to work as a market researcher at 7 a.m., coming home at 6 p.m., and spending the next five hours glued to his computer, writing editorials, arranging meetings and interviews. “It’s the promise I made to Brittany because I also believe that no one should have to go through what she went through,” he says. “To have to up and move, in the middle of the chaos of being told you are terminally ill, no one should have to do that. …This legislation doesn’t result in more people dying. It results in fewer people suffering.”

Opponents have been equally busy. An array of religious organizations and disability rights groups have spoken to Assembly members.

Los Angeles Archbishop Jose Gomez has said the measure has “dangerous implications” for the poorest and most vulnerable citizens. His concern was echoed in a statement by Ned Dolejsi, executive director of the state’s Catholic Conference: “We understand and share the concern for the dying expressed at today’s hearing.  It is a natural impulse for human beings.  But when someone asks for assistance in killing themselves, it is really a call for help, care and compassion during the dying process. California law already allows for patients to refuse extraordinary care, but that is a far cry from aiding a patient in actively ending his or her life.”

“If these bills pass, some peoples lives will be ended without their consent, through mistakes and abuse,” Marilyn Golden, a senior policy analyst in Berkeley for Disability Rights Education & Defense Fund, has said.

Diaz, who also recently spoke at the Aspen Institute, has been talking to legislators, joining Maynard’s mother and others in all-out push for the bill.

Last week, labor and civil rights activist Dolores Huerta added her support, talking to Latino committee members who balked at voting for it. “This is an important measure that really gives families and individuals the right to make that choice if they want to end their lives with dignity when they know that otherwise it would be very torturous and terrible thing for them to go through,” she said. “This is a responsibility of the Legislature in a democratic process to give people that right.”

The practice remains so controversial that there is not even agreement over how to refer to an end of life decision—opponents call it “assisted suicide” while  supporters prefer the terms “death with dignity” or “physician-assisted death.” Leaders on both sides even attack each other’s terminology as offensive: Proponents of the measure say labeling it “assisted suicide” ignores the fact that terminal patients have no choice about whether to die, only the time and circumstance of their end. Opponents say labeling it “death with dignity” insultingly implies that terminal patients who choose to fight for every moment of life are somehow foregoing a dignified end.

Call­ing the prac­tice “the slip­per­i­est of slopes” that would make people “mis­trust a health-care sys­tem un­der con­sid­er­able pres­sure to drive down costs,” he notes that in the past 20 years, all but three of the more than 100 as­sor­ted state cam­paigns to leg­al­ize the prac­tice have failed.

The End of Life Option Act would allow mentally competent adults who are diagnosed as terminally ill to request a lethal prescription. Unlike Oregon’s law, it would give pharmacists, as well as doctors, legal immunity and requires that non-English speakers be provided with translators. It also would allow individual physicians and hospitals to elect not to participate—which helped convince the California Medical Association to switch its historical opposition and instead become officially neutral on the bill.

The amended version bill passed the California Senate before running into serious obstacles in the Assembly .

“Proponents who favor placing society’s stamp of approval on suicide find themselves increasingly on the losing end of public debate,” argues Aaron Kheriaty, associate clinical professor of psychiatry at the University of California at Irvine. Calling the practice “the slipperiest of slopes” that would make people “mistrust a health-care system under considerable pressure to drive down costs,” he notes that in the past 20 years, all but three of the more than 100 assorted state campaigns to legalize the practice have failed.

In a recent poll of state voters sponsored by Compassion and Choices and conducted by two independent opinion research firms, 69 percent said they approve of the bill. So, too, did religious groups: 60 percent of Catholics, 65 percent of non-evangelical Protestants and 57 percent of evangelical Christians. And a majority of all ethnicities—including 70 percent of Latinos—were in favor.

A Gallup Poll conducted in May found that 68 percent of respondents nationwide supported a patient’s right to assisted death. In its analysis, Gallup noted the influence of Brittany Maynard in the national conversation. “The larger effect that Maynard’s story will have is uncertain, but some notable changes in support are evident compared with last year,” the analysis said. “The percentage of young adults aged 18 to 34 who support doctor-assisted suicide climbed 19 points this year, to 81%. Young adults are now significantly more likely than older U.S. adults to support doctor-assisted suicide.”

Members of the committee, particularly Latino and Catholic members, remained apprehensive. But Diaz, who is Cuban American, had said he is cautiously optimistic: “That is my demographic. They are thinking, wait a second, if this happens to them, or someone in their family, then of course that person needs to be the one controlling the process.” 

After shelving the legislation, sponsors Democratic Sens. Lois Wolk of Davis and Bill Monning of Carmel released a statement saying they would “continue to work with Assembly members to ensure they are comfortable with the bill.”

 

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One problem not mentioned here is that if a cure is right around the corner, the decedent will not be able to take advantage of it. This appears to be the case with Brittany, in fact, because in its March 27, 2015, episode, “60 Minutes” reported that researchers at Duke Medical School have been successfully shrinking the aggressive Glioblastoma multiforme brain tumors—like Brittany supposedly had—by injecting polio virus. There are hundreds of papers about the promise of oncolytic viruses. I say “supposedly” because I am Brittany’s aunt—Alison Maynard—and have researched her “suicide” extensively. I have substantial evidence that it is a hoax, or psy op. Not only is there the problem of a cure having been available, but many other things do not add up, such as the use by the mass media of photos of models who are NOT Brittany; a funeral home and a doctor who signed her death certificate without ever seeing a body; no funeral being held; a voting registration secured before she was supposed to have moved to Oregon; an uncle in military intelligence; the fact that it is not even legal, under Oregon law, for an Oregon doctor to prescribe lethal medication when he or she has not made the initial diagnosis of a terminal condition; and much more. I have written a blog post about my findings, which is at: http://therealcolorado.blogspot.com/2015/02/brittany-maynard-my-undead-n... There are powerful interests pushing assisted suicide, such as George Soros, who is funding Compassion & Choices. California legislators will be wise to resist this move.
This post is full of accusations and short on evidence. What are the verified sources? The demonization of George Soros at the end reveals the author’s right-wing bias (and proclivity for conspiracy theories). Perhaps Alison can explain what Mr. Soros has to gain from “pushing assisted suicide.” Meanwhile, who should decide what risks to take about a possible “cure right around the corner?” Shall it be the patient’s relatives? The Government? The Catholic Church? Those of us truly committed to individual liberty would leave that choice to individual patients.
You obviously haven’t reviewed my blog post. That’s where you will find the “verified sources”: I’ve relied almost exclusively on public records. And, far from being a right-winger, I’m a member of the Green Party. I just don’t like anyone manipulating legislation under false pretenses. There are, indeed, many conspiracies and hoaxes being thrust upon the public on an ongoing basis by the mass media. You would do well to inform yourself about them. Here’s a good video about the Sandy Hook psy op, to get your feet wet, called, “We need to talk about Sandy Hook”: https://www.youtube.com/watch?v=IxTafqejV6k
Your “Sandy Hook” (school shooting) conspiracy video makes my point. A good insight into your thinking. It also has nothing to do with our topic. I suppose you also have a video about the planned invasion of Texas. Instead of ad hominem attacks on George Soros and others, how about actually discussing the issues? Here’s my concluding question again: “Who should decide what risks to take about a possible ‘cure right around the corner?’ Shall it be the patient’s relatives? The Government? The Catholic Church?” Those of us who support Death with Dignity legislation (and all the safeguards therein) seek the freedom to make end-of-life decisions for ourselves. We impose no ideology and no decisions on you. Can you offer a serious (non-conspiratorial) response?
Sure. Go stick your head in the oven and leave the rest of us alone.
My question was uncomplicated. It’s a serious policy issue. I was asking for reasoned discussion on the merits. Meanwhile, you refer to yourself as a “Green Party” member. The Green Party in Canada (which actually has voting members in Parliament) recently made this statement: “A movement for Dying with Dignity has gained substantial public support across Canada, and that support base includes the Green Party. Advances in medical care can keep human beings alive much longer when, in the past, the limits of technology allowed death to provide relief. Those in unbearable pain at the end of their lives have repeatedly sought a court ruling that the provisions of the Criminal Code, prohibiting physician-assisted death must be adjusted … Green Party MPs will support changes to the Criminal Code to allow for physicians to assist death in limited cases and circumstances involving adults with full mental capacity to consent, in situations of terminal illness and who find their situation unbearable.” See http://www.greenparty.ca/en/policy/vision-green/people/dying-with-dignity. The Green Party in California has made a comparable statement: “Allow mentally competent Elderly people the right to ask their physician for assistance with ending their lives in the event of a terminal medical condition … See http://www.cagreens.org/platform/elderly. Perhaps you are a different hue of “Green.”
Yup, guess I am. I will work on them. Legalizing their prescription of lethal drugs muddies the waters for doctors. Instead of trying to save lives, they will be pressured to inform patients how to end it all. The point about oncolytic viruses curing cancer is a valid one. We’ve already read about the Oregon woman who received a letter from her insurance company denying coverage for an experimental treatment for her disease, instead advising her about the lethal medication she could take to end her life. Start totting up the “cui bonos” from this legislation. First and foremost are the beneficiaries of the sick person’s life insurance policy. Assisted suicide is legally treated as a death from natural causes, so those beneficiaries can still get the money. That’s the reason for this legislation. There is no question that this is part of a eugenics movement. I’d just like to know how come Henry Kissinger and David Rockefeller are still alive. Rockefeller reportedly bounds up stairs like a teenager, at age 100. You can bet that this “option” of doing away with oneself is not for the likes of them. Why can’t the rest of us get what they got? By the way, this discussion should really take place on my blog, not in this comment section, so this will be the last one I write.
I think others should see your reasoning here. It’s a conversation you started. Your Oregon example wasn’t a woman; it was a man (see the video “Death in Portland”). He rejected the Death with Dignity option (as was his right) and the insurance company decided to provide coverage after all. He died shortly thereafter. Please note in this regard that the people in Oregon have rejected at least two efforts to repeal their law. It has ample safeguards against elder abuse (see the related statement of the California Green Party) and no one has reported even a single instance of “beneficiaries” inducing patients to invoke it. Why should beneficiaries do so? Two physicians must certify the patient will die within six months anyhow. Meanwhile, your references to Kissinger and Rockefeller literally make no sense. It’s another example of delusional conspiracy thinking. Do they have a secret “fountain of youth” potion? Don’t keep us in suspense! Drop the innuendo and speak plainly. Finally, the next time you associate yourself with the Green Party, it would be intellectually honest to point out that you reject the Green Party position on the subject you’re discussing. It’s now clear to anyone reading these posts that you’ve been caught trying to mislead us.
Gary Pavela, Writing from Norway (I’m a Norwegian doctor (neurologist) aged 46 and an humanist/atheist), the debate concerning assisted dying legalization in California is of interest to us as well. One particular point worth noting is the criterion, fetched from the “Oregon model” of physician-assisted suicide (PAS), that the patient must have less than 6 months to live to qualify for PAS. This is thought to restrict PAS to only patients with a terminal illness; i.e. to provide PAS for only those who will shortly die, one way or the other. However, any sound doctor should acknowledge this: It’s virtually impossible, except in some few particular conditions, to make a prognosis concerning length of remaining life in the scope of 6 months. Even though statistical predictions might be made, for instance for certain forms of cancer, these are made for the group of patients, and cannot be utilized for individual cases. At least not with any measure of reliability. Experienced health personnel can recognize that a patient is going into the terminal phase with a few weeks left to live, or perhaps a swiftly progressive course that will lead to death within a few months. But 6 months is too long - if a patient appears to be able to live for (say) 5 months, then she’s vital enough to survive for maybe 7 or 9 months - or she may deteriorate suddenly and die within the months. This means that the “six months left to live” criterion is false and useless as some kind of stringent demarcation of PAS. Rather, it leaves the judgment to the physician(s) and his personal view of whether PAS should be given to this patient or not. Such a decision would be extremely hard to second-guess by the authorities, in retrospect when the patient is already dead. Therefore, this law puts (too much) power into the hands of doctors: The power to decide, based on personal opinion, which patients should die, which should be denied assistance in suicide - and with impunity from the law (how many Oregon doctors have actually been prosecuted for errors in their practice of PAS so far?). One striking example of this is the death of the “father” of the “Oregon model”, dr. Peter Goodwin, who took his life using the very law he himself championed. This is described (among many places) here: http://www.npr.org/2012/03/12/148459270/assisted-suicide-advocate-uses-l... Note the words of dr. Goodwin: “And so I’m going to try and have a six-month prognosis…” Dr. Goodwin was said to suffer from the rather rare neurological illness Corticobasal degeneration (CBD). He featured in a video filmed a short while before his death (http://healthland.time.com/2012/03/14/peter-goodwin-the-dying-doctors-la...). Now, I cannot make a prognosis based simply on a video film. However, for me as a neurologist, it seems very strange (I would say: not possible to accept) that any doctor could accurately prognosticate death within six months for dr. Goodwin, given how he appeared in that film. Sure, he might have died within six months, if he acquired pneumonia and refused antibiotics. But I wouldn’t be surprised if he could have lived for at least a few years more. The point is: Dr. Goodwin wanted to be classified as having < 6 months to live - and he obtained it. The obscurity of the law’s criterion enabled his doctor to comply with his patient’s wish - effectively out-sourcing the power over life and death to the doctor. California’s lawmakers should be aware of this: By copying the 6-months criterion from Oregon, they give doctors (and which doctors? what qualifications would be required? how should the doctors’ judgments be scrutinized, or tried by the authorities?) the power to decide who shall live and who shall die. Do they trust doctors that much? Not to mention the cruelty of allowing one patient (who was “lucky enough” to obtain a prognosis of < 6 months) the option of dying peacefully with the aid of a lethal drug. While another patient, with a painful and debilitating disease (like multiple sclerosis, or traffic accident survivors) must be denied this option, and must either live on in pain and indignity, or commit suicide by one of the “usual” and frequently brutal and degrading methods.
The woman I referred to was named Barbara Wagner and I read about her story here: http://www.firstthings.com/blogs/firstthoughts/2015/06/i-dont-find-digni... Neither the Green Party’s position on assisted suicide, nor my association with the Green Party, is relevant to this discussion. I’ve noticed that you set up straw men, and punch them down, as a substitute for responding to the real points in issue. You are particularly fond of in personam attacks.
Oops—I meant “ad hominem,” not “in personam.”
These are good points. Your story about Dr. Goodwin suggests to me that may have been another hoax. As to your point about doctors being immune from prosecution under Oregon law, I would add that I was denied all records from the doctor, as well as from county health authorities, relating to Brittany’s “death,” even though I am her aunt and a dead person has no privacy rights. I did seek investigations of this doctor, as well as the funeral home, which were rebuffed. As to the doctor, he is not an oncologist, which indicates right off the bat he was unqualified to make any kind of assessment that her condition was terminal. I believe he never even saw her, alive OR dead—just signed his name to a paper.
Alison is correct, it was Barbara Wagner. SB-128 in Calif. is a dangerous bill and is a path to euthanasia. I’ve studied the bill. The 2014 Oregon Report indicates reasons for choosing assisted suicide: it’s not about pain. http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResea... ‘Dr. Linda Ganzini, a professor of psychiatry at Oregon Health and Science University, published a study in 2009 of 56 Oregonians who were in the process of requesting physician-aided dying. “Everybody thought this was going to be about pain,” Ganzini said. “It turns out pain is kind of irrelevant.” At the time of each of the 56 patients’ requests, almost none of them rated pain as a primary motivation. By far the most common reasons, Ganzini’s study found, were the desire to be in control, to remain autonomous and to die at home. “It turns out that for this group of people, dying is less about physical symptoms than personal values,” she said.’
Anna makes our point. Those “personal values” include not wanting to be incapacitated, incontinent, and tethered to a machine in the last days of life. It borders on sadism to compel people to die this way. Die as you wish, but don’t force others to adopt your religion or ideology.
Interesting information, Anna, because the doctor who signed Brittany’s death certificate was putatively associated with Oregon Health & Sciences Center. (If you read my blog post, you’ll understand why I say “putatively.”) OHSC may have an agenda here. I wanted to stress what I said, above, about there NEVER being any prosecutions of doctors, for any reason whatsoever, if this legislation passes. I had very solid grounds to ask for an investigation of the doctor who signed Brittany’s death certificate, for example. This doctor is not an oncologist. It is clear he could not have made the initial diagnosis of cancer, let alone that it was terminal, therefore, which means he was incompetent as a matter of Oregon law to prescribe medication to end her life. The doctor would not answer any of my questions about his relationship with Brittany, and Oregon licensing agencies and law enforcement authorities would not support my quest for information. I was also denied records of permits issued for body pick-up, body transport, and cremation, even though none of those activities have to do with medical care—there are no privacy rights implicated. I believe no such records exist, anyway. That they were not produced is an admission there was no death. The point is, there is and will be complete immunity for doctors in such matters. The law expressly approves of the making of a false statement on the death certificate: that death was from “natural causes.” No one will actually ever be able to find out whether a doctor with a lethal drug was actually involved.
Glad to see you back! You mentioned Green Party affiliation, so it seems reasonable to inquire if you even know where the Green Party stands on the issue you’re debating. You were either ignorant or deceptive in this regard. There’s no other alternative.
Several points: [1] No one (apparently there are several examples) felt compelled to *use* the Oregon Death with Dignity law because an insurance company declined to fund experimental cancer treatments. If you really care about offering appropriate health care options, why not spend comparable effort seeking legislation to compel such insurance coverage? Your compassion in this regard seems highly selective. [2] Thanks for your reference to the religious journal article supporting your view. It contains this statement: “Packer sees that the manner in which she lives out her last days can be her way of loving her children, her husband, and her community.” Good point. I support Packer’s choice. But other people can love their children without forcing them to witness weeks of suffering and debilitation. In short, there can be several different, but reasonable options. One of the benefits of living in this country is making decisions about such options without having someone invoking their religious doctrine as the ultimate authority for everyone else. [3] Your self-appointed “investigation” of Brittany’s physician highlights the the dangers of extremist vigilantism. It would be a gross invasion of patient-physician confidentiality for the physician to respond to you. Urge Oregon to investigate if you like, but if the state doesn’t embrace your narrative, you’ll weave it into another conspiracy (I commend your ability to keep track of them all). [4] Facts are sometimes helpful. Here are relevant standards in Oregon (which the people in Oregon can modify or expand if they deem them inadequate): 1. The patient must be at least 18 years old 2. The patient must be a resident of the state of Oregon 3. The patient must be terminally ill (pre‐existing disability is not terminal illness). 4. The patient must have 6 months or less to live, verified by two physicians 5. Three requests for Death with Dignity must be made (two verbal and one written) 6. Two physicians must verify the mental competence of the terminally ill patient 7. The request must be voluntary, without coercion, verified by two physicians 8. The terminally ill patient must be informed of all other options, including palliative care, pain management and hospice care 9. There is a 15‐day waiting period between the oral request and the written request 10. There is a 48‐hour waiting period between the written request and the writing of the prescription 11. The terminally ill patient’s written request must be independently witnessed, by two people, at least one of whom is not related to the patient or employed by the health care facility 12. The terminally ill patient is encouraged to discuss their decision with family (not required because of confidentiality laws) 13. Only the terminally ill patient may self‐administer the medication 14. The patient may change their mind at any time
I share your view that a six month diagnosis won’t be certain. No one pretends otherwise. That’s another reason the Oregon legislation requires two medical opinions. But I challenge your statement that the decision over life and death was “effectively out-sourc[ed] to the doctor.” That decision rested with the *patient* and his clearly stated wishes, as you described yourself. I honor your (apparent) choice not to assist someone like Dr. Goodwin end his life. But too many in the medical profession are blind to advances in medical technology that extend life in conditions many of us regard as intolerable. Countless numbers of us have seen this reality as we took care of our dying parents—attached under “doctor’s orders” to machines that simply prolonged their agony. The statement from the Green Party in Canada (previously cited here) addressed precisely this issue. Physicians want to have control. Perfectly understandable and commendable. But in many ways you’ve turned that control over to dehumanizing technologies that*prolong* life without concern for *quality* of life. Patients are rightfully seeking better options. We respect your expertise, but the ultimate choice should be ours.
You can make a living will to avoid that outcome. And turning machines off, so that life is not artificially prolonged, is substantively different from having a physician prescribe a drug that will kill you.
It is hardly “extremist vigilantism” to want to know whether the law was complied with, in regard to the death of a family member. All these “safeguards” you recite are, in fact, nothing but window-dressing, as I found out, since I tried to obtain confirmation that the law was complied with in Brittany’s case, and was refused. I was denied copies of any record establishing a terminal diagnosis of my niece; I have been provided no evidence two physicians were involved in the judgment, let alone that the one who signed her death certificate, so presumptively prescribed the lethal medication, was even competent to diagnose her (he wasn’t); that the necessary written and oral requests for “Death with Dignity” were made by the patient; that the waiting period was complied with; and that there were any witnesses to the written request. So, if a family member can’t obtain confirmation that all these necessary steps were followed, do we just assume they were? Because that is what I have been required to do. The State of Oregon needs to know that, instead, I take its failure to produce these records to me as an admission that they were never created.
Please consider this observation from Kaiser Health News (2010): “Even when people have filled out living wills, doctors often ignore them. ” http://khn.org/news/living-wills-often-ignored/. I’ve seen this behavior pertaining to my own family. And some states (Idaho) have allowed physicians to ignore living wills altogether. There’s no evil intent involved, but physicians fear being subject to the kind of attacks and vigilante “investigations” we’ve seen in posts here. It probably not unlawful to pursue doctors this way, but people who do so need to consider the suffering their self-righteousness can cause to others. A growing number of physicians understand that prolonging life without any consideration of the protracted physical and psychological suffering involved doesn’t serve the interests or desires of most patients. I would oppose any law requiring you or any physician to assist someone in ending their life. But there’s a growing consensus in this country and around the world that people should be free (within the law, like Oregon) to seek help from a physician who puts patient well-being ahead of ideology.
Alison, having read your posts I must say I respect your perseverance. You undoubtedly believe what you write, even if I think some of it is over-heated and unduly conspiratorial. Your “investigation” of the doctor you mentioned may have been lawful, but it’s equally lawful (indeed a legal imperative) for the doctor not to disclose any confidential information to you. At heart, our disagreement is grounded on how we would use the power of the state. I would give patients greater autonomy to choose for themselves how and when to end their lives. There are reasonable regulations we could adopt to prevent abuses. You (I believe) would invoke the power of the state to deny *all* patient choice in this regard. Especially if California addresses this subject by popular referendum, I predict the majority of the people will disagree with you. That’s how democracy works (and I don’t always like it myself).
I concluded, with your first comment, that you were a troll and probably on the payroll, with your personal attacks on me and efforts at misdirection. I am only further confirmed in that opinion with each additional comment you’ve posted. It absolutely is not “vigilantism” for a family member to investigate the death—in this case, a widely publicized death that my family had no prior notice was in the offing—of a relative. And it is not “pursuing doctors” to try and find out answers to the most basic questions about a single doctor’s care of, and relationship with, my niece. You enumerate all the statutory requirements which must be fulfilled, to support your contention that there is integrity in the process, then excoriate me for trying to find out if they really have been. Can you understand that these guarantees of integrity are simply illusory, when you can’t even inspect a single one of the records which have supposedly been created, and the doctor will not reveal a single detail? They are just window-dressing, as I said.
I’m challenging your ideas, conspiracy theories, and tactics. I’m not being paid to do so, any more that you’re being paid to express your strongly held beliefs. We have police departments and state agencies to investigate possible wrong-doing. It’s your option to file a complaint. Part of what you described, however, was an effort on your part to obtain confidential medical information from a physician treating someone other than yourself. At least where adults are involved, there’s no confidentiality exception for “family members.” (Think for a moment about the consequences if the rule were otherwise). Then, when a physician rightly declined to respond to you, you turned the refusal into a component of your attack on Death with Dignity legislation. This is circus contortionism, not rational argumentation. So, we’ve both stated and reiterated our views. The topic seems exhausted, unless you prefer otherwise.
Here’s the relevant federal privacy rule: “Health Information of Deceased Individuals” at http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/deced.... The following explanation at the HHS site may (or may not) help you: The “Privacy Rule permits a covered entity to disclose protected health information about a decedent to a family member, or other person who was involved in the individual’s health care or payment for care prior to the individual’s death, unless doing so is inconsistent with any prior expressed preference of the deceased individual that is known to the covered entity. This may include disclosures to spouses, parents, children, domestic partners, other relatives, or friends of the decedent,*provided the information disclosed is limited to that which is relevant to the person’s involvement in the decedent’s care or payment for care.* [emphasis supplied]. See 45 CFR 164.510(b)(5). For uses or disclosures of a decedent’s health information not otherwise permitted by the Privacy Rule, a covered entity *must obtain a written HIPAA authorization from a personal representative of the decedent who can authorize the disclosure* [emphasis supplied]. A decedent’s personal representative is an executor, administrator, or other person who has authority under applicable State or other law to act on behalf of the decedent or the decedent’s estate.” So, Alison, here’s the point. Before setting off on your own extra-judicial investigation of the medical personnel involved, how about seeking authorization for release of medical records from the “decedent’s personal representative?” Without such authorization (or evidence you were “involved in the decedent’s care or payment for care”) the physician you contacted is legally bound *not* to provide the information you seek. It’s wrong and misleading to cite such a refusal as further evidence of any conspiracy. If you *did* make a lawful request under HIPPA—and were wrongfully refused—I think that’s something that will interest the national media and attract far more attention than comments on a blog or here.
Thought you were done with this. But answering you anyway: first, I was denied records relating to body transport and cremation, which are NOT medical records. Second, I qualified under Oregon law to receive the death certificate, as Brittany’s aunt, so it follows I am qualified to receive at least all primary information which supports the death certificate. I was denied these things, however. For instance, my question to the doctor, “Did you see her body before signing the death certificate?” was answered with, “Under Oregon law, a doctor is not required to see a body before signing a death certificate.” I take this as an admission that he did NOT see a body, of course; but I was entitled to a direct answer to my question. I asked him, “Are you the person who prescribed the lethal drug?” and he refused to answer that, too, when, as a matter of law—because he signed the death certificate—he had to have been. Second, please understand that the Maynard family—Brittany’s father’s side—was not “involved in the care” of Brittany, nor did any of us know anything about what was going on until we heard about her video via the mass media. We did not even know she had gotten married (one reason I believe that was part of the hoax). Excluding us was obviously part of the overall scheme here. And I have no way of knowing how to contact Brittany’s putative representative, this man Dan Diaz. A telephone number for him was omitted from the death certificate, in violation of law, and I was unsuccessful finding any listings for Debbie Ziegler (Holmes) or Dan Diaz in Oregon. (I realize there is an address for Dan and Brittany in Alamo, Calif. I have not sent a letter there.) As for HIPAA, I don’t presently know how it meshes with Oregon law. I have been a foe of this act personally from the first contact I ever had with it, as, first, not providing any “privacy” protections of my own health information whatsoever—since it goes not only to my insurer, but to everyone dealing with my insurer, including the government!—and second for the more serious reason that it enables and protects frauds exactly of the type we are examining now. You should be able to see how circular it is, simply in saying, on the one hand, that a family member is entitled to information about the care of the decedent, then on the other hand saying, oh, but only a family member already involved in the care of the decedent can get such information. If I was already involved in her care, why would I seek information about her care? It’s precisely in a situation such as this—when a loving relative outside a small circle of people who have insinuated themselves into the care of the decedent in her last days might have reason to suspect undue influence—that examination of the records should be permitted. Instead, it is precisely in this situation where access is denied. I note that not long before the Brittany video was made, a new regulation was adopted by the Social Security Administration restricting public access to the Social Security Death Index for three years after death. Yet another door closed, another move sealing access to records, done for no other reason I can see than to protect frauds such as this one.
I wrote a response to this, but it isn’t showing up—I’ll check back later. One thing I wanted to add to it is, again, the important point that if records are created establishing that procedural protections have been followed, but no one is permitted to access those records, is there any guarantee of integrity in the process? Of course not. If you can’t see from the Brittany event that the public is being manipulated by people behind the scenes with big bucks, who control the mass media, you are naive. And, right, NO ONE from the mass media has ever contacted me, although I have sent emails and posted online comments on their articles widely. This shows that they are all controlled, heavily invested in pushing this story. One exception: the National Enquirer. It’s strange that the last refuge of investigative journalism should be the NE! They are not doing a story, after all, however, out of consideration for my brother, who believes the suicide must be real, because it simply cannot be the case that the media would lie about such a thing.
You refer to a “fraud” and a “hoax” and an “overall scheme.” This language seems consistent with the video you shared about the Sandy Hook shootings—also a purported “hoax.” I don’t see a world where the President, federal and state governments, and the national news media conspire against us in this way. You have rational policy arguments to make about Death with Dignity legislation (reasonable people on both sides know it’s a difficult issue) and I sincerely think you’re better off focusing on them.
I have. But as for established hoaxes, how about “weapons of mass destruction” in Iraq? The Gulf of Tonkin incident? The sinking of the Maine in Havana Harbor? These were all “false flag” incidents perpetrated by our own government. How about the New York Times announcing the day after his murder that Lee Harvey Oswald was Kennedy’s “assassin”? Lee Harvey Oswald did not even handle a gun. I do suggest you watch that Sandy Hook video—it is a good place to start, with your education. We are being lied to continually.
Let’s end on a pleasant note. I respect your First Amendment right to challenge the government. It’s a worthy American tradition. In this context, it’s been my experience that the following aphorism holds true: “never attribute to malice what can be accounted for by incompetence.” Signing off.
Yes—I’ve appreciated our discussion, and the opportunity to vent a little, as well as organize my thoughts about this better. I apologize for my occasional irascibility. I see that S.B. 128 has failed in California, so…guess that’s that. For now, at least.
In fact there’s a lot problem here. This not a simple question for whether terminally ill patients should get a let themselves die for peace. You don’t even fear the death, what else you would fear for? Imaging that it is legal for a doctor to prescribe lethal drugs for a terminally ill patient, who has some personal dispute with him. If the law is not perfect enough, we don’t even know he died for his own will or something else. No one has the right to take other’s life. We can find a to deal with those diseases by our technology and new research. The death will come someday. We don’t have to be hurry. We can even find a way to do research by ourselves with others’ help…….That’s waht i am doing now at http://www.cd-genomics.com…
Hello, I am a Cal alumna, I now work for Cal, and I married a man with a glioblastoma in 2013. He moved to Oregon to live with his parents because it became too difficult for me to take care of him. I believe that everyone has a right to die with dignity. Had is chosen to end his life just 3 weeks prior to death, his family and friends would not have seen him naked, defecating on himself while crying, unable to speak or move. Anyone who has not been through a horrific ending with a loved one is not a credible source in this matter. I also live in Alamo (many coincidences here) and am willing to help the cause - how can I help?

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