Booth Gardner and Initiative 1000 - Sad HMO Dupes???

[Front paged: NM]

I heard Booth Gardner and his merry band on the radio cheering their "victory" at having secured the signatures for Initiative 1000. It is bad law - poorly informed, short-sighted and the political tool of HMOs.

But even if they can't see the ethical problems with it, the sponsors of this Initiative are intelligent Democrats of great political experience. Therefore, it should be patently obvious to them that the more signatures they got for it - the more popular it is - the more surely Initiative 1000 should be retracted and a bill from the legislature put in its place. Otherwise, it will be a bad law AND a political failure.

Here's why:

First, many Progressives dislike the initiative process altogether. They feel that it is something that will inevitably be abused by the right wing. Although this has been the case in fact, I disagree that the initiative process is broken. I admit that the requirement an Initiative be single-issue tends to favor emotional issues over more comprehensive legislative approaches, but I support the concept of initiatives nonetheless - just not this one.

Initiative 1000 is a terrible idea in and of itself.

  1. It undermines one of the fundaments of Progressivism, one of the oldest and best-working ethics in the history of the world: "First, do no harm."

  2. It gives physicians a power they don't need and shouldn't have to solve a problem of liability that is solved more logically with bills like this and this.

  3. It undermines and confuses the ethics of palliative care by redefining an action intended only to kill a human being as "palliative".

  4. While the AMA tries to help Progressive groups fight against the death penalty by persuading doctors that they must not be involved in executions, this Initiative tells doctors that they SHOULD be involved in an act intended only to kill.

The difference between an administration of medication for the purpose of relieving pain which may become lethal and the administration of a drug intended only to be lethal is a crucial, ethical distinction.

But even if they agree with the Initiative, the enormous demonstrated popularity of it should lead Progressives to conclude that it should be retracted. If the people of the state of Washington really disagree with me and really want "Death with Dignity" on a large, bipartisan basis, then the backers of 1000 should immediately sacrifice the Initiative and use it to push through a new healthcare bill.

A strong, Democratic majority should easily be able to tie the language of this popular Initiative with other, positive healthcare legislation and create a "Healthcare With Dignity Act". Instead of a single-issue Initiative, surely these Democratic leaders would be willing to share their political capital and help pass something that will help more people than the dying who choose to take their own lives this way.

Wouldn't that be a better idea?

Booth Gardner is persuaded that this is important and he's been successful. But surely he'd be willing to use his success on this no-cost, single-issue Initiative that will be used by a very small number of people (only about 350 patients choosing euthanasia in Oregon after 10 years - very small pdf - and obviously no improvement in health outcomes) to push something - or the expansion and funding of existing programs - that would be used by large numbers of some of our state's equally-vulnerable or more-vulnerable populations.

If securing a healthcare "right-to-die" is popular, can we agree that securing the healthcare rights of, for example, children and the mentally ill is more important? Isn't dying a pretty easy "right" to secure relative to the challenges faced by uninsured children and the mentally ill?

Wouldn't a combination of expanding and funding  this breakthrough law and, say, this fledgling initiative as well as giving doctors the freedom to prescribe lethal drugs to these nice elderly ladies, be more positive and useful for the citizens of Washington?

[Sorry about the cute old ladies, but I just don't like this bill. At the same time, if "dignity by death" was combined with something really positive, I'd drop my protests in a minute.]

Shouldn't Booth Gardner and the happy backers of Initiative 100 be willing to share and compromise in order to help more people?

How about using the support for "Death with Dignity" to create "Mental Healthcare with Dignity" and insure "Childhood with Dignity"? How about "Pain Care with Dignity"? How about a bill that protects the elderly and terminally ill as well as offering them drugs to die with?

I appeal to the supporters of Initiative 1000 to table this legislation until it can be combined into a Washington Healthcare With Dignity Act!

Wouldn't that be a real accomplishment compared with this ?

[Again to supporter, I'm sorry about the above link, but I strongly believe that unless it is coupled with positive legislation, Initiative 1000  is worse than useless]

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It undermines one of the fundaments of Progressivism, one of the oldest and best-working ethics in the history of the world: "First, do no harm."
Define "harm".  Here you have a terminally ill patient in extreme pain who explicitly wants to die.  How is it anything other than harm to keep them alive so that they can suffer further?  If you have the means to prevent further suffering to no purpose whatsoever, how can it be "ethical" not to make use of it?  (I also like how it's "ethical" to just quietly prescribe massive doses of morphine under the cover of "palliative care" and oops the patient never woke up, but "not ethical" to be honest and up front about the patient's wish to die and enacting it in a more straightforward manner)

Secondly, existing law and the insistence that assisted suicide remain illegal violate an even deeper tenet of Progressivism:  personal autonomy and the most basic of civil liberties, the right of an adult individual of sound mind to decide what is best for him/herself, the right to control what happens with your own body.

Wouldn't a combination of expanding [children's health funding] and, say, this fledgling [mental health] initiative as well as giving doctors the freedom to prescribe lethal drugs to these nice elderly ladies, be more positive and useful for the citizens of Washington?
The logic of this makes no sense.  Why you're trying to link these at all?  In other words, how does having a physicial-assisted suicide initiative enacted into law prevent the legislature from addressing children's health funding or mental health programs?  If you can't make that case, then mentioning childrens health, mental health, mass transit, ponies-for-everyone/etc is just a non sequitur.

Best I can figure out is if you know A is popular and you can somehow tie B+C to it, then that increases the likelihood that B+C happen,.. and while I can imagine there existing politicians willing to hold suffering, terminally ill people hostage to get their pet projects funded, this kind of cynical position is worthy of nothing but contempt.

Meanwhile, the "nurse-assisted suicide" case from the Portland Journal is likewise a non sequitur.  What those nurses apparently did was already clearly illegal under current Oregon law (and it looks like they're well on track to being prosecuted for it, too).  Moreover, to my knowledge, nobody is proposing to make it legal, whether in Oregon, Washington or anywhere else.  Meaning this case has nothing to do with this initiative.  ... it would be just as dishonest to cite a story about a cocaine ring being busted as an argument against medicinal use of marijuana.

by wrog on Sat Jul 05, 2008 at 01:41:08 AM PST

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Initiative 1000 is based on Oregon's death with dignity law, which has been safely and effectively in place for over 10 years.

  1. It adheres to one of the fundamental tenets of progressivism - person choice. Initiative 1000 would allow terminally ill patients to make their own end of life decisions without government interference.

  2. Physicians who disagree need not participate. But they shouldn't impose their choice on other people either.

  3. Ten years of experience in Oregon shows that palliative and hospice care has actually improved because people are more aware of their options and are allowed to have an open and honest discussion about it.

There has been no abuse or coercion in 10 years of death with dignity in Oregon - by HMOs or anyone else - and there will be no abuse here.

Vote Yes on I-1000.

by Gloria on Mon Jul 07, 2008 at 12:59:59 PM PST

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Noemie, did you actually read this post?

But even if they agree with the Initiative, the enormous demonstrated popularity of it should lead Progressives to conclude that it should be retracted.

Are you saying that any time something is popular, it must be bad?  I realize that popularity should not automatically be an indication of the worth of an idea, but the exact opposite formulation is just as illogical.

There's just so much wrong with the rest of this post, it's hard to comprehend.

First of all, Oregon hasn't had any problems with this law, from an insurance standpoint, an abuse standpoint, or a doctor liability standpoint.  

Second, the initiative does nothing to change the idea of palliative care, and as the comment above explains, it's a stretch to say that allowing for doctor's to prescribe a life-ending cocktail to a patient who is of sound-mind, terminal, and desires it violates the principle of "do not harm."

Beyond that, those who think that progressivism puts the authority of the state over the choices of individuals in this matter, progressivism is no better than conservatism.  That's the real tragedy of this post, in that it clearly illustrates how the progressive movement in this country could potentially fail.  No single initiative can ever fix the myriad problems in our health care system.  Expecting that from I-1000 is foolish.

by thehim on Mon Jul 07, 2008 at 01:35:27 PM PST

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Completely bypassed the system and didn't even lose their licenses.

by dlaw on Wed Jul 09, 2008 at 01:55:57 PM PST

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After a nurse and nurse's aid admitted they had participated in an unlawful assisted suicide hundreds of other cases of possible abuse by nurses were referred to the Oregon Department of Justice. The Washington County, Oregon, District Attorney clearly anticipated that tens or even scores of these cases might land at his doorstep.

This is because:

Typically, if a complaint is made against one of the state's approximately 65,000 nurses, it is made to the nursing board, which assigns one of its investigators to the case.

If the board's investigators find wrongdoing, they present the case to the board, which can offer a variety of licensing disciplines, from revoking the nurse's license to probation or a reprimand.

Often, the allegation against the nurse also will involve criminal activity, such as stealing medication from a nursing home patient. According to the governor's report, and statements made by others with intimate knowledge of the board's workings, for many years board policy was not to report the cases to criminal justice authorities.

Obviously it's hard to find cases of the abuse of an Assisted Suicide law IF NOBODY REPORTS THEM TO AUTHORITIES.

Is a FUNDED, improved system for reporting abuse by healthcare workers in Initiative 1000? Why, no, it isn't. First of all, that would require doing real political work - raising revenue, upsetting people, that kind of thing. Also, Initiative 1000 CANT create that kind of system since initiatives must, by law, be single-issue.

Thus we see the ENORMOUS PROBLEM with creating law like this through initiative. Initiative 1000 will simply create more nasty stuff to sweep under the healthcare rug.

Returning to Oregon, in case you think these new dicoveries will certainly lead Washington County District Attorney Bob Hermann bring breakers of the Oregon Assisted Suicide to justice, think again:

Hermann said that prosecuting defendants for aiding a suicide could be difficult. Finding proof, he said, often is particularly hard.

Hermann also said that the fact that the case occurred in 2005 would make it difficult to put together a prosecutable case.

This is, of course, the purest BS and CYA in response to public pressure to bring the violators to justice.

Somehow I suspect that Mr. Hermann will not be too keen to embarrass the state of Oregon and create a political tempest.

After all, why do that? Mrs. Melcher was going to die anyway. Who cares about the technicalities of a law.

No harm. No foul. Right?

by dlaw on Sun Jul 13, 2008 at 01:21:20 PM PST

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