Thursday, October 27, 2016

Patients May Have Years or Decades to Live

William Toffler, MD
To view similar information in a pdf format, see "Dore Memo Opposing Prop. 106," which can be viewed here and here

By Margaret Dore, Esq., MBA

Prop. 106 applies to "terminal" persons predicted to have "less than six months to live." Such persons may actually have years or decades, to live. This is true for three reasons.

1. If Colorado follows Oregon’s interpretation of “six months to live,” assisted suicide will be legalized for people with chronic conditions such as insulin dependent diabetes

Prop. 106 applies to patients whose terminal illness is incurable and irreversible and which has been medically confirmed and will within reasonable medical judgment, result in death “within six months.”[1]


Oregon’s law applies to terminal patients who meet these same criteria. Oregon’s law states:
“Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months. (Emphasis added).[2]
In Oregon, these criteria are interpreted to include chronic conditions such as “chronic lower respiratory disease” and “diabetes mellitus” (better known as “diabetes”).[3] Indeed, these conditions are listed in Oregon government reports as “underlying illnesses” sufficient to justify assisted suicide.[4]

One reason that chronic conditions qualify for assisted suicide is that the six months to live is determined without treatment. Oregon doctor, William Toffler, explains:
In Oregon, people with chronic conditions are “terminal” [and eligible for assisted suicide] if without their medications, they have less than six months [to] live.[5]
Dr. Toffler elaborates:
This is significant when you consider that a typical insulin-dependent 20 year-old-year will live less than a month without insulin.
Such persons, with insulin, are likely to have decades to live; in fact, most diabetics have a normal life span given appropriate control of their blood sugar. (Emphasis and spacing changed).[6]
If Colorado enacts Prop. 106 and follows Oregon’s interpretation of “six months” to live, assisted suicide will be legalized for people with chronic conditions such as insulin dependent diabetes. As noted by Dr. Toffler, such persons can have “decades to live.”[7]

2.  Predictions of life expectancy can be wrong

Patients may also have years to live due to misdiagnosis and the fact that predicting life expectancy is not an exact science.[8] Consider John Norton, diagnosed with ALS (Lou Gehrig’s disease) at age 18 or 19.[9] He was told that he would get progressively worse (be paralyzed) and die in three to five years.[10]  Instead, the disease progression stopped on its own.  In a 2012 affidavit, at age 74, he states:
If assisted suicide or euthanasia had been available to me in the 1950's, I would have missed the bulk of my life and my life yet to come.[11]
3.  Treatment can lead to recovery

Consider also Oregon resident, Jeanette Hall, who was diagnosed with cancer in 2000 and wanted to use Oregon’s law.[12] Her doctor convinced her to be treated instead.[13]  In a June 2016 declaration, she states:
This July, it will be 16 years since my diagnosis.  If [my doctor] had believed in assisted suicide, I would be dead. [14]
Footnotes:

[1]  Prop. 106, § 25-48-101, (13), (12) & (16) state:
Qualified individual” means a terminally ill adult with a prognosis of six months or less . . . . 
“Prognosis of six months or less” means a prognosis resulting from a terminal illness that the illness will, within reasonable medical judgment, result in death within six months and which has been medically confirmed. . . .
“Terminal illness” means an incurable and irreversible illness that will, within reasonable medical judgment, result in death. (Emphasis added).
[2]  Or. Rev. Stat. § 127.800 s.1.01.(12). ( A-27).
[3]  Declaration of William Toffler, MD (A-27 & A-28, ¶¶ 2, 3 & 6).
[4]  Id., "Exhibit B" (A-35 & A-36)
[5]  Id.,  4
[6]  Id.
[7]  Id.
[8]  See e.g., Jessica Firger, “12 million Americans misdiagnosed each year,"CBS NEWS, 4/17/14 (A-37); and Nina Shapiro, Terminal Uncertainty, (A-19 to A-21), available at https://choiceisanillusion.files.wordpress.com/2016/10/md-term-uncert-excerpts_0011.pdf
[9]  Affidavit of John Norton, 08/15/12,  3.
[10]  Id.,  1
[11]  Id.,  5.
[12]  Declaration of Kenneth Stevens, MD, 1/06/16 (A-50, ¶¶ 3-7); and Declaration of Jeanette Hall, 6/30/16 (A-51).
[13]  Id.
[14]  Declaration of Jeanette Hall, supra at A-51, ¶4.