Tuesday, July 4, 2017

The Measure Applies to People With Years or Decades to Live

William Toffler MD
By Margaret Dore, Esq.

The measure applies to people with a “terminal disease,” meaning those predicted to have less than six months to live. Such persons may, in fact, have decades to live. This is true for the following reasons:

A. If South Dakota Follows Oregon's Interpretation of "Terminal Disease," the Measure Will Apply to Young Adults with Insulin Dependent Diabetes

The measure 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.[1]
Oregon’s law has a nearly identical definition:
“Terminal disease” means an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months.[2]
In Oregon, this nearly identical definition is interpreted to include chronic conditions such as “diabetes mellitus,” better known as diabetes.[3] Oregon doctor, William Toffler, explains:
[P]eople with chronic conditions are “terminal” [for the purpose of Oregon’s law] if without their medications, they have less than six months to live. This is significant when you consider that a typical insulin-dependent 20 year-old will live less than a month without insulin.[4]
Dr. Toffler adds:
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.[5]
If the proposed measure is enacted and South Dakota follows Oregon's interpretation of "terminal disease," assisted suicide and euthanasia will be legalized for people with chronic conditions such as insulin dependent diabetes. Such persons can have decades to live.

B. Predictions of Life Expectancy Can Be Wrong

Eligible persons may also have decades to live because predictions of life expectancy can be wrong.  This is true due to actual mistakes (the test results got switched) and because predicting life expectancy is not an exact science.[6] 

Consider John Norton, who was diagnosed with ALS (Lou Gehrig’s disease) at age 18.[7] He was told that he would get progressively worse (be paralyzed) and die in three to five years.[8] 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.[9]
C. Treatment Can Lead to Recovery

Consider also Jeanette Hall, who was diagnosed with cancer in 2000 and made a settled decision to use Oregon’s law.[10] Her doctor convinced her to be treated instead.[11] In a 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.[12] 

[1]  The initiated measure, § 1(12).
[2]  Or. Rev. Stat. 127.800 s.1.01. Definitions, Section 12
[3]  Declaration of William Toffler, MD, ¶¶ 2-4. 
[4]  Id., ¶ 5
[5]  Id., ¶ 6
[6]  Cf. Jessica Firger, “12 million Americans misdiagnosed each year,” CBS NEWS, 4/17/14, and Nina Shapiro, “Terminal Uncertainty — Washington's new 'Death with Dignity' law allows doctors to help people commit suicide — once they've determined that the patient has only six months to live.  But what if they're wrong?,” The Seattle Weekly, 01/14/09. 
[7]  Affidavit of John Norton¶ 1.
[8]  Id.
[9]  Id., ¶ 5.
[10]  Affidavit of Kenneth Stevens, MD¶¶ 3-7Jeanette Hall declaration
[11]  Id.
[12]  Declaration of Jeanette Hall, ¶4