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Massachusetts "Death with Dignity" Initiative, Question 2 (2012)

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Question 2
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Type:State statute
Referred by:The Massachusetts Death with Dignity Coalition
Topic:Assisted death
Status:Defeatedd
The Massachusetts "Death with Dignity" Initiative, also known as Question 2, was on the November 6, 2012 general election ballot in the state of Massachusetts as an indirect initiated state statute, where it was defeated. The measure was filed with the Massachusetts Attorney General and would have established, according to those who filed the measure, an "Act Relative to Death with Dignity." The petition number for the initiative was 11-12, and was filed by Michael Clarke.[1]

According to the text of the initiative, the proposed measure would have allowed for a terminally ill patient to be given lethal drugs. A terminally ill patient was to be defined as a patient being given six months or fewer to live. The patient requesting the medication had to be mentally capable to make medical decisions while consulting their respective doctors. Patients would have be required to submit their request orally twice and witnessed in writing, and the initial verbal request must be fifteen days prior to the written request and second oral request. The patient's terminal diagnosis and capability to make health care decisions must be confirmed by a second doctor.[2]

The proposed measure, according to the text, required substantial compliance with these and other requirements. The text stated: "A person who substantially complies in good faith with provisions of this chapter shall be deemed to be in compliance with this chapter."[2]

The proposed act also would have allowed blood relatives to participate in assisting the patient to sign up for the lethal dose, providing that one of the required witnesses on the lethal dose request form not be a patient’s relative by blood, marriage or adoption.[2]

Supporters argued that the measure would have given terminally ill patients dignity and control over their deaths, and would alleviate suffering.

Opponents argued that the measure was morally wrong, and that beneficiaries of terminally ill patients could abuse the provisions presented by the proposal.

Election results

See also: 2012 ballot measure election results

The following are official election results.

Massachusetts Question 2
ResultVotesPercentage
Defeatedd No1,534,75751.9%
Yes 1,466,866 48.1%

Results via the Massachusetts Secretary of State.

Text of the measure

Ballot language

The ballot language of the measure read as follows:[3]

A YES VOTE would enact the proposed law allowing a physician licensed in Massachusetts to prescribe medication, at the request of a terminally-ill patient meeting certain conditions, to end that person’s life.

A NO VOTE would make no change in existing laws.[4]

Support

Supporters

  • The main supporters of the measure included The Massachusetts Death with Dignity Coalition.

Arguments

The following is information obtained from the supporting side of the initiative.

  • According to Steve Crawford, spokesman for The Massachusetts Death with Dignity Coalition: "The act gives patients dignity, control, and peace of mind during their final days with their families and loved ones. These are very intimate personal choices that should remain in the hands of the individual not the government."[5]
    • Crawford later stated in a newspaper interview: “This provides people with a choice to request, from their doctor, a medicine that would end their life, when other medical efforts to alleviate their pain and suffering are inadequate." Crawford also responded to Cardinal Sean P. O'Malley's comments against the initiative efforts by saying: "We certainly respect the cardinal's opinion and believe that the people of Massachusetts are ready for the discussion, about how best to provide peace, dignity, and control for terminally ill patients in their final days of life."[6]
    • Crawford later stated about the measure, and the term "suicide" that some reports out of the state termed it: “It’s not suicide in the traditional sense of someone who suffers from depression or despair, and that’s the distinction we hope to make in that language."[7]
  • Representative Louis Kafka was sponsoring a similar bill, but was not involved in the current initiative effort to place the ballot question on the ballot.[5]
  • Marcia Angell, MD, a Senior Lecturer in Social Medicine at Harvard Medical School and former Editor-in-Chief of The New England Journal of Medicine, stated in an opinion piece, "I believe it is wrong to require dying patients, against their wishes, to continue on a downhill path of suffering."[8]
  • When circulating the petitions to place the measure on the 2012 ballot, or have it enacted by state legislature, signature gatherer Randee Laikind commented: “I try to be very polite. I say, ‘Would you consider signing this petition to put the Death With Dignity Act on the ballot, so Massachusetts citizens can vote on it? I’ve never had anyone say no. They don’t even ask me questions; they just say, ‘Where do I sign?’”[9]
  • Kristen Bahler, columnist at The Next Great Generation, the measure deserved to be on the ballot, "[Physician-assisted death] certainly shouldn't be considered a crime. The idea that a dying patient -- stripped of mobility, strength, and, as the proposal ascertains, dignity -- can choose to end his or her suffering on terms undesignated by disease is, quite simply, beautiful. And even if you disagree...Voters should make that decision. Right now, the argument isn't whether physician-assisted suicide should be made legal; it's whether Massachusetts voters should get a say in the matter. Despite efforts to the contrary, we definitely, definitely should."[10]
  • According to Tim Kutzmark, a Unitarian-Universalist minister in Reading, "I’ve really changed...I believe that death is a highly personal experience, and it can be excruciating and drawn out for the individual who is ill and for their families. Sometimes what is best and right for the individual is to claim that moment of death for themselves, knowing they are freeing themselves from...needless pain and suffering.”[11]
  • When asked in an interview about her thoughts on The Massachusetts Medical Society saying the measure was “fundamentally incompatible with the physician’s role as healer," Marcia Angell, a senior lecturer in social medicine at Harvard Medical School and a former editor of the New England Journal of Medicine, stated, "It seems to me that this argument misses the point in two ways. First, assisted dying is specifically limited to patients for whom “healing” is no longer possible because they are dying of an incurable illness. And second, the focus of the debate should be on the individual patient’s needs and wishes, not on the physician’s self-image."[12]
  • Dr. Tim Quill, author of the book Death and Dignity: Making Choices and Taking Charge, stated about the type of patients that would need this "Death with Dignity" option: "There are two groups of patients for whom this is really important,” said Quill. “The bigger group of people who are quite sick may worry about what might happen if their pain gets really bad and want to have a choice if their suffering gets out of hand. For most of those people, palliative care is pretty affective at relieving suffering, and it works most of the time. So those people don’t need this option. But there will be a small amount of cases where this doesn’t work sufficiently, and suffering is more extreme."[13]
  • Roger Williams University of Law professor Buzzy Baron stated, "I think more and more people are taking responsibility for their own health, and this is just another step in that direction...It's the patient who decides whether or not to take the medication. It just stays there by their bedside. This is me deciding how to determine what I want for my life. I think there's absolutely no reason not to respect that."[14]
  • Heather Clish, writing on behalf of Dignity 2012, stated in a column, "Question 2 on the Massachusetts ballot this November will give mentally competent, terminally ill adults an option to take life-ending medication prescribed by a physician. No doctor is forced to participate and nobody is forced to take the medication within a certain timeframe or ever. I urge you to vote yes on Question 2 because, while this choice is not for everyone, everyone has a right to this choice."[15]

Opposition

Opponents

Arguments

The following is information obtained from the opposing side of the initiative:

  • A group of disability rights advocates called Second Thoughts came out in opposition to the measure. Disability activist John Kelly leads the group. According to Kelly, when commenting on the measure and Oregon, who administers "Death with Dignity": “Some people may ask why disabled people are speaking out about problems with a proposal that’s supposed to be about terminal illness, but when you look at the reasons Oregon reports for giving lethal prescriptions, it’s mainly about the social and emotional issues of becoming disabled, like depending on others and feeling like a burden.”[16]
  • Kristian Mineau, president of the Massachusetts Family Institute, commented on potential initiative petition signers: "Literally, some people will be signing their own death warrants."[5]
  • Kristian Mineau argued: "It's a further erosion of the sanctity of life in our commonwealth. You talk about the slippery slope; this is going off the cliff -- morally."[5]
  • According to James Driscoll, executive director of the Massachusetts Catholic Conference, "We are in support of any type of palliative care that relieves a patient’s pain, but that does not promote a quicker end to life."[5]
  • Cardinal Sean P. O'Malley, leader of the Roman Catholic Archdiocese of Boston, stated at a Mass for state lawyers and jurists, without specifically referring to the initiative by name: “We are called upon to defend the gospel of life with courage and resolve. Your very profession invests in all of you a great responsibility to ensure that all laws are just."[6]
    • O'Malley also claimed during the mass: "We hope that the citizens of the commonwealth will not be seduced by the language, ‘dignity, mercy, compassion,’ which are used to disguise the sheer brutality of helping someone to kill themselves."[7]
    • Reverend J. Bryan Hehir stated about the cardinal's arguments: "The cardinal’s point is that the act of suicide is always regarded as tragic...It is tragic in the sense that the act of...intentionally taking innocent human life is something that is always seen as against the good of the human person."[17]
  • According to a column in the New York Times by Margaret Dore, an attorney in Washington State where assisted suicide is legal, and President of Choice is an Illusion: "Proponents tout assisted suicide as providing 'choice' over the timing of one's death. But choice under the Oregon and Washington acts cannot be assured. For example, neither act requires witnesses at the death. Without disinterested witnesses, the opportunity is created for an heir, or someone else who will benefit from the patient's death, to administer the lethal dose to the patient without his consent. Even if he struggled, who would know?"[18]
  • Jennifer Popik, JD, of the Robert Powell Center for Medical Ethics called the measure a "threat," pointing out five points that make the measure dangerous, according to Popik. Popik stated: "While this ballot initiative poses a real threat to the people of Massachusetts, the same pro-doctor prescribed death lobby has been promoting a nearly identical measure far and wide across the nation for nearly two decades with very limited success...Once several key points about the law are considered, most states have rejected the notion that doctors ought to be able to prescribe death to patients." Read about those five points that Popik writes here.[19]
  • According to Massachusetts Against Assisted Suicide, the term "terminal patients" was also the subject of opponents' arguments. The term, opponents said, did not necessarily mean a patient was dying. Opponents presented a story of Oregon resident Jeanette Hall, who was diagnosed with cancer and given 6 months to a year to live. She wanted the act of assisted death to be performed, but was persuaded by her doctor to be treated instead. She was still alive 11 years later, according to opponents of the measure.[20]
  • Dr. Lynda Young, MD, stated her opposition when she said, "Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer. Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life … in order that these patients continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy and good communication."[21]
  • According to Rabbi Andrew Vogel of Temple Sinai in Brookline, “Ultimately, the moment of death is not for us to decide. That’s the gift of the spiritual tradition to say it’s ultimately God’s choice.”[11]
  • Needham Board of Health member Jane Fogg stated about the organizations opposition, “We looked really at the practical nature of the law, and came down firmly on the side that we don’t see this is written in a way to prevent potential abuse."[22]
  • In a statement made by the Massachusetts Medical Association, the group stated its opposition by commenting, "The proposed safeguards against abuse are insufficient. Enforcement provisions, investigation authority, oversight, or data verification are not included in the act. A witness to the patient’s signed request could also be an heir...Assisted suicide is not necessary to improve the quality of life at the end of life. Current law gives every patient the right to refuse lifesaving treatment, and to have adequate pain relief, including hospice and palliative sedation." The full statement can be read here.
  • According to Judith E. Arnold, resident of Bradford Court, "Personally, I would not expect my primary-care pyhsician to lie about the real cause of my death. The act requires that the cause of death on the death certificate must be the underlying condition, NOT the lethal dose of barbituates, which actually ends the life of one who takes it. Any doctor who particpates in this assisted death must disavow the primary oath to “do no harm” and then lie on a legal form. According to the act, he or she will not be prosecuted, but where are the safeguards against that being changed in the future? If citizens believe that the Commonwealth needs such a law, it should at least be crafted with more care."[23]
  • In a column by Rosanne Bacon Meade, chairman of the Committee Against Physician-Assisted Suicide, she stated, "It lacks any public safety oversight once the lethal drug is obtained; a suicide prescription could fall into the hands of someone for whom it was not prescribed. No medical professional is required to be with the person when the 80 to 100 pills are consumed. Question 2 sidesteps any questions about possible complications involved in taking the pills, or what happens to the pills if they are not consumed."[15]

Media endorsements

See also: Endorsements of Massachusetts ballot measures, 2012

Opposition

  • The Boston Herald stated, "We are fortunate in this country — and in this commonwealth — to have a strong network of end-of-life services for the terminally ill. Hospice provides compassionate care. Access to palliative care could be improved, and that should be the focus of those who are committed to humane and dignified treatment of the dying."[24]

Polls

Polls, 2012 ballot measures
  • A poll that was released in early April 2012 by Public Policy Polling showed that those surveyed favored the measure, with one-fifth of those polled showing they were undecided on the issue. The complete results of the poll are below.[25]
  • A late-May poll was taken by both Western New England University and MassLive.com showing support for the measure. The survey had a margin of error of +/- 4.4 percentage points and polled 504 likely voters in the state.[26]
  • On August 22, 2012, Public Policy Polling released a poll which showed support for the measure. The survey had a margin of error of +/-2.9% and surveyed 1,115 likely Massachusetts voters.[27]
  • Suffolk University released a poll on September 17, 2012 showing support for the measure. The margin of error for the survey was +/- 4% and 600 likely Massachusetts voters were polled.[28]
  • A late-Sept. poll for the Boston Globe was conducted by University of New Hampshire Survey Center showed support for the measure. The survey had a margin of error of +/- 4.4 percentage points and polled 502 likely voters in the state.[29]
  • A poll was released on October 10, 2012 by University of Massachusetts showed 65% of Massachusetts registered voters favored the measure. The complete results of the poll are below. The survey had a margin of error of +/- 5.4%.[30]
  • On October 11, 2012, Public Policy Polling released a poll which showed support for the measure. The survey had a margin of error of +/-3.0% and surveyed 1,051 likely Massachusetts voters from October 9-11, 2012.[31]
Legend

     Position is ahead and at or over 50%     Position is ahead or tied, but under 50%

Date of Poll Pollster In favor Opposed Undecided Number polled
Mar. 16-18, 2012 Public Policy Polling 43% 37% 20% 936
May 29-30, 2012 Western New England University 60% 29% 11% 504
Aug. 16-19, 2012 Public Policy Polling 58% 24% 18% 1,115
Sept. 13-16, 2012 Suffolk University Political Research Center 64% 27% 9% 600
Sept. 21-27, 2012 Boston Globe & University of New Hampshire 68% 20% 12% 502
Oct. 2-8, 2012 University of Massachusetts & YouGov America 65% 19% 17% 498
Oct. 9-11, 2012 Public Policy Polling 56% 30% 14% 1,051


Lawsuit

John Kelly et al vs. Martha Coakley

2012 measure lawsuits
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By lawsuit type
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Signature challenges
Initiative process

On May 17, 2012, over 60 Massachusetts voters, including members of the disability rights group Second Thoughts, filed a challenge before the Supreme Judicial Court against the measure, challenging the wording to the measure. On June 4, 2012, the claim was denied by Justice Cordy.[32]

According to John Kelly, director of the Second Thoughts group, and who was listed in the title of the lawsuit, "The ballot language is clearly misleading. We want the voters of Massachusetts to know exactly what they are voting on this November." The petition asked the Supreme Judicial Court to remand the language to Massachusetts Attorney General Martha Coakley (D) and Secretary of State William Galvin (D) with the requirement that they amend the language for clarity and accuracy. The measure was placed on the ballot despite the litigation.[33]

The case docket can be read here.

Path to the ballot

See also: Massachusetts signature requirements

Each of the ten original signers of the proposed measure must obtain certificates of voter registration from the board of registrars or election commission in the city or town where they are registered voters. The certificate of voter registration must be signed by at least three registrars. These certificates and the original petition must then be submitted to the Massachusetts Attorney General.

Once the petition is found acceptable, the Attorney general will prepare a summary and return it and the petition to the petitioners, who must file the petition and summary with the Massachusetts Secretary of State.

Once that is submitted, petitions are printed and circulation can begin.

Circulation and submission

Backers were required to collected 68,911 signatures by November 23, 2011 and turn them into local registrars. Signatures were filed by that deadline, according to reports, by supporters. Validated signatures were then returned to supporters, who had until the December 7, 2011 petition drive deadline to turn those signatures in to the Massachusetts Secretary of State's office. Supporters turned in those signatures by the deadline.[34]

Those signatures were deemed valid, leaving the proposed law to be sent to the Massachusetts General Assembly for consideration, since the measure is an indirect initiated state statute.

The proposal was filed with the Massachusetts Legislature by Massachusetts Secretary of State William F. Galvin as signatures were verified before the start of 2012.[35]

Second signature gathering phase

May 2, 2012 was the last day for the Massachusetts General Assembly to enact legislation similar to the measure. However, since the general assembly did not choose to make the proposal a law, supporters must have gathered additional signatures to obtain ballot access. Those signatures must have been obtained from about 1/2 of 1% of voters who voted in the last governor election.[36]

Validated signatures were required by the first Wednesday of July to the Massachusetts Secretary of State's office. Since the deadline fell on a national holiday, July 4, that deadline was July 3. Supporters turned in signatures by the deadline. Those signatures were verified.[37]

See also

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Additional reading

References

  1. Massachusetts Attorney General, "Current Petitions Filed," accessed August 3, 2011
  2. 2.0 2.1 2.2 11-12 Massachusetts Attorney General, "Text of Measure," accessed April 27, 2012
  3. Massachusetts Secretary of State, "2012 Information For Voters," accessed September 14, 2012
  4. Note: This text is quoted verbatim from the original source. Any inconsistencies are attributed to the original source.
  5. 5.0 5.1 5.2 5.3 5.4 Boston Herald, "Mass. petition aims to OK doctor-assisted suicide," August 24, 2011
  6. 6.0 6.1 Boston.com, "Cardinal rips suicide ballot effort," September 19, 2011
  7. 7.0 7.1 National Catholic Register, "Massachusetts vs. Assisted Suicide," December 12, 2011
  8. Lowell Sun, "Giving a choice to terminally ill patients," September 26, 2011
  9. New York Times, "The Next Death-With-Dignity Battleground," October 26, 2011
  10. Boston.com, "OPINION: Why the Mass. Death with Dignity Act should appear on the November ballot," January 4, 2012
  11. 11.0 11.1 Boston.com, "Massachusetts religious communities divided over doctor-assisted suicide measure," September 11, 2012
  12. Boston University, "Physician-Assisted Suicide on the Massachusetts Ballot," October 15, 2012
  13. Wicked Local, "Residents divided over 'Death with Dignity' ballot question," October 4, 2012
  14. Turn to 10, "Mass. voters to decide assisted suicide question," October 2, 2012
  15. 15.0 15.1 Wicked Local, " Retrieved October 25, 2012
  16. Digital Journal, "Disability Rights Group Announces Opposition to Massachusetts Assisted Suicide Initiative," December 9, 2011
  17. Boston.com, "Death with dignity in Mass.," September 23, 2011
  18. The New York Times, "Margaret Dore, "A Recipe for Elder Abuse," April 10, 2012
  19. National Right to Life News, "The Dangerous Assisted Suicide Ballot Measure in Massachusetts: 5 Key Facts," December 15, 2011
  20. Boston Globe, "She pushed for legal right to die, and - thankfully - was rebuffed," October 4, 2011
  21. AMA-ASSN.org, "Push for “death with dignity” in Massachusetts picks up steam," July 16, 2012
  22. Boston.com, "Needham's Board of Health speaks out against medical marijuana ballot question," September 12, 2012
  23. Wicked Local, "LETTER: Reasons abound to oppose Question 2," October 14, 2012
  24. Boston Herald, "No on Question 2," October 22, 2012
  25. Westborough Patch, "Doctor-Assisted Suicide: Most Support It, Do You? [POLL," April 3, 2012]
  26. MassLive.com, "Massachusetts voters support medical marijuana and 'death with dignity' ballot initiatives," June 4, 2012
  27. Public Policy Polling press release, August 22, 2012
  28. Suffolk University poll results, September 17, 2012
  29. Boston Globe Poll #34 results, September 27, 2012
  30. University of Massachusetts, "Massachusetts Ballot Question 2: Prescribing Medication to End Life," accessed October 10, 2012
  31. Public Policy Polling results, October 11, 2012
  32. Judicial Supreme Court of Massachusetts, case docket for "John Kelly et al vs. Martha Coakley, as she is the Attorney General and William Francis Galvin, as he is the Secretary of the Commonwealth"
  33. PRWEB.com, "Disability Rights Group Challenges Language for Assisted Suicide Ballot Measure as "Misleading, Inaccurate, and Euphemistic," May 17, 2012
  34. Mass Live, "4 proposed ballot laws could go to Massachusetts voters in November," December 4, 2011
  35. Mass Live, "Secretary of State William Galvin to file statewide ballot questions proposing 'death with dignity,' medical marijuana and teacher evaulations," January 3, 2011
  36. Boston Herald, "Next stage to begin in Mass. ballot effort," May 2, 2012
  37. Massachusetts Secretary of State, "Initiative Petition for Law," accessed August 10, 2011