New Jersey Assembly Advances Death With Dignity Legislation

By Nicholas Little
Legal Director, Center for Inquiry

On Thursday, November 13, the New Jersey State Assembly, the lower legislative house, voted 41-31 to pass a bill permitting physician-assisted suicide in the Garden State. The bill was originally intended to be voted on in June of this year, but that vote had been dropped, and the bill finally came to the floor in the recent aftermath of cancer sufferer Brittany Maynard making use of Oregon’s humanitarian law permitting death with dignity in that state.

The New Jersey law closely follows those already in place in Montana, Oregon, Washington and Vermont. It requires a diagnosis from two separate doctors that a patient is suffering from a terminal disease, which will cause death within the next six months. In order to take advantage of the law, a patient must be a New Jersey resident, over the age of 18, and possess the capacity to make health care decisions. The bill includes multiple safeguards, including a requirement that the patient is referred for counselling if depressed or suffering from a psychological or psychiatric disorder, that the patient’s next of kin be notified (unless the patient declines said notification), and that no medical personal be required to participate in the process.

For patients who meet the requirements, and make the informed decision to request, the law permits them to be provided with medication which they can self-administer in order to end their lives. The medication must be requested both orally and in writing, and, at least 15 days after the initial oral request, the patient must make a second oral request. At that point, the physician is required to offer the patient the opportunity to rescind the request. After this, and at least two days after the signed written request, the physician may prescribe the medication.

The passage of this bill is a major step forward for the rights of terminally ill patients in New Jersey. However, its future passage is far from clear. While the New Jersey Senate has a Democratic majority of 24 out of 40 seats, it is not clear whether the bill would gain approval there. New Jersey has a plurality (40%) of Roman Catholics, a church whose leadership is inextricably opposed to assisted suicide legislation. Lay opinion amongst Catholics, as on other issues, varies, with significant support for the rights of terminally ill patients to control their passing. Even if the bill were to pass both chambers, it seems likely that Republican Governor Chris Christie would veto it. Governor Christie has stated repeatedly that he is pro-life, and has vetoed funding for Planned Parenthood in New Jersey multiple times. Current reports from the pro-life movement indicate he has pledged to them he will veto this bill. Such a veto seems particularly likely if Governor Christie is planning to seek the Republican nomination for the Presidency for the 2016 election. To override such a veto, the bill must receive the votes of two thirds of the members, requiring thirteen further Assembly members to grant their support.

Quoting Hobby Lobby, Federal Appeals Court Hands Down Big Victory For Birth Control

ThinkProgress reports on a promising decision by a federal appeals court regarding whether an employer can deny employees health care coverage based on religion:

A federal appeals court in Washington, DC handed down a decision on Friday that could neutralize some of the impact of the Supreme Court’s decision in Burwell v. Hobby Lobby if it is upheld on appeal. Hobby Lobby held that employers with religious objections to birth control have broad immunity from federal rules requiring them to include birth control in their employer-provided health plan. Judge Nina Pillard’s decision in Priests For Life v. Department of Health and Human Services, however, indicates that there are limits to an employer’s ability to deny birth control coverage to their employees.

You can read the full article here.

How Religious Leaders Are Hindering Vaccination Programs Across the World

Christian Today covers efforts by bishops with the Catholic Church in Kenya to stop the spread of the tetanus vaccination:

The vaccine is aimed at women in their childbearing years and the bishops say that it is being used as a population control measure.

However, the World Health Organisation (WHO) and UNICEF, which are running the programme to immunise 2.4 million women, expressed in a statement for Christian Today their “deep concern about the misinformation circulating in the media” about the vaccine.

The statement said: “The allegations are that the tetanus vaccine used by the Government of Kenya and UN agencies is contaminated with a hormone (hCG) that can cause miscarriages and render some women sterile. These grave allegations are not backed up by evidence, and risk negatively impacting national immunisation programmes for children and women.”

You can read the full article here. You can also read coverage  by Religion News Service here.

A Mix of Wins and Losses in the 2014 Midterm Elections

CFI’s Director of Public Policy, Michael De Dora, summarizes noteworthy midterm election results, including a couple wins on the reproductive rights front:

Win: For the third time, Colorado voters rejected an amendment to the state constitution (Amendment 67) — this time by a nearly two-to-one margin — which would have defined a fertilized egg as a legal “person” starting at fertilization.

Win: North Dakota voters, 64% to 36%, rejected an amendment to the state constitution (Measure 1) that stated, “The inalienable right to life of every human being at any stage of development must be recognized and protected.'”

Win: Illinois voters approved, 66% to 34%, a non-binding advisory question that asked whether health insurance plans should be required to provide coverage for prescription birth control.

Loss: Tennessee voters, 53% to 47%, approved an amendment to the state constitution (Amendment 1) that will allow the state legislature to enact, amend or repeal state laws regarding abortion, including for pregnancies resulting from rape or incest or when necessary to protect the mother’s life.

You can read the full post here.

Center for Inquiry Urges Federal Government to Protect Contraceptive Mandate

From the newsdesk of the Center for Inquiry’s Office of Public Policy:

The Center for Inquiry (CFI) has submitted formal comments to the Departments of Health and Human Services, Labor, and Treasury, urging policymakers at the federal agencies to keep religious exemptions to the contraceptive mandate as narrow as possible.

You can read the full news update, as well as CFI’s  comments, here.

 

Vaccine Ignorance — Deadly and Contagious

Expounding upon their public health work at the Council on Foreign Relations, including a continually-updated global map of vaccine-preventable outbreaks, Laurie Garrett and Maxine builder connect anti-vaccine conspiracies both Western and international, and the apathy that tolerates them:

Today, vaccinators and healthcare workers providing lifesaving interventions are targeted for bombings and assassinations, and children in Pakistan are suffering. Our interactive map clearly demonstrates the correlation between an increase in Taliban propaganda and assaults on health workers and the resurgence of polio. Worse, recent outbreaks of polio and other vaccine-preventable diseases in the Middle East have been linked to Pakistani-trained combatants who have carried pathogens to Syria and Iraq, along with their anti-immunization ideology.

And anti-vaccine sentiments aren’t limited to the developing world. The effects of Andrew Wakefield’s now thoroughly debunked 1998 Lancet study claiming links between vaccinations and autism are still being felt in the Western world, as can be seen in our interactive map. Outbreaks of pertussis in wealthy California communities, of mumps in Ohio college towns and of measles throughout the United Kingdom demonstrate the broad impact of the anti-vaccination movement.

In light of the paranoia evoked by Ebola, political and public health leaders must appreciate that not a single voice dispensing misinformation should go unchallenged. The general public has proved its inability to weigh facts accurately and reach a rational conclusion when fear clouds its judgment. Remarkably, in the case of the purported associations between autism and vaccines, the concept has gone viral in some of America’s most highly educated and wealthy communities, as has unscientific advice about delaying certain immunizations to avoid “vaccine overload.”

Too many political leaders around the world have either fanned the flames of fear or have shrugged off responsibility for dispelling them, assuming that countering conspiracies and false worries is a job for doctors and public health officers.

Americans of All Ages Divided Over Doctor-Assisted Suicide Laws

In light of rising discussion about assisted dying legislation in the United States, Pew points to a 2013 poll that showed overwhelming support for allowing patients to die, but far less support for doctor-assisted suicide.

[T]wo-thirds of Americans say there are circumstances in which a patient should be allowed to die, as opposed to doctors and nurses always doing everything possible to save the life of a patient. But U.S. adults are more divided about laws that allow doctor-assisted suicide for terminally ill patients, with 47% in favor of such laws and 49% opposed. Views on doctor-assisted suicide are little changed since 2005.

By religious demographic, the unaffiliated lead the way in supporting assisted-dying, with 66% in favor. White mainline Protestants and Catholics follow, with 61% and 55% in support, respectively. Opposition is centered on black Protestants (72% oppose), white evangelical Protestants (67% oppose), and hispanic Catholics (63% oppose).

Surprisingly, the youngest group measured, 18-29 year olds, disapprove of assisted dying (54% oppose) nearly as much as the oldest group, those 65 years and older (56% oppose). Relatedly, 18-29 year olds also report having given end of life issues the least amount of thought, with 41% having given “no thought at all” or “not very much thought” and only 25% having given them a “great deal of thought.”

These numbers are somewhat dispiriting in light of last month’s poll showing that 84% of Canadians favor legalized assisted dying in their country.

Pew’s full review can be viewed here.

Doctors Learn to Push Back, Gently, Against Anti-Vaccination Movement

In the face of persistent anti-vaccine efforts, doctors are learning to fight back by educating not only their patients, but themselves. The LA Times follows University of Pennsylvania pediatrician and vaccine advocate Paul Offit to a doctor training session he recently gave at UCLA:

[Offit] wanted to give them the kind of pushback doctors have come to expect in affluent parts of Los Angeles and California, where increasing numbers of parents are refusing to inoculate their kids against contagious, even life-threatening diseases for fear of complications.

For many of the pediatricians in the audience, taking a hard line on the immunization schedule can mean potentially alienating well-intentioned, if misinformed, parents.

Dr. Lisa Stern, background, took part in coaching in talking about vaccinations with parents like Rachel Gipson, who brought her twins in for a checkup at Tenth Street Pediatrics. (Rick Loomis)

If Offit, a rock star in his field, could give these doctors more factual ammunition — and a little practice on their delivery — could they help convince resistant parents that science is simply not on their side?

The salt-and-pepper-haired Offit slipped straight into character and zeroed in on one young doctor.

“I know you doctors keep telling me that vaccines don’t cause autism. If that’s true, then why is it on this package insert?” he asked, playing the role of a parent who had read the blogs and heard the celebrities who connect the two.

Shifting in her seat, the designated victim shot Offit an unsure look.

Then she began citing studies and said that drug packaging inserts include many “temporally associated symptoms” that weren’t necessarily caused by the vaccine.

“Why?” Offit pressed. “Why would they put that there — just to scare me?”

The doctor kept trying. “They’re required by law,” she said. “I actually didn’t know the answer.”

The Anti-Vaccine Movement Is Forgetting the Polio Epidemic

On the anniversary of his 100th birthday, The Atlantic interviews the son of polio vaccine researcher Dr. Jonas Salk on the polio epidemic and the forgetting that has occurred since:

At a time when a single case of Ebola or enterovirus can start a national panic, it’s hard to remember the sheer scale of the polio epidemic. In the peak year of 1952, there were nearly 60,000 cases throughout America; 3,000 were fatal, and 21,000 left their victims paralyzed. In Frankie Flood’s first-grade classroom in Syracuse, New York, eight children out of 24 were hospitalized for polio over the course of a few days. Three of them died, and others, including Janice, spent years learning to walk again.

Then, in 1955, American children began lining up for Jonas Salk’s new polio vaccine. By the early 1960s, the recurring epidemics were 97 percent gone.

On misplaced concerns about vaccines and the necessity of herd immunity:

Rothenberg Gritz: People have been concerned by the idea that vaccines can cause disease in healthy children.

Salk: There are some subtleties to this. With pertussis, for instance, the old vaccine was based on using the whole killed organism. That was very effective, but because there were a whole lot of different kinds of proteins that were all mixed up, there were some side effects. Later on, they developed a so-called acellular pertussis vaccine, where you use purified materials from the bacterium. It doesn’t produce as strong or long-lasting an immune response—people need to have booster shots when they’re adults, for instance. But it doesn’t cause the same side effects.

When my own son Michael was born 31 years ago, the whole-cell vaccine was still in use. Whooping cough was essentially gone in this country by that time, so from one perspective, why should we take the risk of causing a high fever or other side effects in our own child? I know I certainly thought about this a lot. But I just couldn’t bring myself to take advantage of the good that other people had done by immunizing their kids—to take a free ride, so to speak. Michael did end up developing a fever. But I couldn’t have lived with my decision if we hadn’t given him the vaccine.

On the misinformation spread by the anti-vaccine movement:

Rothenberg Gritz: Some vaccine opponents argue that as long as children live healthy lifestyles, they can either avoid illnesses like polio or recover quickly and develop “natural immunity.”

Salk: No. I wouldn’t hesitate to use very strong words about that. Of course it’s a good thing to live a healthy life, to keep the body strong and well-rested. I won’t rule out that it can help to protect against some types of disease. But when it comes to these organisms that can be very damaging to people, I think it’s wishful thinking to imagine that a healthy lifestyle can protect against infection.

And what we see is that many diseases are starting to come back. Measles is recurring; whooping cough is recurring. The kids whose parents are choosing not to immunize them are at risk, but so are babies and kids who might not be able to be vaccinated for one reason or another. These kids are no longer having the same benefit of herd immunity. Their level of protection is now eroding.

[…]

Rothenberg Gritz: Why do you think this misinformation has spread so widely?

Salk: Part of it is that people have become complacent because these diseases aren’t rampant anymore. During the polio epidemic, people were really frightened. This was a disease they didn’t understand, whose appearance they couldn’t predict, and it had terrible effects on kids. Swimming pools and movie theaters were closed. It’s easy to forget this now. Also, these days, there are a lot of concerns about living naturally and not wanting to be exposed to things that are made in a laboratory.

But there are probably other forces at work. Back in the 1950s, people really looked to science and medicine as something that would make their lives better. But once the fear of these diseases began to subside, people started looking at other large-scale forces in the world—the Vietnam War, the government, and so on—and wondering, Canwe trust large institutions?Can we trust pharmaceutical companies? I think that that’s something that’s driven people also: a sense of alienation.

Read the full interview here.

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