Saturday, January 21, 2017

In Oregon, Other Suicides Have Increased with Legalization of Assisted Suicide. The Financial and Emotional Cost is "Enormous"

The cost is "enormous."
By Margaret Dore, Esq., MBA

A pdf version can be viewed here and here.

If not rejected, Act 21-577 will legalize physician-assisted suicide in the District of Columbia. The Act is based on a similar law in Oregon, which was enacted in 1997.[1] Since then, there has been a significant increase in other (conventional) suicides in Oregon. This is consistent with a suicide contagion in which the legalization and promotion of assisted suicide has led to an increase in other suicides. A government report from Oregon, which is a smaller population state, says:
The cost of [conventional] suicide is enormous. In 201[2] alone, self-inflicted injury hospitalization charges... exceeded $54 million; and the estimate of total lifetime cost of suicide in Oregon was over $677 million.[2]
The Fiscal Impact Statement for Act 21-577 completely overlooked this issue. The Statement does not address the issue of suicide contagion and its potentially enormous financial (and emotional) cost. [3] Act 21-577 must be rejected to prevent suicide contagion.


“Suicide” means the intentional taking of one’s own life.[4]  “Physician-assisted suicide” means that a physician facilitates a
person’s suicide by providing the necessary means and information.[5] For example, 
[he or she] provides sleeping pills and information about the lethal dose, while aware that the patient may commit suicide.[6]  

A.  Suicide is Contagious 

It is well known that suicide is contagious. A famous example is Marilyn Monroe.[7] Her widely reported suicide was followed by “a spate of suicides.”[8]

With the understanding that suicide is contagious, groups such as the National Institute of Mental Health and the World Health Organization have developed guidelines for the responsible reporting of suicide, to prevent contagion. Key points include that the risk of additional suicides increases:
[W]hen the story explicitly describes the suicide method, uses dramatic/graphic headlines or images, and repeated/extensive coverage sensationalizes or glamorizes a death.[9]
B. Lovelle Svart and Brittany Maynard

In Oregon, prominent cases of assisted suicide include Lovelle Svart and Brittany Maynard.

Lovelle Svart died in 2007.[10] The Oregonian, which is Oregon’s largest paper, violated the recommended guidelines for the responsible reporting of suicide by explicitly describing her suicide method and by employing “dramatic/graphic images.” Indeed, visitors to the paper’s website were invited “to hear and see when Lovelle swallowed the fatal dose.”[11] There are still photos of her online, lying in bed, dying.[12]

Brittany Maynard reportedly died from assisted suicide in Oregon, on November 1, 2014.[13] Contrary to the recommended guidelines, there was “repeated/extensive coverage” in multiple media, worldwide.[14] This coverage is ongoing, including before this body, where her image and story is being used to promote Act 21-577.

C. The Young Man Wanted to Die Like Brittany Maynard

A month after Ms. Maynard’s death, Will Johnston MD was presented with a twenty year old patient during an emergency appointment.[15] The young man, who had been brought in by his mother, was physically healthy, but had been acting oddly and talking about death.[16]

Dr. Johnston asked the young man if he had a plan.[17] The young man said "yes," that he had watched a video about Ms. Maynard.[18] He said that he was very impressed with her and that he identified with her and that he thought it was a good idea for him to die like her.[19] He also told Dr. Johnston that after watching the video he had been surfing the internet looking for suicide drugs.[20] Dr. Johnston’s declaration states:
He was actively suicidal and agreed to go to the hospital, where he stayed for five weeks until it was determined that he was sufficiently safe from self-harm to go home.[21]
The young man had wanted to die like Brittany Maynard.

D. Other Suicides Have Increased

Oregon government reports show the following positive correlation between the legalization of physician-assisted suicide and an increase in other suicides.  Per the reports:
  • Oregon legalized physician-assisted suicide “in late 1997.”[22]
  • By 2000, Oregon’s conventional suicide rate was "increasing significantly."[23]
  • By 2007, Oregon's conventional suicide rate was 35% above the national average.[24]
  • By 2010, Oregon's conventional suicide rate was 41% above the national average.[25]
  • By 2012, Oregon's conventional suicide rate was 42% above the national average.[26]
E. The Financial and Emotional Cost of Suicide

The financial cost of suicide to state and local governments includes expenditures for burial/cremation services and police investigations. In the case of attempted suicides (that fail), expenditures can include costs for hospitalizations, physical and psychological rehabilitation, and nursing home care. Consider also, "suicide by cop," which is a recognized form of suicide[27]. A suicidal person threatens police or civilians in order to be killed by the police, which can result in costly litigation over the use of force, and in some cases damages paid by government bodies to the suicidal person's family.[28] Consider Runnels v. City of Miami where the family received a $1.25 million settlement in a lawsuit against the city.[29]

There is also a trend for suicidal people to take other people with them (murder suicide). Consider Andy Williams, a suicidal 15 year old boy who in 2001 killed two schoolmates and injured 13 others.[30]  His "grand plan" was suicide by cop.[31] He instead survived the incident and has been incarcerated in a California state prison with his first parole hearing to be held at age 65.[32]  Obviously, this incident caused great financial expense, which is ongoing.

Finally, there is the emotional cost of suicide. The most recent report from Oregon on conventional suicide states:
The financial and emotional impacts of suicide on family members and the broader community are devastating and long-lasting.[33]
F. The Significance for the District of Columbia

The District of Columbia currently has the lowest suicide rate in the nation.[34] If Act 21-577 is not rejected and the District of Columbia repeats the Oregon experience: The District will have increased suicide; the District will have financial and emotional cost. As in Oregon, the total cost could be enormous for the District of Columbia, which is a smaller population jurisdiction.


The D.C. Council completely overlooked the issue of suicide contagion. Act 21-577 must be rejected to prevent suicide contagion and its potentially enormous financial and emotional cost. I urge you to reject Act 21-577.

Respectfully submitted

/s/  Margaret Dore, Esq., MBA
Law Offices of Margaret K. Dore, PS
Choice is an Illusion, a nonprofit corporation
1001 4th Avenue, Suite 4400
Seattle, WA  98154


[1]  Oregon Committee on Health and Human Service Committee Report, filed 10/06/16,  p. 2 (regarding “physician-assisted suicide”). Attached to contagion memo attachments pdf, as page A-1.
[2]  Shen X, Millet L, “Suicides in Oregon: Trends and Associated Factors 2003-2012,” Oregon Health Authority, page 6, 1st ¶. (Attached to contagion memo attachments pdf, as page A-2.
[3]  See Fiscal Impact Statement, dated November 1, 2016. (Attached to contagion memo attachments pdf, as page A-3.
[4]  Definition of “suicide” by Medical Dictionary,
[5]  The AMA Code of Medical Ethics, Opinion 2.211, attached to the contagion memo attachments pdf, as page A-4.  
[6]  Id.
[7]  Margot Sanger-Katz, “The Science Behind Suicide Contagion,” The New York Times, August 13, 2014, excerpt atttached to contagion memo attachments pdf, as page A-5.  
[8]  Id.
[9]  “Recommendations for Reporting on Suicide,” The National Institute of Mental Health
attached to the contagion memo attachments pdf, as page A-6. See also “Preventing Suicide: A Resource for Media Professionals,” World Health Organization.
[10]  Ed Madrid, “Lovelle Svart, 1945 - 2007, The Oregonian, September 28, 2007. atttached to contagion memo attachments pdf, as page A-7.
[11]  Id.
[12]  See photos printed from online sources on November 8, 2016, at 
the contagion memo attachments pdf pages A-8 & A-9. 
[14]  The worldwide coverage of Ms. Maynard in multiple media started with an exclusive cover story in People Magazine. The cover can be viewed 
at the contagion memo attachments pdf at page A-10. Other media included TV, radio, print, web and social media.
[15]  Declaration of Williard Johnston, MD, May 24, 2015, viewed at the contagion memo attachments pdf at pages A-11 to A-12.
[16]  Id., paragraph 2.
[17]  Id.
[18]  Id.
[19]  Id.
[20]  Id.
[21]  Id., paragraph 4.
[22]  Oregon Death with Dignity Act: 2015 Data Summary," Oregon Public Health Division, February 4, 2016, p.2, attached to 
the contagion memo attachments pdf at page A-13. 
[23]  Oregon Health Authority News Release, September 9, 2010, at  ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000"). Attached to the contagion memo attachments pdf at page A-14.
[24]  Suicides in Oregon: Trend and Risk Factors, issued September 2010 (data through 2007). Attached to the contagion memo attachments pdf at page A-15 & A-16.
[25]  “Suicides in Oregon: Trends and Associated Factors, 2003-2012 (data through 2010), attached to the contagion memo attachments pdf at pages A-17 & A-18.
[26]  “Suicides in Oregon: Trends and Associated Factors, 2003-2012, attached to the contagion memo attachments pdf at page A-19. 
[27]  Bernard J. Farber, Suicide by Cop, 2007(8) AELE Monthly Law Journal, Civil Liability Section, August 2007. Can be viewed at the contagion memo attachments pdf at pages A-20 & A-21; Farber bio attched at A-22.
[28]  Id. at A-20 & A-21.
[29]  Farber, supra, writes:
That such shootings may result in substantial liability is clearly illustrated by.... Runnels v. City of Miami, U.S. Dist. Ct. No. 00-2930 (S.D. Fla. 2002), the family... received a $1.25 million settlement in a lawsuit against the city...
[30]  Rebecca Jacobson, "School Shooter: 'My Grand Plan Was Suicide by Cop,'" February 18, 2013.  Can be viewed at contagion memo attachments pdf at page A-21. 
[31]  Id.
[32]  Id.
[33]  Shen X. supra.  Can be viewed at the contagion memo attachments pdf at page A-19. 
[34]  Center for Disease Control and Prevention, Age-Adjusted Suicide Rates by State, 2012.  Can be viewed at the contagion memo attachments pdf at page A-24.