Category Archives: Nursing Care Suicide

Assisted Suicide Ban Challenged in the Golden State

Jack Kevorkian
Doctor Death or Angel of Freedom?

There have been endless battles over patient rights and assisted suicide. People take their lives in many ways. Doctor Jack Kevorkian, left, was a pioneer in the field of assisted suicide and received much media exposure. But then like now, when another person, even a doctor helps, it can become a homicide charge for the assistant, typically a doctor administering a painless sleep inducing type of drug. In fact, the doctor, or aider and abetter could also face a lawsuit for wrongful death (source.) The fact that a doctor could be facing a murder charge, makes it very hard to find an otherwise willing physician to help the patient.

San Francisco leukemia patient Christie White along with her doctors is challenging the ban on physician assisted suicide. They plan to use the legal strategy going state-by-state to challenge the bans on assisted suicide, while right-to-die advocates continue their pursuit with politicians.

White age 53 filed her lawsuit using the legal tactic that states such as New Mexico, Montana and New York against California’s laws.
The lawsuit claims California’s laws involving end-of-life treatments have been on the books for 140 years and are outdated and by denying patients these treatments physicians are threatened with criminal prosecution. It claims state constitutional protections are violated, since California laws cover privacy, “personal dignity” and independence making medical decisions.

Disability Rights Legal Center attorney Kathryn Tucker, who is representing White stated the case is to bring focus on the fact that patients choosing end-of-life treatment is not suicide.
On the Disability Rights Legal Center website White has discussed her seven year battle with leukemia and why she wants her physicians to be able to help in her death. She also mentions she would like to die in her own community and speaks of Brittany Maynard’s case.

Maynard’s video went viral in 2014 about having brain cancer and her right to die with dignity. In her case Maynard was forced to move from San Francisco to Oregon in order to receive end-of-life treatment for her terminal cancer.  The video is below for your viewing pleasure.

Currently Oregon is one of three states where doctor assisted suicide is legal.

White said she did not want to be forced to move to Oregon, leaving her husband, family and friends and said it is time for California to allow patients to make their own end-of-life medical decisions.

The U.S. Supreme Court previously has ruled doctor assisted suicide laws should be determined by the states (See Wiki Here.) Legal experts say this forces advocates of end-of-life treatment to refrain from arguing that denying physician assisted suicide violates the patient’s federal constitutional rights.

White has stated she says she will back the lawsuit while fighting her illness and when her time comes she wants to be with her loved ones and die a peaceful death in California with dignity. White’s attorneys stated they want to speed up White’s lawsuit and raise the argument of a “fundamental right” in the state construction for patients with terminal illnesses to get the life ending treatments.

According to University of New Mexico law professor Robert Schwartz physician assisted life ending treatments and gay marriage are the two civil rights issues of the decade. Schwartz believes that the strategy in the California lawsuit is fitting.

Targets of White’s San Francisco legal action are San Francisco District Attorney George Gascon and Attorney General Kamala Harris. They have declined comment about the lawsuit and they would be responsible for prosecution of White’s physicians if they provided life ending treatment for the leukemia patient.

Democratic Senator Bill Monning of San Luis Obispo and Lois Wolk of Davis introduced a bill last month in an attempt to legalize doctor assisted suicide in California. The legislation is modeled after Oregon’s law and should soon be the topic of committee hearings.
Last year in New Mexico a judge ruled doctors could not be prosecuted for assisting dying patients but the ruling is now being reviewed by the state appeals court.

Legal arguments that can be used in challenging California’s 1874 assisted suicide statute, include the New Mexico ruling. Montana is a state where the Montana Supreme Court also ruled in 2009 to ban the prosecution of physicians providing end of life treatment to patients. The ruling used the State Constitution that protects the patients.

Californians Against Assisted Suicide spokesman Tim Rosales said the lawsuit in a broader sense is a strategy to legalize the use of drugs that accelerate death. Rosales said this strategy is an attempt to throw anything out and see what works. Groups that are against the end of life treatments by doctors are becoming involved with court cases to preserve the laws against doctor assisted suicides.

Statistics of Suicidal Patients in Long-Term Care Settings

Rosenfeld Law
Attorney Jonathan Rosenfeld Injury Attorneys

Patients who have a history of mental illness or depression are at a great risk for being deemed suicidal patients in nursing homes. Research studies indicate that those patients who commit suicide typically have an illness like depression, and they commit suicide within less than six months of living in a nursing home. Suicide attempts usually involve behaviors like drowning, hanging or medication overdoses. Other research studies of long-term care patients have shown that 12 to 50 percent of nursing home patients suffer from depression at any given time. In some states, the suicide rate can be as much as 14 individuals for every 100,000 patients. Nursing home workers need to pay special attention to this group of patients and monitor any suicidal tendencies that they may exhibit.

The Geriatric Medicine and Medical Direction Journal states that suicide in long-term care patients is most often associated with depression. Suicide rates in these patients are also not decreasing every year. The level of depression that a long-term care patient can experience ranges from minor depression to major depression. Depression can also develop in patients who were previously happy individuals due to the conditions of the nursing home or other institutional environment.

Causes of Suicide in Nursing Home Patients

It is important for nursing homes to identify conditions that may cause residents to develop depression. Since depression is the leading cause of suicide in nursing home patients, it is important to take any precautions possible to prevent this illness from developing in nursing home patients. Nursing home patients can develop depression when they lose personal autonomy or do not have social interaction with other people on a regular basis. They may suffer from fatigue or sleep problems that nursing home workers fail to recognize. Some patients even suffer from severe anxiety after entering a long-term care facility due to concerns over their financial ability to pay for the care services. These patients can also be at risk for having suicidal thoughts and need to receive the attention of nursing home workers.

Protocols to Assess At-Risk Seniors in Nursing Homes

Nursing homes have a legal duty to care for those patients who are at risk for committing suicide in the future. They need to take certain protocols to ensure that they take every measure to prevent suicide in these patients. Here are some of the ways in which nursing homes may be liable when a patient does commit suicide:

  • Failure to create a care plan for the at-risk patient
  • Failure to abide by the care plan for the at-risk patient
  • Failure to assess the mental health of the patient upon his or her admission into the facility
  • Failure to monitor patients with a history of depression or who have expressed suicidal ideations
  • Failure to discuss major changes in the patient’s mental health with a family doctor, family members or a legal guardian

When nursing home administrators and workers fail to take these protocols, they may be cited for neglect. Neglect refers to a nursing home’s failure to provide the goods and services required to avoid the physical harm or mental suffering of a patient. Nursing home workers must receive training so that they can notice the signs of depression in patients. A nursing home may even wish to implement a standardized program in which all patients are screened for depression after being admitted to a nursing home for two weeks. In addition, a nursing home can also screen all nursing home residents for depression every six months.

Duty to Monitor Nursing Home Patients with Suicidal Ideations

Those patients who have expressed an intention to take their own lives should immediately be referred to a therapist or other mental health professional. These patients need outside help to cope with their suicidal thoughts and improve their mental health. Even if patients do not express suicidal ideations, there may be other signs that create a reasonable suspicion that the individual will take his or her life. Nursing home workers also have a legal duty to transfer this individual to the nearest emergency room or psychiatric facility.

If a patient has already taken steps toward taking his or her life, then nursing home workers must notify the police. The staff should not be responsible for attempting to disarm the individual. The individual may pose a threat to his or her own safety as well as the safety of others. Police members are trained to deal with people who express suicidal ideations.

Family members who have lost a nursing home patient due to suicide may have a legal claim against nursing home administrators or workers. These individuals may be liable for failing to take steps to protect the at-risk patient, and nursing home lawyers can help file a lawsuit for family members.

For additional information on nursing home safety and suicide prevention:

Jonathan Rosenfeld is a personal injury and medical malpractice attorney in Chicago and regularly handles cases involving nursing home neglect.