Editor's note: As part of our continuing election coverage, we're taking a closer look at amendments and propositions that will be on the Colorado ballot in November. Yesterday, in a post headlined "Why You Should Vote Yes for Proposition 106, Regarding End-of-Life Options," we examined Proposition 106 by way of an interview with a spokeswoman for the campaign. Today we highlight a Q&A with a representative of the opposition.
Vote No on Prop 106, the coalition opposing an initiative that would create a legal framework for terminally ill individuals wishing to utilize what proponents refer to as medical aid in dying, includes many members of the faith community, who object to the proposal on religious grounds. However, spokeswoman Peggi O'Keefe stresses that the Vote No force also includes representatives from secular organizations — among them groups advocating on behalf of the disabled community.
In a Westword interview, O'Keefe outlines her problems with the measure and counters assertions made by its backers.
The following transcript of our conversation is supplemented by videos of other opponents sharing their views, as well as links and occasional insertions for reasons of fact-checking and clarification.
Westword: Why does your organization object to Proposition 106?
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Peggi O'Keefe: Because there are a lot of flaws in the language as it's been drafted. The legislature has rejected this language twice in the state of Colorado, and thirty other states around the country have rejected it multiple times. [Click for more about states with and without death-with-dignity acts or similar laws.] The proponents focus on Oregon and kind of signify that as the model. But there have been thirty other states that have considered this initiative, either through the initiative process or through the legislature, and have rejected it. It's because the proponents have refused to make changes in the language that would add some protection.
What are the most significant flaws in this measure from your perspective?
They go on and on. But from the beginning, as we know, physicians make mistakes. We've all heard stories where someone's been given six months to live and they go on to live for two years longer, four years longer, even ten years longer. Johns Hopkins has said that medical errors are the third leading cause of death. So when other states have gone in and tried to shorten the window [for requesting prescriptions], the proponents have refused. We believe that's because there's not a requirement that there be a psychiatrist or psychologist that does some kind of review. There's a real question about whether someone has good mental standing. There's absolutely no requirement that someone have that review by a mental-health professional.
The initiative talks about a patient having mental capacity, but someone who's qualified in that realm isn't required to do an exam. And in Oregon in 2015, when people cite why they're asking for the assisted-suicide medication, they point to a fear of the illness, losing a zest for life, not wanting to lose their independence. And pain is actually the second to last reason people cite for wanting the medication. [For more about Oregon's experiences, click to access the state's Death With Dignity Act guidebook.]
It's human nature: If you get diagnosed with a terminal illness, you probably do have some depression issues. But there's no requirement that a mental-health professional be seen.
If I'm understanding you correctly, your organization's opposition to an end-of-life proposal isn't absolute. Does that mean your group might support an end-of-life measure of some kind — one that offered more protections, in your view, than this one does?
The Catholic Church and some of the faith organizations would never support an end-of-life measure. I think there are other organizations out there, and other individuals — district attorneys, coroners, DAs, maybe people in the disability community, although I'm not sure — that would be more comfortable with the language if some of these flaws were addressed.
[Opponents of Proposition 106 include Dr. Michelle Stanford, who shares her views in the following video.]
How do the objections mentioned by faith organizations parallel some of the problems cited by other organizations in your coalition?
The disabled community is very concerned with the language of the bill. This is a community that's already devalued by the medical system, and when we look at some instances in Oregon with the state Medicaid program — the state insurance system sent out letters that said, "Hey, we're going to reject these chemotherapy treatments and some of these other more expensive treatments — but we will cover assisted suicides." [This controversy dates back to 2008.] For the disabled community, they're very concerned that this becomes an insurance issue, and an issue where they're not given proper quality of life. They want to be functioning members of the community. And if they're starting to be denied treatment because it's expensive, they're very concerned. Without attending care or the ability to parent or the ability to be an active member of the community, you take away the things that allow people to live their life.
For the disabled community, this is about social justice. It's not a choice issue.
Is there fear among members of the disabled community that assisted suicide could become more prevalent simply as a cost-saving measure?
Absolutely. For insurance companies, money is the bottom line, and a lot of these treatments and medications are expensive. If you're taking away folks' ability to fully engage in their community, you're taking away those things that make life worth living.
As you mentioned, proponents talk about Oregon being a model for the Colorado policy. They also say that in Oregon, there have been no complaints about people being coerced into applying for or using these medications, and they stress that it's not been used all that often during the period when it's been legal. What's your reaction to those assertions?
I think part of the problem is there's very little data collected in Oregon. [Click to read annual reports about Oregon's death-with-dignity act dating back to 1999.] To say there haven't been any abuses I think is false, because there hasn't been any ability to report anything. The language has blanket immunity in it that pretty much renders any protections void. You can't prosecute abuses under the law. Someone just has to claim they were acting in good faith, and it's nearly impossible to determine if that's the case. Once a prescription is written, you can't pursue that — questionable heirs with influence over patients.
One of the main proponents of this measure tells a very personal story about her father having ALS and writing a letter to legislators asking for this measure to be passed here — and yet it wasn't passed. Why do you think the legislature has balked thus far in approving an end-of-life-options law?
When you go back and look at the committee hearings [into the proposal], they raised a lot of concerns similar to the ones our campaign is raising. There were concerns raised by DAs, coroners, the disabled community. [This linked article covers the rejection of legislation in 2015.] The initiative is very poorly written. The proponents have been unwilling to make significant changes that would really tighten up all these loopholes that are in the initiative. This language is based very similarly to the legislation that was rejected by the General Assembly.
What other loopholes are particularly problematic from your point of view?
It talks about two physicians that are either specialists or experienced — that they can sign off on this. But what does experienced mean? Is that two years? Is that five years? And the two doctors — is that an ear doctor? A foot doctor? In Oregon, we've seen there are about 100 physicians who have written most of these prescriptions out of 10,000 physicians in the state. [This statistic, which is frequently cited among death-with-dignity-act opponents, covers the years 2001 through 2007, according to the Boston Pilot.] So there's real concern there's going to be doctor shopping. [This 1999 Weekly Standard article features the doctor-shopping angle.] There was a physician who advertised that for $5,000, you could bring your family to his lobby, and you'd get counseling and there was music — and the Oregon medical licensing organization pulled his license. [Here's an ABC News profile of the physician in question, Dr. Stuart Wiesberg.] So the whole doctor-shopping thing is a concern.
I talked a little bit about the medical-errors piece and the insurance-company piece. But there's a real concern that this is a slippery slope — that it gives insurance companies an excuse to not cover legitimate treatment options and instead provide this as an option. That raises a fear that experimental or even proven treatments aren't going to be covered by insurance companies. And that's really a scary place to be. We've all had experiences with insurance companies that deny, deny, deny. How does that multiply this problem?
Some members of the faith community would oppose this kind of measure under any circumstances, as we've discussed. Is your focus on the flaws in the measure an effort to broaden support for opposing the measure beyond those communities?
That's right. We don't often get the chance as general-population voters to vote on life-or-death issues. So we really need to consider this, really think about the details of the measure and understand what it does. And this measure is flawed. Even if they're okay with the moral issues and don't have a problem with it, this is written terribly. There are all kinds of loopholes in it, and the proponents don't seem to care. They don't want to make changes that would make folks more comfortable with it.
Even if somebody doesn't come from that faith concern, there are still a heck of a lot of problems with this initiative.
[Priests throughout the Archdiocese of Denver have been delivering homilies against Proposition 106. The following video features Father Nathan Goebel, speaking from the pulpit of St. Joan of Arc Catholic Church in Arvada.]
In driving around Denver, I seem to see more signs about Proposition 106 than anything else on the ballot, including the presidential race. Why do you think this issue has stirred so much passion among members of the community?
I think it goes back to the fact that we don't get to weigh in on life-or-death issues very often. This isn't something about an oil-and-gas company losing millions of dollars. This is about people who are in a very vulnerable place in their life and what happens — how they're protected. I think for a lot of voters, they're skeptical about the language of the initiative and concerned about the way it's drafted. So people are really taking a close look at this, and we think that's the proper path.
How are you planning to get your message out leading up to the election?
We don't share our campaign strategy. I don't believe there's a TV buy out there right now, but even if there was one, I don't think we'd go into a lot of detail.
Are you optimistic that the "no" vote will prevail in this case?
I think that the more people learn about this issue, the more problems they see in it. There are a lot of other ballot initiatives and other races out there. In a lot of ways, voters are overwhelmed with these issues. But the more they hear about it, the more concerns they have. So our hope is to raise questions for voters, and when they go to examine the details of the initiative, they'll see there are a lot of issues that aren't being properly addressed in this initiative.
Something else to mention is that the proponents are funded by the Compassion and Choices Action Network, which is a George Soros organization. [Soros is a liberal philanthropist reviled by many conservatives.] I know there's a lawsuit out there right now saying that organization should have registered as an issues committee and should have disclosed where the money came from, because a huge amount of it — north of $4 million — has come from that George Soros organization, and I think that's something voters should be aware of.
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Who are the funders of your campaign?
There's a broad range of funders. There are folks from the faith community, the disabled community and general citizens. But the issue is, people know where money from the faith community comes from — but [proponents'] funds have been filtered through Compassion and Choices.