The apparent murder-suicide of a death-with-dignity advocate and his ailing wife

The apparent murder-suicide of a death-with-dignity advocate and his ailing wife

One gunshot. Then another. Within minutes, a prominent death-with-dignity advocate was shot dead along with his ailing wife in an assisted living center in Florida.  The couple was found at the Solaris HealthCare Charlotte Harbor center in Port Charlotte, Fla. Charlotte County Sheriff’s Office spokesman Skip Conroy said the case is being investigated as a murder-suicide. But those who knew the Kavanaughs said it may have been their only option. “It was a rational suicide,” Final Exit Network President Janis Landis told The Washington Post. “Both of them made this decision. It was not murder.” Fellow members of the Final Exit Network said Kavanaugh had recently pulled away from his own life to stay by his wife’s side as she battled a degenerative brain disease. “He had really disengaged from everything else,” Landis said. “He was at her side every day, all day. He hadn’t spent a night away from home since she got the diagnosis.” Landis, the group’s president, said several members knew what the Kavanaughs had been going through but none knew how bad it had gotten. “We’re not surprised that both of them felt strongly about their right to decide the timing and manner of their deaths when the quality of their lives became unacceptable,” she said. Landis noted that, as far as she knew, no one was aware of the couple’s plan.  Authorities have not yet released a possible motive in the Kavanaughs’ case. Just after 1 a.m. Tuesday, authorities were called to the Solaris HealthCare Charlotte Harbor center, where they found the couple. Both had been shot and killed.  After the couple’s deaths, friends, neighbors and fellow right-to-die advocates started to speak out about the violent and heart-wrenching scene.  People in the pair’s Punta Gorda community depicted a heartbreaking image of an elderly husband who was desperate to help the love of his life. “He was in good shape, good health; I can’t imagine why this horrible thing happened,” Gale Petrillo told WZVN. “I’m stunned. It’s horrific. Sometimes we could hear him say, ‘Barbara, but I’m only trying to help. I’m only trying to help.’ ” But another friend, Ted Goodwin, said Kavanaugh had started having health issues, which, Goodwin thought, may have led to a deadly decision. “They were with each other constantly over a lifetime,” he told the news station. “My guess is they had determined to go together. While my heart is breaking on one hand, I have to honor the fact they went on their terms.” Frank Kavanaugh was retired after a long teaching career at the George Washington University School of Medicine, according to his Final Exit Network biography. The school, however, could not immediately verify his employment history.  “With my 23 years in the medical center, I saw the wonderful things that we did in intervening in people’s lives and making them better — and, unfortunately, I also saw how when we could not make them any better we too often walked away from them at the most critical time in their lives,” he said in 2014, adding that he didn’t think the medical profession was responding in the right way. “Lots of emphasis on keeping people alive; not enough on what we could call ‘end-of-life care’ or really ‘aid-in-dying.’ ” In recent years, there has been an emotional push from right-to-die advocates such as Kavanaugh to urge states to adopt laws that would allow terminally ill patients to choose how they want to go.    That same year, a Pew Research survey showed that public opinion was split, with 47 percent of U.S. adults supporting the practice and 49 percent opposing it. A Gallup poll that year suggested that results varied according to how the question was presented: Some 70 percent of Americans were in favor of allowing physicians to “end the patient’s life by some painless means,” but only 51 percent were in support of allowing doctors to help a patient “commit suicide.” Since then, some things have started to change. Last year, California Gov. Jerry Brown (D) signed a measure to legalize physician-assisted suicide in the state. A poll at the time showed a 10-point rise in support from 2014 — an increase “consistent with changing attitudes related to a number of once-controversial social issues,” according to Gallup. But not everyone agrees with doctor-assisted suicide — and some opponents have made their opinions known. Amid the debate in California, Stephanie Packer, who has been battling her own terminal illness, said she worried that the option to die would prevent people from trying to find a way to live.  The American Medical Association, it seems, agrees. “Instead of participating in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life,” the organization said in its opinion on physician-assisted suicide. “Patients should not be abandoned once it is determined that cure is impossible.” The deaths in Florida this week have already prompted further discussion about the death-with-dignity debate. Landis, the Final Exit Network president, drew parallels between the Kavanaughs’ deaths and a time before abortion was legal, when some women would use coat hangers to perform their own procedures. “In an ideal word,” she said, “people would not have to resort to such violent means.”

Murder-suicide disturbing trend among the elderly

KANSAS CITY, Mo. — Golden years? Not every senior citizen thinks so. Murder-suicide is occurring with alarming frequency among the elderly. This week a 93-year-old man reportedly stabbed his 95-year-old wife to death early Wednesday morning in their south Kansas City, Mo. home. Then he tried to stab himself in the chest, but failed to kill himself and woke up in the hospital. Harry Irwin told a paramedic, “Yes, I killed her. And then killed myself. Why am I still awake?”    *[WSU]: Wayne State University This did not appear to be a mercy killing, intended to relieve pain and suffering. Irwin told a nurse his wife, Grace Irwin, had been “arguing and screaming at him all night,” and he couldn’t take it anymore. The couple’s 70th wedding anniversary was last month. They have seven children who live in the area. The Jackson County prosecutor has charged Harry Irwin with second-degree murder. “No victim deserves someone else deciding when they will die,” Prosecutor Jean Peters Baker said in a statement released to the media. The Kansas City murder-attempted suicide is hardly an isolated incident. Two weeks ago Roy Boldt, 81, visited his wife at a Tequesta, Fla. nursing home. He shot and killed 75-year-old Virginia Boldt and then turned the gun on himself. Family members told a reporter the couple had known each other since she was 5 and he was 12-years-old.    *[WSU]: Wayne State University In October James Stanton, 75, shot his wife, Patricia Stanton, 68, during a visit to the Jacksonville, Fla. inpatient rehabilitation facility where she had been admitted after suffering injuries from a fall. She survived the murder attempt, but he died after shooting himself at the scene.    *[WSU]: Wayne State University Earlier this year in the Washington, D.C. area, Charles D. Snelling killed his wife and then himself a week after their 61st wedding anniversary. Snelling, who’d written an essay for The New York Times on the love story he shared with his wife, had once chaired the authority overseeing Reagan and Dulles airports and the construction of Metro’s new $6 billion Silver Line. Adrienne Snelling, a fine arts photographer, had suffered from Alzheimer’s disease for years, and her condition had deteriorated.    *[WSU]: Wayne State University   Adrienne explained, in a letter written three years earlier to the couple’s children, “We are both in agreement that neither one of us wants to live after all reasonable hope for a good life is over.” “Might more support have made a difference? Or did he just not want to go on without her?” wrote Paula Spencer Scott on Caring.com about the Snellings. Murder-suicides among people 55 and older have increased from 21 percent in 2002 to 25 percent in 2011 of the total murder-suicides in the United States, according to the Violence Policy Center.    *[WSU]: Wayne State University A murder-suicide involving an elderly couple occurs about every two weeks in Florida, Donna Cohen, a professor at the University of South Florida, told the Kansas City Star. The author of several scholarly research articles on the topic, Cohen estimates that 20 older Americans die _each week_ as the result of murder-suicide.    *[WSU]: Wayne State University The typical case? A depressed, controlling husband who shoots his ailing wife — without her permission, according to Cohen. For most, this isn’t the romanticized Romeo and Juliet suicide pact with the couple agreeing on the time and place to ride off into the sunset together. Although the Snellings might have agreed to end it together, the majority of murder-suicides among older couples are not suicide pacts, reports Sonia Salari, a sociologist at the University of Utah. Salari analyzed data from 225 murder-suicides in which one member was age 60 or older.    *[WSU]: Wayne State University Experts say depression, exhaustion and isolation all play a role; often, it’s men who are thrust into the unfamiliar role of caregiver. They may suffer from undiagnosed clinical depression. And if they learn their own health problems put them at risk of dying before their spouses, they may believe that no one else can take care of their wives as well as they can. And they don’t bother asking their wives for permission; in fact, the spouse is often unaware of the plan — and probably wouldn’t agree to it. Grace Irwin’s brother, Salvatore Privitera, told the Kansas City Star, “My sister was very much interested in living,” he said. “She was very content.” _To get help: Ask your doctor or mental health professional or visit the Web site ofThe Institute on Aging in San Francisco, which offers a Center for Elderly Suicide Prevention & Grief Counseling. The phone number for their Friendship Line is (800) 971-001. _    *[WSU]: Wayne State University _Diana Reese is a freelance journalist in Overland Park, Kan. Follow her on Twitter at @dianareese._    *[WSU]: Wayne State University

Husband of New York judge who was found dead challenges reports of apparent suicide

The sudden death of Judge Sheila Abdus-Salaam — and the hours that led up to it — remains shrouded in mystery.  But about a week later, following an inconclusive autopsy, authorities have begun asking for the public’s help in the investigation. While there are still no signs of foul play, the case is being treated as suspicious, a spokesman from the New York Police Department said. And on Wednesday, Abdus-Salaam’s husband, the Rev. Gregory Jacobs, joined the police in appealing for help from anyone with information that might help determine what happened in the moments before his wife’s death. In his first public comments since the death, Jacobs firmly pushed back against reports that Abdus-Salaam’s death was an apparent suicide.   “Sheila’s mother, the matriarch of our family who died at age 92 in 2012, did not take her own life,” their statement read, NBC News reported. “Shelia’s younger brother, who died in 2014, lost his battle with terminal lung cancer.” Abdus-Salaam was found on the afternoon of April 12, floating in the river near Upper Manhattan wearing sweats and sneakers, authorities said, a day after her husband reported her missing. In the moments after her inexplicable death, colleagues, relatives and local political leaders remembered the judge as a humble trailblazer. They hailed her as an intelligent, clear and fair decision-maker — a fixture in New York legal circles. Her husband’s family wrote a message on the website for his church. “We are deeply grieved at the untimely passing of Sheila Abdus-Salaam, whom her family mourns as a beloved wife and devoted stepmother,” the family wrote. “She gave tirelessly and selflessly as a public servant, mentor, distinguished jurist, and community leader throughout her 40-year legal career. She was greatly admired for compassion, wisdom, commitment to excellence, and revered for her support of and sensitivity to the aspirations of young lawyers and law students.”

Maryland should adopt a death-with-dignity option for the terminally ill

Seven-and-a-half years ago, I witnessed my husband’s death from an aggressive form of lymphoma. Three-and-a-half years ago, I was diagnosed with metastatic cancer that has spread from my breast to my bone marrow. These life-changing events have forced me to face the reality of mortality that most of us would prefer to ignore. Before retiring, I spent four decades as a clinical social worker, including 20 years in a private psychotherapy practice. Because of both personal and professional experiences, I support the legal option of death with dignity for terminally ill, mentally competent adults with fewer than six months to live. These laws authorize a physician to prescribe medication that will bring about a peaceful death at the time and place of the dying person’s choosing. They facilitate most people’s preference to die at home, surrounded by their loved ones, rather than in settings where it is not always possible to effectively control pain and suffering. Maryland needs an end-of-life option like Vermont, where in 2010, then- gubernatorial candidate Peter Shumlin (D) promised to pass a death-with- dignity law. In May 2013, Shumlin fulfilled that pledge by signing such a measure into law, becoming the first state to reach that point through legislative action . This end-of-life option is now also legal in Oregon and Washington as a result of successful ballot initiatives. In Montana and New Mexico, the right to death with dignity came about via a state Supreme Court ruling and district court ruling, respectively. Last year, a bipartisan group of Democratic and Republican Montana state representatives and senators helped defeat a bill that would have reversed the Supreme Court ruling. In Maryland, there has been some support for the issue. In April, Del. Heather R. Mizeur (D) became the first gubernatorial candidate in the state to publicly pledge to pass death-with-dignity legislation if elected governor. Democratic gubernatorial nominee Lt. Gov. Anthony Brown, who voted against prohibiting death with dignity when he was a delegate, recently said he is willing to discuss  such a measure. If pollsters surveyed Maryland voters on this issue, I believe they would discover strong support for passing a death-with-dignity law in the state. Why do voters support death with dignity and the candidates who champion it? Because they don’t want government interfering in their most intimate, personal decisions at the end of life. And why do opponents use the terms “assisted suicide” and “euthanasia” when nothing could be further from the meaning of these pejorative words? Because polls show that using these words frightens voters who don’t actually understand the proposed treatment. As a psychotherapist, I’ve experienced many times the difference between someone who is suicidal and could be treated for this condition and one who is dying and the process can’t be stopped. Euthanasia is defined as one directly acting to bring about the death of another person; death with dignity requires that a dying person who is mentally capable of making this decision to personally request, obtain and self-administer the medications that will bring about a peaceful death. I’m grateful for the time I’ve been given since receiving the diagnosis of terminal-stage cancer. When the time comes that my treatment is no longer helpful, I want the option of ending my dying process peacefully. No one should have to suffer — neither a dying person nor those who care about him or her — when we can use medicine for what it is meant to do: relieve suffering. I want to be able to exert full autonomy at the end of life as I’ve been privileged to do throughout my life. Whenever I talk about this topic — whether with friends, family, those I meet in presentations or with candidates for public office — without fail, I hear a personal story that would lead that person to support this option at the end of life. I’m hopeful that a growing understanding of what is meant by death with dignity will lead to the political will in Annapolis to make this option available to those in Maryland who would wish to use it.

Neil Gorsuch wrote the book on assisted suicide. Here’s what he said.

Not since 2006 has the Supreme Court taken up a case involving “death with dignity” legislation — the handful of state laws that allow people to end their lives with the help of a physician. That year, the court handed a victory to death with dignity advocates, ruling that the attorney general could not bar doctors in Oregon — the first state to pass such a law — from giving terminally ill patients drugs to facilitate suicide. It was only the third time the court had heard a case challenging such statutes, and the six-member majority tread lightly, recognizing the sensitivity of the issue. “Americans are engaged in an earnest and profound debate,” the majority wrote, quoting from a previous opinion, “about the morality, legality, and practicality of physician-assisted suicide.” That debate is far from resolved today — and it’s one Neil Gorsuch, President Trump’s nominee to the high court, will surely be eager to weigh in on, should he win confirmation. Gorsuch, a 49-year-old federal appeals court judge from Colorado, was tapped by Trump on Tuesday to replace Justice Antonin Scalia, who died last year after three decades on the Supreme Court. Aside from his bona fides as a lawyer and a jurist — which may all but guarantee a favorable vote in the Senate — Gorsuch has cultivated something of an expertise in assisted suicide and euthanasia in his legal career.   “All human beings are intrinsically valuable,” he writes in the book, “and the intentional taking of human life by private persons is always wrong.” He continues:  At the beginning of his book, Gorsuch thanks Finnis, saying he “provided thoughtful comments on, and kind support through, draft after draft.” Over the following 300-some pages, Gorsuch, while against assisted suicide, lays out an exhaustive but evenhanded case, treating respectfully the positions of those who disagree with him. He touches on everything from Greek and Roman laws on taking one’s own life to present-day arguments in support of aid-in-dying legislation. But he specifically avoids discussing war and capital punishment, saying they “raise unique questions all their own.”   Gorsuch rejected that view, writing it would “tend toward, if not require, the legalization not only of assisted suicide and euthanasia, but of any act of consensual homicide.” Posner’s position, he writes, would allow “sadomasochist killings” and “mass suicide pacts,” as well as duels, illicit drug use, organ sales and the “sale of one’s own life.” Gorsuch concludes his book by envisioning a legal system that allows for terminally ill patients to refuse treatments that would extend their lives, while stopping short of permitting intentional killing.   “Far from definitively resolving the assisted suicide issue,” he wrote, “the court’s decisions seem to assure that the debate over assisted suicide and euthanasia is not yet over — and may have only begun.”

Assisted suicide does not lead to a death with dignity

Regarding the Feb. 15 front-page article “Rehm’s topic: Death with self- determination”: In 2009, I lost a beautiful, physically healthy 30-year-old daughter to suicide after a 16-year battle with substance abuse and other issues. It was like an atom bomb dropped on our family. Despite all of our efforts to save her over the years, my daughter told me that she learned how to kill herself from visiting suicide/assisted suicide Web sites and reading Derek Humphry’s book “Final Exit.” Her death was neither dignified nor peaceful. My Marie was one of the almost 40,000 suicides reported that year. In contrast, about 800 assisted-suicide deaths have been reported in the past 16 years in Oregon. Our real health-care crisis is an enormous and increasing suicide rate , not the lack of enough assisted suicides. Over my 45 years of nursing, I have cared for several suicidal people. Professionally and personally, I will always try to prevent the suicide of any person. However, it is a fact that tall buildings, cars in closed garages, etc., are easily available if a person is determined to die. But the assisted-suicide movement still demands the help of medical professionals and the approval of society. That help and approval should be denied for the good of the individual and society itself. ****Nancy Valko** , St. Louis** The writer is a spokeswoman for the National Association of Pro-Life Nurses.

‘Death With Dignity’ laws are proposed, bringing national debate to D.C. and Md.

A national discussion over whether the terminally ill should be permitted to end their lives appears to be headed to the District and Maryland, where lawmakers are proposing “Death With Dignity” laws as more than a dozen other states wrestle with the issue. Five states currently permit “aid in dying,” as advocates prefer to call laws that have commonly been referred to as physician-assisted suicide. Voters in Oregon and Washington passed ballot measures allowing the practice, while legislators in Vermont and judges in Montana and New Mexico have authorized it. D.C. Council member Mary M. Cheh (D-Ward 3) introduced her “Death with Dignity Act of 2015” on Wednesday. In Maryland, Sen. Ronald N. Young (D-Frederick) said Thursday he is in the process of drafting a bill, also titled “Death With Dignity,” and plans to introduce the measure in the coming weeks. “It’s allowing the person to say, ‘I’m in pain, I’m in sound mind, and I don’t want to go on like this,’ ” Young said. The Death With Dignity campaign won national attention last year thanks to the efforts of 29-year-old Brittany Maynard, who was diagnosed with an inoperable brain tumor, to advocate for laws allowing mentally competent, terminally ill adults to seek medical assistance in dying. Maynard died Nov. 1 after moving from California to Oregon to take advantage of that state’s Death With Dignity law. “Everyone agrees that Brittany Maynard was a game-changing advocate,” said Anne Singer, a spokeswoman for Compassion and Choices, a Colorado-based group that offers counseling to terminally ill Americans and advocates for state aid-in-dying laws. Besides D.C. and Maryland, aid-in-dying legislation is expected to be introduced or debated in at least 15 statehouses this year, Singer said. The issue was highlighted closer to Washington after the death of John B. Rehm, a lawyer who had suffered from Parkinson’s disease. His wife, National Public Radio host Diane Rehm, described how her husband wished to die after his illness progressed to the point that he could no longer use his limbs or perform basic functions without assistance. Rehm’s doctor, citing Maryland law, declined to help his patient end his life, according to his wife’s accounts. Rehm chose to stop eating or drinking until he died several days later, on June 23. Cheh said Maynard’s and Rehm’s deaths hadn’t led her to introduce her bill. Rather, she said, she has contemplated pursuing such a measure for years but held back while the council took up other hot-button issues. “I think the time is right,” she said. “There are some things that are momentous and are deserving of singular attention. . . . This is something we ought to take up as a community.” Young said Maynard’s plight had an impression on him, as well as the sentiments of his constituents. “I know a lot of people who have said, ‘I want that option,’ ” he said. “I would just like to take the stigma off of it.” Young said he’s gotten a “tremendous response” in support of the bill since announcing his intentions earlier this week. He said he has also encountered some opposition, mainly from devout Catholics. The U.S. Conference of Catholic Bishops spoke out against physician-assisted suicide in 2011, saying legalization would prompt a “radical change” in society. “Jewish and Christian moral traditions have long rejected the idea of assisting in another’s suicide,” the bishops said. “Catholic teaching views suicide as a grave offense against love of self, one that also breaks the bonds of love and solidarity with family, friends, and God.” The Archdiocese of Washington did not respond to requests for comment Thursday on the local proposals. Cardinal Donald W. Wuerl previously spoke out on the subject in 1999 while serving as bishop of Pittsburgh, calling assisted- suicide laws part of a “eugenic philosophy” that “only adds to the problems of our society, already mired in violence and death.” While the practice has been called “assisted suicide” in common parlance, advocates avoid the term as they have sought to draw a sharp distinction between the suicides of those who are physically healthy but mentally ill and the decisions of people who are mentally competent and wish to hasten an impending death. Cheh’s bill would allow patients with illnesses likely to result in death within six months to seek medication to end their lives. Two physicians would have to consent to dispensing the life-ending drugs after certifying the patient’s terminal prognosis and mental competency. The bill is modeled on Oregon’s law, which took effect in 1997. Cheh said the experience there has given her confidence that her bill is well-crafted. “Very few people have actually used it,” she said, adding that not all of those patients who gain authorization end up hastening their deaths. It is not clear how quickly or how far each bill might advance. Young said he has gotten supportive signals from Senate leadership but said his discussions about its prospects have been cursory. Incoming Gov. Larry Hogan (R), who is Catholic, told an archdiocesan newspaper in October that he would oppose attempts to legalize aid-in-dying. “I believe a physician’s role is to save lives, not terminate them,” he told the Catholic Standard. The future of Cheh’s bill will largely depend on the wishes of the colleague who chairs the committee to which it is referred. D.C. Council Chairman Phil Mendelson (D) said he is likely to refer the bill to the Committee on Judiciary and Public Safety, which is chaired by Kenyan R. McDuffie (D-Ward 5). McDuffie said Thursday he had yet to review Cheh’s bill and had no immediate reaction to it. What is clear is that the Death With Dignity debate stands to be less strident in D.C., whose liberal lawmakers have long pushed the envelope on social issues that have been deeply divisive elsewhere in the country. The District has successfully legalized same-sex marriage, but Capitol Hill lawmakers have balked at attempts to allow marijuana possession or use public funds to fund abortions for low-income women. “In terms of occupying the council, I wouldn’t put it in the same league as marriage equality,” an issue that drew hundreds of witnesses to hearings, Mendelson said. “This is not a jurisdiction that gets all twisted up over a lot of these social issues.” The debate carries an additional dimension in the District, where local laws are subject to congressional review. Mendelson, currently in a standoff with Capitol Hill Republicans over marijuana legalization, declined to speculate on how Congress might react to an aid-in-dying bill.

D.C. is about to vote on physician-assisted death. Here’s why it’s dangerous.

Politicians in the nation’s capital will vote this week on a physician-assisted death bill, a measure that cuts to the core of human nature, dignity and civilization. If it passes, the bill would allow a competent adult patient who has been diagnosed with an illness that will be fatal within six months (who is not under readily identifiable coercion and is not clinically depressed) to request and receive a prescription from a licensed D.C. physician and D.C. pharmacist to end the patient’s life. The D.C. Death With Dignity Act of 2015 is patterned after a 1997 law in Oregon, and, buoyed by the recent passage of a similar measure in California, the bill’s proponents are confident that it will pass. The proposed legislation, which enjoyed the endorsement of The Washington Post’s editorial board, is slated to go to committee vote Wednesday. If the legislation is approved by a majority committee vote, the council is expected to vote on it as a whole in the weeks ahead. As a doctor and as a theologian, the ethical dimensions of this bill must be considered in light of medical practice, as well as more foundational beliefs about the nature and value of human dignity. The most vocal proponents of the bill include the patients’ rights advocacy group Compassion and Choices. The group has called for a formal structuring of an aid-in-dying practice guideline as part of a program they see as nationally desirable and inevitable, despite the medical establishment’s long-standing opposition to the practice. The group’s agenda centers on the patient’s right of autonomy as the sole determinant of action and on the assumption that dying patients have inadequate choices available to them as they prepare for death. But the proposed legislation is fundamentally flawed and out of touch with normative ethical medical and public-policy decisions. Advocates suggest that dying patients don’t really have a “choice,” an idea that is simply uninformed. In fact, programs already exist for the terminally ill in the form of hospice, palliative care and intensive care — all of which provide excellent care, and prevention and alleviation of suffering. The programs provide for active dialogue, where autonomy is valued and dignity — however defined by a patient — is maintained. And patients’ next-of-kin and powers-of-attorney are integral members of the decision-making process. We believe end-of-life care would be improved by focusing on refining these existing programs. We should not expect to make physicians complicit in what we consider to be a “suicide-on-demand” paradigm, which invites no regulation, oversight, training and accountability to a wider community. Throughout history and across cultural contexts, broader community involvement has discouraged the taking of innocent life. Under the proposed legislation, involvement in the decision to end the patient’s life, even of a patient’s next of kin (think husband or wife), is optional, thereby skirting the most rational and important safeguard against abuse. Many patients who are dying do not wish to assert a right, as to not be a burden. These patients are susceptible to subtle forms of coercion and control. Financial pressures will certainly influence some doctors, families and third-party payers. As a result, patients, especially the elderly and disabled, could feel not a right to die so much as a “duty to die.” The safeguards of the larger community, one that will protect all aspects of the patient’s interests and dignity, are necessary. The patient’s individual autonomy should be one of several guiding principles, but that autonomy must be held in balance with health-care providers and the broader community. Throughout history, human civilization has been maintained by the individual-community balance, sometimes in tension but always necessary. In the biblical book of Genesis, for instance, human dignity is related to individual autonomy, never separated from human relationship. The primary dignifying relationship for the human is his or her relationship with God, a relationship that is empowered by the fact that the human is created in the image of God. As the image of God, the human is an actual representation of the creator on Earth. Human dignity is also derived from relationships with other humans who are made in the image of God. In fact, human dignity can be described in terms of the community of the entire human race, so that one might say that the image of God is made more complete as each human being is born. When we make human dignity merely a matter of human autonomy, we risk devaluing the dignity of human community, and we neglect the importance of the individual as a member of a broader community that itself enriches dignity. Such a balance between the individual and the community safeguards against radical individualism like the type that we see expressed in the D.C. Death With Dignity Act. Given that options and choices already exist in end-of-life care that are highly regulated by a larger professional and ethical community, the legislation is simply not necessary. When we turn human dignity into merely a matter of human autonomy, we not only diminish foundational truths about dignity but we also deny the individual their rightful place within a broader human community. Although it is perhaps well-intentioned, the legislation would undermine human dignity by severing the vital connection between the patient and the broader community where they are loved, cherished and honored. We urge this community to not cross to the wrong side of history by allowing the taking of human life by physicians.

‘She wanted him to suffer’: Sheriff explains why Texas mom killed two daughters in front of husband

Nearly a week ago, on June 24 , his 45th birthday, Jason Sheats gathered with his family in the living room of their Houston-suburb home about 5 p.m. Beside him were his daughters, Taylor, 22, and Madison, 17. His wife, Christy, had called a family meeting. After years of challenges with Christy’s mental health, her struggles with depression and anxiety, her suicide attempts, Jason told authorities that he thought perhaps she was going to announce she had decided to file for divorce. The couple had talked about separating.  Jason Sheats walked away physically unscathed. But he was so emotionally distraught, so numb from what he’d witnessed, that authorities hospitalized him anyway. In interviews with police, Jason said he believes that was all part of Christy’s plan.  “Mr. Sheats will have to live the rest of his life with this horrible memory,” Nehls said.  The girls, screaming and crying, can be heard begging their mom to stop. In the background, a man’s voice pleads: “I promise you, whatever you want.” Early reports indicated that Christy, described by friends and family online as a loving and proud mother, may have been struggling with mental illness. At Wednesday’s news conference, Nehls confirmed that theory.  The calls for service varied in substance: Three were after suicide attempts by Christy; two were medical calls; one was a call from the Sheriff’s Office Crisis Intervention Team; another was a verbal altercation. Once, Christy called 911 because she wanted to speak to a deputy. Five of the calls were “false alarms,” the Sheriff’s Office said in a statement. Jason Sheats told investigators that his wife struggled with depression and anxiety and after each suicide attempt had been treated and evaluated at different private mental health facilities. After she stayed several days, Jason told authorities, he would pick Christy up and take her home. At the time of the shooting, Jason said, his wife was taking “numerous” prescription medications. She was also seeing a therapist.  The gun she used to kill her children was inherited from her grandfather, authorities said. Christy had applied for a concealed carry permit, Jason told investigators, but the state of Texas rejected her application. Nehls said at the news conference that his office is investigating why the license was not approved. It was unclear whether it had to do with Christy’s mental health history. From the outside, the Sheats family appeared to be tight-knit and loving. In the immediate aftermath of the shooting, friends told local news outlets that Christy and Jason both loved their daughters. The girls were described as happy and kind. In one Facebook post, Christy called Madison and Taylor “very best friends.” Their social media lives reflected the same. Posts on Christy’s wall include drawings from Taylor, an avid and talented artist who attended Lone Star College. She shared photographs of herself and Madison at country music concerts, alongside musings about her faith and support of the Second Amendment. She often tagged her husband in comments and joked with friends. But behind the scenes, Christy, along with her family, was crumbling. Other posts on her social media accounts hint at that. She wrote often about how painful it was to lose her grandfather, a man she called “Pa-paw” and who she credited with teaching her the ways of the world. She called him her best friend, mentor and hero. On anniversaries of his death, Christy would pen lengthy, heartfelt tributes to the man and discuss the emptiness she still felt without him.  She continued: “But 3 years…36 months…1,095 days without seeing his million dollar smile, without his ray of sunshine has felt like my heart has been stranded in the middle of the artic without shelter.” In 2012, she wrote that she felt she’d never get over losing him, “but hopefully one day, my heart will begin to heal.” Her family and friends, including Jason and Taylor, responded with comforting comments. On a post on the two-month anniversary, Christy’s eldest daughter wrote: “He’d want you to not spend your life on sadness, as he brought so much happiness unto us all. Love you and hope you feel better. With time, it may get easier. He’s with you now, and forever.”  “YOU ARE SO LOVED,” one said. At the news conference Wednesday, Nehls said it was an argument with Taylor on Friday that precipitated the killings. Christy and Taylor argued, he said, and the mother wanted to prevent her from seeing her fiance, whom she was scheduled to marry Monday, according to reports. Jason disagreed, arguing it was “inappropriate” to ground their 22-year-old daughter just because of a spat. By the end of the night, everyone but Jason was dead. At the news conference, Nehls said that the father didn’t want to speak publicly about the shootings but had given police permission to share the details about what motivated Christy.

D.C. jail death of Paul Mannina raises many questions

A 58-YEAR-OLD man held at the D.C. jailwas found dead Tuesday and, though authorities have yet to officially determine whether the death was by suicide or homicide, the incident has raised questions about the decisions of court and corrections officials. It’s important that a prompt, full and transparent investigation take place. Paul Mannina, a senior attorney with the Labor Department, was discovered at 3:43 a.m. with his throat slashed.He was being held in the savage sexual assault of a co-worker and shared the cell with another inmate. D.C. police are investigating, and a spokeswoman said Wednesday that they were still awaiting autopsy findings from the medical examiner. Initial signs pointed to suicide, according to sources who stressed that the investigation was not complete. Mr. Mannina’s cellmate, we were told, alerted corrections officers that something was wrong; a disposable razor may have been used. The prospect that Mr. Mannina may have committed suicide is troubling because, just hours before his death, issues about his mental state had been raised in a D.C. Superior Court hearing. His attorney, The Post’s Keith L. Alexander reported, had unsuccessfully argued for Mr. Mannina to be released so that he could seek mental treatment, pointing to a series of troubling signs that included hospitalization before his arrest because of a “change in his mental state.” No mention was made of suicide; Mr. Mannina sobbed throughout the proceedings. Given the brutality of the crime with which Mr. Mannina was charged — a woman beaten so severely that she required facial surgery — it’s understandable that Judge Robert I. Richter saw him as a danger and didn’t agree to unrestricted release. But the question is whether the jail should have been alerted, by either the court or his attorney, to the mental issues that had been discussed. Was the screening, routinely done by corrections officials and health providers upon intake, sufficient, or were warning signs missed? Finally, did lapses in jail procedures allow an instrument capable of cutting a man’s throat to become available? This is the second death at the jail in less than a year; efforts must be undertaken to ensure there are no more. **Read more about this issue:** The Post’s View: Virtual visits for inmates? Colbert I. King: Death without dignity in D.C. jail Colbert I. King: How and why did Jonathan Magbie die?

Prince George’s couple dead in apparent murder-suicide

A husband and wife were found dead in their Capitol Heights area home early Tuesday in an apparent murder-suicide, authorities said. The couple’s niece came to their house in the 1000 block of Nyanga Avenue just after 1 a.m. and found them fatally wounded, said Cpl. Clinton Copeland, a Prince George’s County police spokesman. It appeared that the man had shot his wife and then himself, Copeland said. Police identified the couple as Dennis Bernard Mace, 53, and Marilyn Yvette Mace, 52. Assistant Prince George’s Police Chief Kevin Davis said the two were recently married and “having some domestic issues,” although he said it was unclear what those issues were. Family members and friends sobbed and hugged one another outside the couple’s modest home Tuesday afternoon. Approached by a reporter, a man said they were too grief-stricken to be interviewed. The case is the 18th slaying in Prince George’s County this year, not including one incident that is being investigated as a justified homicide. At this time last year, Prince George’s had 29 homicides, including two deemed justified.

What led Claude Kinney to kill his wife?

D.C. Court Superior Judge Gerald I. Fisher characterized Claude Kinney as suffering “a momentary lapse of sanity” as he fatally stabbed his estranged wife [“Man gets 30 years in wife’s death,” Metro, Jan. 14]. I’m puzzled by this description. Before her brutal murder, Alecia Wheeler had filed at least two court complaints against Mr. Kinney, alleging domestic assault. She filed one of these complaints the day before she was killed. Mr. Kinney’s actions appear to be a pattern of behavior rather than a momentary lapse. ****Sharon Hurley,** Washington**

Aid in dying is not assisted suicide

The Death With Dignity Act before the D.C. Council does not countenance suicide. The Oct. 5 Metro article previewing the vote on the bill referred to medical aid in dying for the terminally ill as “physician-assisted suicide” [“Assisted-suicide law faces key council vote”]. Suicide, in my view, is when a healthy person willfully takes his or her life. When someone is terminally ill, has exhausted all medical options and has only a few months left to live, it is the disease that is killing the person. Medical aid prescribed by a physician and self-administered gives the dying patient a choice to die peacefully with loved ones nearby. To call this option suicide is to align with those who try to impose their religious dictums on others rather than showing respect for someone else’s choice. ****Stella Dawson** , Washington**

The right to die battle: A timeline

Public radio talk show host Diane Rehm’s entry into the right to die debate comes less than a year after her husband chose to not eat or drink when his Maryland doctor refused to help him end his life. The battle she’s entering has been a long one. Here below, some key moments:    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **1980: The Hemlock Society.** After helping his wife to die, Derek Humphry starts the organization, becoming a key figure in launching the modern right- to-die debate in America.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **1990: Jack Kevorkian.** Known as Dr. Death, he helps his first patient — a woman with Alzheimer’s disease — use his suicide machine to end her life.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **1990: The Supreme Court.** In _Cruzan v. Director, Missouri Department of Health,_ the court essentially gave patients the right to refuse medical treatment.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **1991\. “Final Exit.”** Humphry publishes a book detailing how to plan a suicide. It becomes a national best-seller.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **1992:** **Proposition 161 defeat.** The California Death With Dignity Act fails.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **1994: Oregon**. The state becomes the first in the country to pass a doctor-assisted suicide law.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **1994 to 1997: Kevorkian trials.** Kevorkian stood trial four times in the deaths of six patients. He was acquitted three times. The fourth ended in a mistrial.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **1999: Kevorkian conviction**. Kevorkian is convicted of second-degree murder for administering a lethal injection to a man suffering from Lou Gehrig’s disease.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **2002: Oregon anniversary.** Five years after Oregon passes its law, the number of those making use of it hits nearly 130.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **2008: Legalization in Washington:** The state follows Oregon, passing its own doctor-assisted suicide law.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **2012: Referendum defeat.** Voters in Massachusetts defeat right to die legislation strongly opposed by the Catholic church, which mounted a campaign against it.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **2013: Legalization in Vermont.** The state follows Oregon and Washington, becoming the third to legalize doctor-assisted death.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **2014: Brittany Maynard.** A 29-year-old woman with terminal brain cancer moves to Oregon to end her life, garnering headlines around the world.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Our excessive tolerance of suicide

From Belgium comes news that a mentally disturbed prisoner is to be granted government help in committing suicide. A typically shallow ethical debate ensued — isn’t assisted suicide for a prisoner a bit too close to capital punishment? — before the trump card of individual autonomy was played. “Regardless, he’s a human being,” said Jacqueline Herremans, the head of Belgium’s right-to-die association, “a human being who has the right to demand euthanasia.” This is the culmination of a certain line of moral reasoning: the human right to cease to be a human being. If your overriding values are individual autonomy and choice, this is an easy case. In fact, all cases — however individually tragic — are theoretically easy. A mentally ill criminal — or a lonely senior, or a depressed teenager — has every right to take his or her own life. It is just another profound, self-determining decision, like marriage or retirement. Retirement from an existence one finds unbearable. But even the Belgians don’t really believe this. They surround assisted suicide with legal qualifications. The prisoner in this case apparently had an incurable mental disorder, which Belgium’s justice minister cited as the reason for state action in putting him to death. Assisted suicide is generally available to Belgians in cases of serious physical and (more recently) mental illness. According to the Associated Press, 1,800 Belgians took advantage of the offer last year — an increase of 400 from the previous year. Causes included dementia, cancer and psychosis. Belgium is simply extending this right to prisoners. This is justified by an ideology of choice. But the determination of certain societal classes that are helped in committing suicide is hard to separate from a judgment about the worth of those classes. The right to suicide adheres, in this case, not to all human beings but to sick and apparently flawed human beings. And such a “right” begins to look more and more like an expectation. A mentally or physically ill person can be killed, in the end, because they have an illness. A qualification can slide into a justification. This is a particularly powerful social message since people with cancer or severe depression sometimes feel worthless, or like a burden on their families, anyway. It is pitifully easy to make them — with an offer of help — into instruments of their own execution. All of us — particularly those who face cancer, Alzheimer’s, Huntington’s or other gnawing horrors — can imagine circumstances in which the extension of life does not seem to serve the cause of life. Our “excessive tolerance” of suicide, said sociologist Emile Durkheim, “is due to the fact that, since the state of mind from which it springs is a general one, we cannot condemn it without condemning ourselves.” We are accused by our own darkest thoughts. But when a friend takes his or her own life — a cause of death now more common in the United States than traffic fatalities — it does not seem like a choice. It seems like the end of all possibility of choice. It doesn’t seem like freedom; it seems like slavery to a single moment of despair. Our immediate response is: I wish I had known his night was so dark. I might have done more. Even in cases of lingering suffering, many of us have known dying people to give tremendous, life-affirming gifts — words of encouragement, examples of fortitude and faith — to those who remain. Most of us will eventually need such models. “He who was living is now dead,” wrote T.S. Eliot. “We who were living are now dying. With a little patience.” The hardest cases — the hopeless coma, the stroke that steals most of a brain’s function — remain hard. But the first tendency of our society should mirror our best instincts as human beings: To support those with serious physical and mental illness. To care for those in dark moments. And not to send a social message — through a law and a doctor with a final IV — that those who feel fragile and useless are right to think so. Whatever modern political theories may claim, human life has a value greater than autonomy and choice. That value is not absolute, as is shown in war, criminal justice and self-defense. But the value of life is high, and particularly demonstrated by the manner in which a society views and treats the vulnerable. There is no human right to forfeit all our rights. And our dignity exists even when we cease to see it. _Read more fromMichael Gerson’s archive, follow him on Twitter or subscribe to his updates on Facebook _. **Read more about this topic:** The Post’s View: Mental health care in the U.S. needs a check-up Pete Domenici and Gordon H. Smith: Waiting for mental health parity The Post’s View: Americans’ mental health Alyx Beckwith: The risk of skimping on mental health funding Catherine Weber: Maryland should adopt a death-with-dignity option for the terminally ill

Aid in dying respects vulnerable groups too

Contrary to claims by the Heritage Foundation’s Ryan T. Anderson in his Nov. 6 letter, “Two views on ‘death with dignity,’ ” a Journal of Medical Ethics study, “Legal physician-assisted dying in Oregon and the Netherlands,” “showed no evidence of heightened risk” for patients in “vulnerable groups,” including “the elderly, women, the uninsured . . . people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities.” In addition, the Journal of Palliative Medicine concluded last year: “Oregon was the only state in the highest quartile of hospice use and the lowest quartiles of both very short and very long hospice enrollment. . . . It is possible the Oregon Death with Dignity Act has resulted in or at least reflects more open conversation and careful evaluation of end-of-life options, more appropriate palliative care training of physicians, and more efforts to reduce barriers to access to hospice care.” Finally, a growing number of national organizations representing health-care professionals have endorsed or taken a neutral position on medical aid in dying as an end-of-life care option. They include the American Academy of Hospice and Palliative Medicine, the American College of Legal Medicine, the American Medical Student Association, the American Medical Women’s Association and the American Public Health Association. ****Herbert S. Gross** , Rockville ** The writer, a clinical professor of psychiatry at the University of Maryland School of Medicine, is chairman of the American Psychoanalytic Association’s Committee on   Government Relations and Insurance.

Military policy shouldn’t encourage suicide

While the military must improve its handling of brain, mental and emotional injuries incurred in combat, the effects of potential policy changes need to be considered from the point of view of those who are suicidal [“Marine’s suicide only start of family’s struggle,” front page, Feb. 12]. Among the actions that have either been proposed or are now being executed by the U.S. government after a service member’s suicide are: significant cash payments to bereaved family members, a letter to the family from the president, and naming of buildings or bases after the deceased. To a desperate mind, these possibilities could be perceived as rewards and provide cruel, unintended incentives to kill oneself. The mental state of someone considering suicide may be so hopeless that he or she cannot properly evaluate consequences. Before we modify the procedures that follow a the suicide of a current or former military member, we should find a way to support a deceased’s family members that avoids creating a perverse justification to those contemplating death. ****Kurt Sanger,** Quantico ** The writer is a major, judge advocate and law instructor in the U.S. Marine Corps. The views expressed are his own.

Gov. McAuliffe made an irreversible mistake

_Gene Rossi is a retired Justice Department prosecutor. Edward J. Ungvarsky is a career public defender based in Vienna who represents defendants prosecuted in Virginia on capital murder charges._ William Charles Morva was put to death because our legal system failed him. When Virginia Gov. Terry McAuliffe (D) denied Morva clemency on July 6, he apparently misunderstood the facts about Morva’s mental illness and squandered an opportunity for compassion. When the governor refused to intervene, he missed a chance to exercise a solemn constitutional duty to save Morva’s life. In a case that cried out for mercy, McAuliffe disregarded that the sentencing jurors never heard the compelling evidence of Morva’s long-standing, debilitating mental illness. Although Morva’s death is an irreversible mistake, he should not die in vain. Death should be an extraordinary, rare punishment. U.S. and Virginia laws reflect the centuries-old bedrock principles that a death sentence is exceptional and that mercy alone is always reason enough to avoid the death penalty. Jurors are not only allowed but also required to follow their individual moral judgment in determining whether death is the appropriate punishment. The governor, in wielding his awesome power to grant or deny clemency, carries that same obligation. Virginia’s constitution provides the governor the unrestricted power to commute capital punishment to life in prison. If McAuliffe had fully understood Morva’s disease, he would have surely spared Morva’s life. In 2006, believing himself to be the target of a sprawling conspiracy to kill him through abusive prison conditions, Morva escaped from a jail where he awaited trial on felony charges and killed two public-safety officers. If told little more than these facts, a jury might understandably have little sympathy for Morva. But what jurors never got to hear was testimony from a psychiatrist — placed on the case in 2014 — that Morva suffered from a treatable, schizophrenia-like illness with psychotic features and was mentally incompetent to participate in his legal proceedings. This psychiatrist could have related to jurors what scores of Morva’s family members and friends reported to her: They had watched Morva’s mental health precipitously decline in the years before the crimes and had seen his untreated illness worsen for the remainder of his life. Morva’s mother and others reported how, for years, he refused to take visits or calls from her and his lawyers, believing them all to be part of the grand conspiracy. Jurors also did not hear that Morva believed his behavior was saving Native American tribes, nor that he subsisted on a diet of raw meat and pine cones while living in the woods barefoot in the winter. The experts at Morva’s trial never learned, or bothered to learn, about Morva’s debilitating delusions. Instead, jurors heard only that Morva’s “odd beliefs” resulted from a personality disorder that the prosecution asserted was untreatable and made him likely to kill again. Given the sparse, inaccurate information before them, the jurors unsurprisingly sentenced Morva to die. The details of Morva’s debilitating illness from his family, friends and psychiatrist would have been powerful evidence — had the jurors ever heard it. Faced with this new and clearly relevant evidence, the state chose to ignore it, never seeking an expert to consider what witnesses said and to review the psychiatrist’s findings. Oddly, the governor’s statement denying clemency relied on the fact that the psychiatrist’s post-trial diagnosis conflicted with the testimony jurors heard at trial. But that is precisely the point: Jurors never heard the observations of severe symptoms that anyone who crossed Morva’s path in the years before the crime would have seen and the informed opinion of a qualified doctor. Rather, the experts at trial relied on outdated information about Morva’s childhood long before his symptoms began. In short, the trial evidence painted a grossly inaccurate picture of Morva’s life and true self. Before Morva’s delusions began, friends, classmates and family described acts of care and love toward them and others. The jurors never got to hear of Morva — a young man, like others, of character and promise — as McAuliffe did. In denying clemency, the governor asked, “Does Morva deserve to live?”Instead, he should have asked, “Do I, in my personal moral judgment, think the state proved it has the right to take this life?” The right question would have led McAuliffe to reach a different conclusion and to spare Morva’s life. Applying mercy to capital cases reaffirms our common beliefs in the rule of law and in the dignity and value of every person regardless of what he or she has done. **Read more about this issue:** Radley Balko: William Morva’s execution shows no death penalty case is easy Nicholas Cote: Executing a severely mentally ill man would be an injustice The Post’s View: Why the U.S. should end the death penalty The Post’s View: Virginia’s false choice on the death penalty

Let’s talk about dying

In a culture that can be sold just about anything if it includes the picture of a beautiful young woman, it is no surprise that it took the death of beautiful, young, intelligent Brittany Maynard to get Americans to really talk about aid in dying. Diagnosed at 29 with terminal brain cancer, this young woman and her family spent the final months of her life advocating for aid in dying (or, as its opponents call it, “physician-assisted suicide”). Her reasons, including quality of life, were compelling. She ended her life on Nov. 1, 2014. This version of our national conversation is quite different from the one that began nearly 20 years ago when Jack Kevorkian allowed “60 Minutes” to air a videotape of how he helped a 52-year-old with amyotrophic lateral sclerosis, or Lou Gehrig’s disease, kill himself. Kevorkian was convicted of second- degree murder and imprisoned for eight years. I witnessed the suffering and pain my grandmother endured as a hospice patient. As is required of Medicare beneficiaries who enroll in hospice, she had a terminal diagnosis with a prognosis of less than six months to live, she had to forgo curative treatment and she could receive only “comfort care.” As with many families, mine thought hospice would ensure that she would not die in pain in a hospital, tethered to life- support machines. But, in the final days of her life, she and my family asked hospice to boost her pain medicines. Hospice nurses refused, saying that they did not want to hasten her death or cause her to become addicted. Instead, her intractable pain landed her in the hospital, where she died in November 1994. Little has changed. Most of us still die in the hospital , and many die in pain. In 2010, a friend’s mother died in a home-based hospice, which responded to her husband’s repeated requests over a weekend for a nurse by ordering a hospital bed. Last year, a friend died while in a home-based hospice program. One Friday afternoon, a hospice nurse, irritated by having to stay late to set up a urinary catheter, suggested that it could just wait till Monday. I am not banking on hospice or its cousin, palliative care, to prevent suffering at the end of my life or the lives of my loved ones. Instead, I want to rely on death-with-dignity laws that allow people with terminal illnesses to receive legal prescriptions for lethal medications. Because I am an American, I guess, I want to control what I can about my own life, including how it ends. The reality is that, as with many of my fellow boomers, I am most likely to end up with cancer or heart disease or dementia. At best, I’ll live a few months after diagnosis. At worst, I’ll stick around for years, increasingly unable to care for myself. Whatever the future holds, I want the option that legal aid in dying guarantees: to die on my own terms. I first testified about this issue in the late 1990s, as a way to cope with my distress at my grandmother’s death. I wrote for many years for various groups devoted to bettering end-of-life care, and I’ve written books that described for other families what to expect at the end and how to help. Having been at this for 22 years now, I am weary of the old arguments: the slippery slope, euthanasia, etc. In states where such measures have been enacted (most recently, California), the laws include strict measures to ensure that the patients in question are, in fact, dying of a terminal illness, that they are not “just” depressed and suicidal, and that they are not being coerced. In Oregon, the first state to legalize aid in dying, many more people request the prescription than take the lethal dose. For some, it appears, having the option gives them comfort and the ability to endure. Maryland will reintroduce its version of the law in 2016. Known as the Richard E. Israel and Roger “Pip” Moyer Death With Dignity Act, it was introduced this year and was in committee for much of the fall. Now that Maynard has given people a real glimpse of what it means to die of brain cancer — with seizures, utter dependence and worse — will we dare to allow people in Maryland the right to die? Or will we continue, as the hospice nurse told my family, to believe that there is something noble and holy about suffering, that, as the nurse said, “This must be God’s will for her.” Not her God, not my God. Let us talk instead about the will of the people. **Read more about this issue:** George F. Will: Affirming a right to die with dignity Marcia Angell: How Brittany Maynard is changing the debate on assisted dying The Post’s View: A humane way to end life

Eugene Robinson: There’s no humane way to carry out the death penalty

_N_ o one who supports the death penalty should have the slightest problem with the way Clayton Lockett died. Lockett, a convicted murderer, spent 43 minutes in apparent agony Tuesday night as the state of Oklahoma tried to execute him by injecting an untested cocktail of drugs. Instead of quickly losing consciousness, he writhed in obvious distress and attempted to speak. Witnesses described what they saw as horrific. Prison authorities halted the procedure — they were going to revive Lockett so they could kill him at a later date, presumably in a more aesthetically pleasing manner — but the condemned man suffered a heart attack and died. The state postponed a second execution that had been scheduled for the same night, but I wonder why. We fool ourselves if we think there is a “humane” way to way to kill someone. Sure, the second inmate, Charles Warner, probably would have suffered an equally agonizing death. But isn’t this the whole point? When I read about the crimes Lockett committed, I wish I could support capital punishment. When I read about what Warner did, I want to strangle him with my own hands. But revenge is not the same thing as justice, and karmic retribution is not a power I trust government to exercise. The death penalty has no place in a civilized society. Lockett raped, brutalized and murdered an 19-year-old woman who had graduated from high school just two weeks earlier, shooting her and then burying her alive. Lockett and his accomplices also beat and robbed a 23-year-old man and raped an 18-year-old woman. The crimes took place in 1999; Lockett has been awaiting execution since 2000. Warner, the other man who was to die in the Oklahoma execution chamber Tuesday, was convicted in 1999 of raping and murdering an 11-month-old child who was the daughter of his live-in girlfriend. The baby suffered unspeakable abuse. The question is not whether Lockett and Warner deserve to die; clearly they do, as far as I’m concerned. The question is whether our society, acting through the instrument of government, should kill them. I believe there is no way to impose capital punishment without betraying the moral standards that our justice system is theoretically designed to uphold. Put simply, when we murder we become murderers. Perhaps the most powerful argument against the death penalty is that it is irreversible. Sometimes, judges and juries make honest mistakes and innocent people may be condemned to death. Some studies have shown an apparent racial bias in the way capital punishment is meted out, with blacks who kill whites more likely than other defendants to end up on death row. Put all this aside for the moment and assume that both Lockett and Warner committed those heinous crimes and that each was convicted in a scrupulously fair trial. The judgment of the state of Oklahoma is that both men must die. How, then, are they to be killed? What about a public beheading, like in Saudi Arabia? No one would seriously suggest such a thing. Yet a razor-sharp sword surely would have been less agonizing — or at least much quicker — than the drugs injected into Lockett’s bloodstream. The general idea of lethal injection is to give the condemned a powerful sedative followed by one or more lethal agents. But the sole manufacturer of one of the commonly used drugs stopped making it in 2011. Drug makers in Europe, where the death penalty is considered barbaric, refuse to export drugs to the United States for use in executions. As a result, there have been shortages. Oklahoma was using a new, unproven cocktail to kill Lockett. Reportedly, Lockett’s vein “blew” shortly after the execution began, meaning that he was not getting the full doses. But his was hardly the first lethal injection execution in which the condemned showed visible signs of great pain. I would argue that there’s no reason to believe lethal injection is a more humane way to end a life than electrocution, poison gas, hanging, firing squad or even guillotine. Of course, we’ll never know. We can tell ourselves any story we want about how quickly and painlessly death arrived, and the one person who could prove us wrong will never speak again. But why even pretend? Clayton Lockett was a bad man. Those who believe it was right to kill him have no reason to be ashamed of the way he died — and no right to look away. _Read more fromEugene Robinson’s archive, follow him on Twitter or subscribe to his updates on Facebook. You can also join him Tuesdays at 1 p.m. for a live Q&A;._ **Read more on this issue from Opinions:** E.J. Dionne Jr.: A more benevolent nation? The Post’s View: An end to death row? Richard Cohen: Holder’s political cowardice in seeking the death penalty

‘He’s gone’: Anger, grief as plug is pulled on toddler after sudden court decision

It all started with an asthma attack. Israel Stinson was an adorable toddler with a sweet smile and unruly hair. But on April 1, he began having trouble breathing. After he was taken to a northern California hospital, the unthinkable happened: Israel suffered a heart attack. After 40 minutes of CPR, doctors were able to restart his heart. But nearly an hour without oxygen had left him brain dead, they determined. That’s when the battle began. Stinson’s parents did not believe the doctors. Nathaniel Stinson and Jonee Fonseca went to court to demand that Israel be kept on life support in the hope that he would recover.  When courts ruled against them, the parents flew their son to Central America in a desperate attempt to find him treatment. The four-month saga came to an abrupt end Thursday, however, when a judge issued a surprise ruling against the parents. Israel was taken off a ventilator and quickly stopped breathing. This time there was no disagreement.  After Israel’s parents posted emotional but controversial videos of their son’s condition online, the tragic case drew national attention and sparked debate over conflicting medical, legal and religious definitions of “death.” What doctors dismissed as Israel’s involuntary muscle twitches, the family saw as intentional responses. The debate echoes previous cases, some of which became causes célèbres. The most famous was that of Terri Schiavo, a woman with brain damage whose parents fought for years to keep her alive until a judge ultimately granted her husband’s wish to have her feeding tube removed. In 2013, 13-year-old Jahi McMath was declared brain dead after a tonsillectomy went tragically wrong. Her family is still fighting to keep her on life support. Thursday’s events are unlikely to dampen the decades-old national debate. A pro-life group representing Israel and his family pro-bono told The Washington Post the outcome was “cruel” and potentially criminal. “In no circumstances ever, ever should somebody be put to death without due process of law,” said Alexandra Snyder of the Life Legal Defense Foundation, adding that the family felt state law entitled them to consult another doctor before Israel was taken off life support. Children’s Hospital in Los Angeles told The Post it could not comment because of “privacy regulations.” Israel had already been declared brain dead by three doctors at two hospitals, Snyder says, although she said the family questioned those diagnoses. Israel’s sad story began this spring.  The toddler was then transferred to another hospital, Kaiser Permanente in Roseville, Calif., where two more doctors determined that he was brain dead. He could not breathe or maintain a heartbeat on his own and had no hope of recovery, they said. Israel’s parents, however, disagreed. According to Snyder, the boy’s parents “distrusted” the diagnosis at UC Davis because they felt their son’s heart attack might have been prevented. “There were things that undermined their trust,” Snyder said. They also rejected the opinions of the doctors at Kaiser, which the parents felt was too quick to rule Israel brain dead. Doctors put Israel on a diet of dextrose, or sugar. But his family felt the hospital was mistreating him.    “We will use your contribution to fight Kaiser Permanente Roseville Medical Center in Sacramento and to pay for an air medical transfer to another hospital, likely in another state,” they wrote. “Israel means apple of God’s eye and he truly is a child of God with a lot of fight in him!”  They also posted moving videos showing Israel reacting to being tickled. “Israel baby, Mommy’s here. I’m gonna tickle you one more time. Do it one more time,” Fonseca can be heard saying in one video. “There you go. There you go. His blood pressure’s going way up. Oh, you can hear Mommy and you can feel Mommy, huh? Israel, you gotta stop fooling everybody. How long is it going to take, huh? I know you’re going to come out of this, baby.” The videos drew sympathy and donations but did not spur any hospitals to take Israel in. So Israel’s mother filed an injunction to prevent Kaiser from taking the boy off his ventilator.  “While Ms. Fonseca’s maternal instincts and moral position are completely understandable,” U.S. District Judge Kimberly J. Mueller wrote, “the concerns reviewed here suggest she is unlikely to obtain the relief she seeks, and weigh against a preliminary injunction based on the law this court is sworn to apply and uphold.” “I’m a parent and I can’t imagine how this family must feel,” Wade Smith, director of the neurointensive care unit at the University of California at San Francisco told the newspaper. “But this is a situation in medicine where we have very clear absolutes. This child will never wake up. … It is really hard for a physician to bring the news to a parent that their child has died. But that’s the reality. I’m sad for the parents and sorry for the situation. But at some point, they have to accept it and move on.” Israel’s parents did move on, but not in the way the doctor expected. On May 22, just days before a deadline to prove their case or pull the plug, they swept Israel out of the country.  The sudden flight out of the country was funded by more than $20,000 the family had received, mostly from strangers. “Because of you all and your generous donations, Israel was able to beat the odds and is now being cared for as a live human being,” they wrote. The mystery country, it turned out, was Guatemala, where Snyder had helped the family gain admission to a private hospital. There, doctors did what American doctors had refused, giving Israel feeding and breathing tubes. They also gave the parents hope. According to Snyder, three Guatemalan doctors, including a neurologist, declared that the boy was not brain dead after all. That diagnosis was based in part on EEG, or electroencephalogram, tests, used to measure electrical activity in the brain, she said. Snyder declined to name the Guatemalan doctors or their hospital but dismissed the idea that their opinion weighed less than that of American doctors. “We’re not talking voodoo here,” she told The Post. “They have access to the same equipment as American doctors. Many of them probably have degrees from American medical schools.” From Guatemala, the family posted more videos in which they said Israel was improving.  Then, after about three months in Central America, Israel suddenly returned to the United States. Despite the pending death certificate, and possibly because of the EEG tests from Guatemala, he had been accepted as a patient at Children’s Hospital of Los Angeles. Again, the family was jubilant.  Within days, however, the new hospital also moved to take the boy off life support. Once again, the family sought an injunction. And on Aug. 11, they received a temporary restraining order blocking the hospital from taking Israel off his ventilator. Then, on Thursday, came a final, sudden twist in the international medical saga. A Los Angeles Superior Court judge removed the restraining order, saying the case had already been decided at state and federal level before the family traveled to Guatemala. And with that, doctors turned off Israel’s ventilator. “I heard them disconnect the ventilator and then heard, of course, a very grieving mother,” said Snyder, who was on the phone with Fonseca at the time. “They’re understandably devastated,” she told The Post. “What happened today was just so awful. Obviously a young child lost his life, but the way it happened, the way the hospital went about removing his life support, is exactly what should never happen to any family anywhere in this country.”  Alexandra Snyder, from LLDF, called the judge’s decision “unexpected” and said she was in court with Fonseca just last week. She said the hospital should not have turned off Israel’s ventilator until the parents got to see another, “independent” neurologist and that one had already agreed, although she refused to give his name. She also said Israel’s parents were not asking the courts to keep him in the hospital forever, but rather wanted to take him home, and that the hospital’s hands were not tied by Thursday’s court ruling. “What I really don’t understand is why this hospital agreed to take this little boy in the first place,” she told The Post, saying the boy’s parents never would have brought Israel back to the United States if they had known the hospital was going to pull the plug. “They knew exactly what his condition was, what his treatment was, and they agreed to take him. But it appears they only accepted him as a patient to put him to death. … “The irony is this little boy was cared for so much better in Guatemala than he was here,” she added. Snyder said Israel’s parents, who also have a 1-year-old daughter, were too distraught to talk Thursday night. “They are tremendous people,” she said. “The way they fought for their son was truly heroic.”

Wife of abusive police officer pleads guilty to killing him

A mother who killed her husband, who was a police officer who abused her for years, pleaded guilty in Loudoun County on Monday to voluntary manslaughter. Rosangela Spradling, 45, who fatally shot her husband, Cpl. Steven Spradling, in 2013, entered an Alford plea, which means she maintains her innocence but wishes to plead guilty rather than go to trial. In a statement, Commonwealth’s Attorney Jim Plowman said, “While it is natural to be sympathetic to one that has suffered years of abuse, it doesn’t absolve someone of accountability for a homicide, in this case manslaughter. If you find that someone you know is in an abusive relationship, please encourage them to seek immediate help.” Spradling’s husband had been an officer with the Metropolitan Washington Airports Authority police for 25 years when his wife shot him inside their Sterling home. The Loudoun County Commonwealth’s Attorney’s Office said in a statement on Tuesday that Cpl. Spradling’s severe alcohol abuse had caused police to come to the house to resolve domestic disputes many times before May 17, 2013. That night, Cpl. Spradling, 52, pinned his wife to the floor and choked her. He only let go of her neck when their two young children came into the room. Spradling then got her husband’s gun and shot him, authorities said. She is currently being held without bond and will be sentenced on November 16.

My opposition to Neil Gorsuch is personal

_Matt Witt is a writer and photographer who lives in rural Oregon._ My problem with the nomination of Neil Gorsuch to the U.S. Supreme Court is not political. It’s personal. It’s about my father and mother. And it’s about one of our most sacred rights as human beings. As The Post recently reported, Gorsuch wrote a book in 2006 opposing state laws that allow people with terminal illnesses to decide the timing and terms of their final days. In the book, he laid out why he believes judges should be able to prevent families such as mine from making our own choices, arguing that “all human beings are intrinsically valuable” and that legal recognition of a dying person’s right to make end-of-life decisions could create a slippery slope to legalization of “sadomasochist killings,” “mass suicide pacts” or even the “sale of one’s own life.” Gorsuch certainly is entitled to apply that view to his own life, but given the experience of families such as mine, he should not be elevated to the Supreme Court, where he could impose his personal beliefs on those who do not share them. My father was in his 90s when he was diagnosed with a fatal disease that would make him progressively less able to function. The news made him fearful — not so much of death, but of spending an extended time confined to a chair or bed, enduring increasing pain and being unable to do the things that, to him, made life worth living. He decided to move in with my wife and me in rural Oregon, a state that for 20 years has recognized that end-of-life choices should be made by the individual, not the government. Under Oregon’s Death with Dignity Act , when my father had less than six months to live he had the right to ask his doctors to prescribe medication that would end his life at his discretion. He knew his doctors would respect his wishes (although under the law they had the right to refer him to other doctors if writing that prescription would violate their own beliefs). My father died before he needed to use his Death with Dignity rights. But knowing he had access to such medication gave him great peace of mind and allowed him to focus on enjoying his final days instead of worrying about what was to come. His experience is typical of many others in our state. While an average of only 59 people per year in Oregon have ended their life under the Death with Dignity law, countless others find comfort in knowing they are in control, even if they never have to take that step. Gorsuch writes in his book that while he would not allow people such as my father the right to take end-of-life medication, he would graciously permit patients to refuse food or medicine that would prolong their life. My family, unfortunately, has experience with that too. When my mother was in her late 80s, she was hospitalized after a risky surgery. When it became clear that she was not going to recover, she told her doctor and family that she wanted to spend her remaining time at home. By law at that time in California, where she was living, she could ask her doctor for painkillers — but not medication to end her life. Instead of leaving that decision to her, the state dictated that she had to continue to live, regardless of the pain she would suffer. Deprived of that choice, my mother took the only path she saw open. She refused to eat and spent her final days enduring the devastating effects of starvation. If Gorsuch chooses not to go that route when it is his time, that should be up to him. But he should not be in a position to dictate what such people as my mother can and cannot do as they are dying. As I enter old age, I don’t know what terminal condition I will someday face, but I too take comfort knowing that I live in a state where I can have some say over the terms and timing of my final days. Unless, of course, Gorsuch and a new Supreme Court majority take my rights away. Or unless death-with-dignity opponents in Congress such as Rep. Jason Chaffetz (R-Utah) figure out a way to override the end-of-life rights that an increasing number of states protect. For decades, we have heard conservative public figures rail against what they say is too much government interference with individual liberty. But it it turns out they only want to protect individual liberties that are consistent with their own religious beliefs. The arrogance of Gorsuch’s position on this issue alone ought to disqualify him from serving on our nation’s highest court, which has the sacred duty to ensure liberty and justice for all. **Read more on this topic:** Jason Chaffetz and Jim DeMint: D.C. is disregarding the sanctity of life. Congress must act. Archbishop Desmond Tutu: When my time comes, I want the option of an assisted death The Post’s View: A congressman overreaches on D.C.’s death-with-dignity law Kathleen Parker: Freedom to kill, permission to die The Post’s View: Make the District a place to die with dignity

The horrifying toll of domestic violence

ONCE AGAIN, residents and officials in the Washington suburbs are reeling from a case of unspeakable domestic violence. Before NeShante Alesha Davis and Chloe Nichole Davis-Green , the mother and daughter gunned down last week in a reported  dispute over child support, there was 11-year-old William McQuain, beaten to death with a baseball bat by his mother’s boyfriend, who also killed the boy’s mother, Jane McQuain; 3-year-old Laila Miller, shot and stabbed to death by her father; 35-year-old Tonya Wilkerson-Sullivan , mother of four, killed in a murder-suicide; 47-year-old Ana Ayala, fatally stabbed by her estranged husband inside a vehicle; 2-year-old Jamir Shipe, fatally battered by his mother’s boyfriend after he jumped on a sofa; 36-year-old Shauntelle Marie Lewis, mother of two, beaten to death by a man she dated; and 15-month-old Prince McLeod Rams, allegedly killed by his father for insurance proceeds. Before them, it was Yvette Cade, who spotlighted the dangers of family abuse after she somehow survived being set on fire by her husband. “Enough is enough,” said Prince George’s County State’s Attorney Angela D. Alsobrooks as she talked to us about her frustration — and her determination to combat domestic violence. So far this year, four of the 11 homicides in her county involved abuse; last year, 13 of 77 homicides were rooted in family violence. Particularly horrifying have been the number of cases involving children. The 2-year-old strapped into her car seat who was fatally shot Tuesday, allegedly by a father who didn’t want to pay $600 a month in child support, was the second homicide this year involving a child. A 6-month-old girl died after suffering blunt- force injuries allegedly caused by her mother’s boyfriend. With stranger-perpetrated crime dropping, officials are searching for new strategies to combat domestic violence. Montgomery County State’s Attorney John McCarthy has put new resources into tackling unaddressed issues of mental illness. In Prince George’s, Ms. Alsobrooks formed a special unit of prosecutors and reached out to the community with training on how to spot and deal with abuse in families. Police, judges and the government have joined in that effort; a Family Justice Center consolidating public and private services was established. So a question that arises in the wake of this terrible double homicide is what more can be done. Ms. Alsobrooks has some ideas — such as more education of young women so that they can recognize signs of abuse that appear before the first shove or slap — but she stresses that the problem cannot be solved at the police station or courthouse. She thinks that the deaths of Ms. Davis and her daughter have touched a chord that will prompt more public involvement. Sometimes in the wake of a family killing, officials offer reassurance once the suspect is identified. The public has nothing to worry about, they say: The violence wasn’t random, and there isn’t a killer on the loose. We understand the impulse, but none of us should take comfort from such news. With the lives of women and babies at stake, everyone has a responsibility to get involved. **Read more:** The Post’s View: An extra safety measure for domestic violence victims The Post’s View: What domestic violence looks like Lisette Johnson: A change in Virginia’s gun laws that makes a big difference for domestic violence victims

Suspect in 4 W.Va. killings is found dead of apparent self-inflicted gunshot wound

Police in West Virginia said Monday night that the suspect in a series of fatal shootings had been found dead. The body of Jody Lee Hunt, a 39-year-old man from Westover, W.Va., was discovered in his truck hours after a shooting spree left four people dead. The Monongalia County Sheriff’s Department and West Virginia State Police confirmed to CBS affiliate WDTV that Hunt was found dead “with an apparent self-inflicted gunshot wound to the head off of U.S. Route 19 near the Monongalia and Marion County border.” Police had spent hours Monday searching for Hunt after, they say, he apparently killed four people in a series of shootings in the north-central part of the state. Sharon Kay Berkshire, 39, and Michael David Frum, 28, were killed in one incident in the Cheat Lake area, the Charleston Gazette reported. Police said two other shootings occurred in the Westover area, the Associated Press reported. Westover Police Sgt. John Morgan identified Doug Brady as the third victim, the Wall Street Journal reported. “These are all people he has a relationship with, knows. It’s not random,” state police Lt. Michael Baylous told Reuters. Berkshire had filed a domestic violence case against Hunt last month, the AP reported, citing court documents, but no current protective orders were found. **— Elahe Izadi** Attorneys who contend that a condemned Texas inmate set to die this week is too delusional for execution asked the Supreme Court on Monday to halt his lethal injection and determine whether mentally ill people should be exempt from the death penalty. Scott Panetti, 56, is set for lethal injection Wednesday for the 1992 shooting deaths of his in-laws at their home in Fredericksburg, in the Texas Hill Country. Panetti was diagnosed with schizophrenia in 1978 and had been hospitalized more than a dozen times for treatment in the decade before killing Joe and Amanda Alvarado, his estranged wife’s parents. Justices in 2002 prohibited the execution of mentally impaired people, deciding it violated the Constitution’s ban on cruel and unusual punishment. But they have allowed capital punishment for mentally ill prisoners as long as the inmate has a factual and rational understanding of why he’s being put to death. The “rational understanding” provision was added by the Supreme Court in a 2007 ruling on an appeal from Panetti, whose case has gone to the court at least five times since his 1995 conviction and sentence. **— Associated Press** **— From news services**

A decade later, a gruesome triple murder in Ottawa still shocks a quiet city

On June 30, 2007, the bodies of Alban Garon, a 77-year-old retired tax judge, his 77-year-old wife, Raymonde, and a neighbor, 78-year-old Marie-Claire Beniskos, were found hogtied with plastic bags over their heads on the 10th floor of the luxury Rivera condominium in suburban Ottawa. The ferocity of the attacks — the bodies lay in a pool of blood and the retired judge showed signs of a severe beating to his head — and the fact the killings apparently took place in broad daylight caused consternation in the normally sedate Canadian capital. Dozens of detectives converged on the scene, collecting forensic clues that included traces of DNA from blood stains and a bloody shoe print, but there were no eyewitnesses and few leads. The gated condo complex provided video surveillance of its entrances — but the cameras' output wasn't recorded. There was no sign of forced entry and valuables in the apartment were left undisturbed. Only the judge’s credit card was missing. Family members recalled that Raymonde Garon had mentioned a bizarre incident a day before the killings, when a deliveryman had turned up at the door. When he found out the judge wasn’t home, the courier said he would return the next day — even after the judge's wife agreed to accept the parcel. Relatives were suspected, among them a Salvadoran woman who had lived with the childless couple for many years and had been treated like an adopted daughter. That path led nowhere. Investigators combed through the judge’s career as chief justice of the Tax Court of Canada for clues, but the court generally deals with mundane tax matters. Police tried to make a link to one case in which a Judge Garon had participated in a judicial inquiry that eventually led to the murder conviction of a Quebec leader of the Hells Angels. That, too, proved fruitless. No real progress was made. But then, in late 2014, a decorated 101-year-old World War II veteran named Ernest Cote was the victim of a home invasion at his Ottawa condo. A man claiming to be a city employee rang Cote’s apartment; when he was let in, the man bound Cote with duct tape and covered his head with a plastic bag before fleeing with cash. This time, the victim lived to tell the tale (although Mr. Cote died a year later of natural causes). Video footage was circulated, allowing rapid identification of the intruder, and police arrested Ian Bush, now 61, a human resources consultant from suburban Ottawa with no criminal record. Police investigating the 2007 triple slaying were intrigued by the similarities to the Cote case and were soon able to match DNA from both crime scenes. A search of Bush’s Ottawa home turned up a stash that included a sawed-off semiautomatic rifle, a pump-action shotgun, duct tape, rubber gloves, fake IDs and plastic bags. The most intriguing evidence the police uncovered, according to the Ottawa Citizen, was a rambling personal journal in which Bush railed against Canadian tax authorities, calling them the “lowest form of humanity.” Comments on social media by Bush also showed a hatred for war veterans. The newspaper also published a copy of a bizarre notice faxed in 2001 to Judge Garon from a fictitious “High Court of Humanitarian Justice.” The fax called on Garon to appear at a “hearing” about his ruling in a tax case involving Bush. The hearing was to be held at a home where Bush lived in suburban Orleans. There are no indications that the judge attended the “hearing” or ever met Bush. Bush, who is married and has three adult children, was charged with three counts of first-degree murder in a trial that finally got underway this month and is expected to last 12 weeks. He was found fit to stand trial after a psychiatric assessment, and he pleaded not guilty. So far, the trial has focused on the discovery of the bloody murder scene by Raymonde Garon’s brother and the intense police investigation that followed. The jury was told that all three victims died of suffocation. Judge Garon also suffered blunt force trauma to the head, which fractured his skull, and a noose was placed around his neck. Bush, who is attending the trial in a dark suit with shackles around his ankles, was observed diligently taking notes and occasionally half-smiling during the proceedings. As the trial resumed Thursday and was about to hear from a hair and fiber expert, Bush admitted in writing that a hair found at the crime scene was indeed his. How this admission will play into the strategy of his defense lawyer, Geraldine Castle-Trudel, remains unclear. Bush has made no such admission regarding blood found at the scene that was not the victims'. And, even 10 years after this strange crime, the motivations of the accused and the savagery of the acts remain a mystery.

Man arrested in Md. killing spree allegedly menaced his wife, stepdaughters

When Gladys Tordil went to court in March to plead for protection against her husband, she portrayed him as a man who had menaced her and her two daughters for at least a decade. Eulalio “Leo” Tordil, 62, a career law enforcement officer and former Army reservist with a black belt in aikido, subjected his stepdaughters to “intense-military-like discipline — push ups, detention in dark closet” and used violence against his wife, Gladys Tordil said in a petition for a restraining order filed in Prince George’s County District Court. During one fight in 2010, she told the court, “He slapped me so hard during our altercation, my glasses broke on my face.” On March 2 of this year, she said, “He threatened to harm me if I leave him.” The protective order was granted. Eulalio Tordil’s superiors at the Federal Protective Service took his gun and badge as a result of the complaint and put him on administrative duty. But that didn’t save Gladys, a 44-year-old chemistry teacher at Parkdale High School. Instead, it allegedly set off a two-day rampage of violence across suburban Maryland that left her and two others dead and drove her daughters into hiding until Eulalio Tordil was taken into custody at a Boston Market on Friday afternoon. He is charged with first-degree murder and related charges in connection with his wife’s slaying. He may have meant to be the final fatality, allegedly telling colleagues that he wanted to commit “suicide by cop,” according to two people in law enforcement. In the hours after the first shooting, a picture of the twice-divorced Tordil emerged of a longtime — and well-armed — police officer with a history of domestic turmoil. The recent protective order included allegations that Tordil physically abused his two stepdaughters and his wife over the course of a decade. It detailed a personal arsenal that included a .40-caliber handgun, a .45-caliber handgun, an M4, a revolver and a “hunting gun” at home. His favorite quote, according to his Facebook page, is the misspelled: “You can ran, but you can’t hide.” Tordil created a Youtube channel where he posted videos of his stepdaughters performing concerts in Arizona and he also made a playlist of his favorite songs including musicians playing covers of Nowhere Man by the Beatles, Green Day’s Time of Your Life and Poison’s “Every Rose Has Its Thorn.” Tordil is originally from the Philippines, and he still has ties there. Gladys Tordil moved her daughters to Maryland from the Philippines in 2006, according to the protective order. Tordil served 15 years in the Army reserve, according to the database Nexis. Montgomery police said he was an Adelphi resident. He began his federal employment in October 1987 as a police officer with the General Services Administration, according to a federal employee database. Later, he joined the Department of Homeland Security and was paid a salary of more than $90,000. Almost a decade ago, Tordil was accused of misusing a housing program that aimed to help law enforcement officers. Tordil obtained a $26,500 discount on HUD-owned property in Hyattsville, Md., under a Good Neighbor program but didn’t live at the residence, according to a 2008 report by the U.S. Department of Housing and Urban Development Office of Inspector General. The report said that Tordil agreed to pay HUD $15,900 as part of a civil settlement. At least once in 1995, he helped teach a women’s self-defense course to staffers at the National Institutes of Health, Md., one of the agencies that was put on lockdown during the manhunt for Tordil. Tordil was working in Phoenix in 2005 when Stephen Jeckel met him at a martial-arts studio where both were students. Tordil, who was more advanced in the craft, became a second teacher to Jeckel, who is now an aikido instructor himself. He described Tordil as kind and family-oriented. “The man I knew wouldn’t hurt a fly,” said Jeckel, who remained in touch with Tordil after he returned to the Washington area. But Thursday night, police said, Tordil went to the Beltsville, Md., high school where he knew his estranged wife was picking up her daughters. Gladys Tordil was a popular chemistry teacher known to dote on her children and her students alike. Chris Mejia, a friend of Tordil’s two daughters at High Point High, remembers her paying for bowling and pizza for students who couldn’t afford to pay their own way. “She was always happy, always singing, always dancing,” said Mejia, the school’s senior class president, who has started a GoFundMe page to raise scholarship money for the two daughters, both seniors preparing to start college in the fall. One of the daughters was leaving the school’s band room Thursday night just as her mother was shot, according to Mejia, who has talked with a student who was with her at the time. The other student had to pull the girl back from the scene, he said. “That’s when the whole school panicked,” Mejia said. The violence continued Friday when Tordil allegedly opened fire outside the Macy’s at Westfield Montgomery Mall, killing one man and wounding two other people. Then he allegedly drove to a nearby Giant in Aspen Hill and shot a woman sitting in her car. Police said they have no evidence Tordil knew any of Friday’s victims. Tordil ended his alleged killing spree with a strangely calm visit to a shopping plaza. According to Montgomery State’s Attorney John McCarthy, Tordil parked, bought a cup of coffee at Dunkin’ Donuts, went to a Michaels craft store to “browse around,” and then ordered lunch at Boston Market. Whatever plans he might have had to go out with further violence were interrupted by as many as 100 police officers who were waiting as he left the restaurant. Officers rammed his car and surrounded him. Asked why the suspect didn’t shoot himself or the police, McCarthy said, “That was the fear everyone had. He didn’t.” Theresa Vargas, Michael S. Rosenwald, John Woodrow Cox, Alice Crites, Martin Weil and Jennifer Jenkins contributed to this report.

Temple Hills couple dead in apparent murder-suicide

On Winston Street in Temple Hills, Md., a weathered wooden ramp leads to the red door of the small brick house where Amando and Virginia Velasco lived for nearly three decades. Amando Velasco built the ramp a few years ago after his wife had a stroke, friends say, so that he could care for her at home. But Virginia suffered more strokes, and Amando’s health began to deteriorate because of his diabetes, friends said. In recent months, he had begun to ask neighbors for help driving Virginia to doctor’s appointments. It is that mental and physical toll, longtime friends say, that might explain why Amando shot his wife before turning the gun on himself. Both were 72. Pamela Proctor, a friend and neighbor who has known the Velascos for nearly 30 years, said she remembers how devastated Amando was after his wife had her first stroke. “She’s my whole life,” Proctor, 58, remembered him saying. “I love her. I love her.” Prince George’s County police found the Velascos at about 2 p.m. Wednesday. Detectives are calling the incident a murder-suicide and say there had been no previous signs of trouble. They were called to the house by someone asking them to check on the couple’s welfare. Experts on aging say they expect to see an increase in these types of cases as baby boomers age and experience the strain of caring for an ill or disabled spouse. “This is going to become more and more of a problem,” said Patrick Arbore, program director at the Institute on Aging and founder of the Center for Elderly Suicide Prevention. “It’s not an easy job [to be a caregiver], and to think that one is older and dealing with their own health issues really contributes to this kind of tragedy.” According to a 2009 survey from the National Alliance for Caregiving and AARP, older caregivers are more likely to be aiding a spouse or partner. And the people providing daily medical support and attention to their partners are aging themselves. Ten years ago, the average age of caregivers was 46. That has increased to 49 in more recent years. Dwight Grant, 60, has been a friend and neighbor to the Velascos for the past five years. He said speech and physical therapists frequently visited the couple’s house. And Grant and other neighbors would drive Virginia Velasco to medical appointments to help her husband. “They were the best neighbors I’ve ever had,” said Grant, who added that the Velascos had been married for 47 years. “They were sweet and loving.” Before Virginia Velasco’s health deteriorated, she spent a lot of time outside. Amando Velasco liked to tinker with tools and was always prepared to help his neighbors with yardwork. At least seven bird feeders dangled over the wheelchair ramp. Virginia Velasco liked birds and her husband wanted to make her happy, Grant said. The couple had asked neighbors to pitch in, but never indicated that they were struggling, Grant and Proctor said. And Amando Velasco’s brother, who lives in the Philippines, recently died, but he couldn’t attend the service, Proctor said. That may have added to the stress. “He and I talked a lot,” said Grant, who is a church minister. “We were praying for each other.” Stephen R. Treat is a senior therapist at the Council for Relationships based in Philadelphia. He said that murder-suicides are not unusual among the elderly. “It’s violence at one level,” Treat said. “But it is also hopelessness and desperateness, and the love and caring and wanting to go together.” In some cases, people tending to aging spouses shuttle them to medical appointments and assist them in the bathroom. They have little time to care for themselves. The stress builds. “Think of it as a backpack,” Treat said. “I could put 30 pounds in there and you could stand up just fine. But if I add 100 pounds or more, there comes a point where your knees can’t actually hold you up.” Proctor said that although her 25-year-old son would sometimes take the Velascos to medical appointments, for the most part, Amando Velasco wanted to take care of his wife himself. “He was a proud man,” Proctor said. “He wouldn’t let anyone help him push her in the wheelchair when he first came home with her after the stroke.” Proctor met the Velascos when she was pregnant with her now-adult son. The neighbors barely knew each other, but the Velascos knocked on Proctor’s door with gifts — a couple of baby outfits. Proctor last saw Amando Velasco on Monday. He was on his porch, smiling and waving the way he often did. But now, she said, it’s hard to look at the house across the street. “Nobody knew,” Proctor said. “But I guess everyone has a breaking point. I just wish he would have let someone know he was at that point so that someone could have helped them.”

100-year-old killed his sleeping wife with an ax in a gruesome murder-suicide

Often, neighbors spotted 88-year-old Rosalia Juskin and her 100-year-old husband, Michael, walking around together outside in their Elmwood Park, N.J., neighborhood. Other times, he walked alone — surprisingly active for his 100 years — and she tended to the garden she loved. “They were always together, putzing around outside,” Barbara Szczecina, a neighbor, told the North Jersey Record.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico That all came to a horrifying end over the weekend. On Monday, a relative discovered their two bodies and called police to the home, Elmwood Park Police Chief Michael Foligno said.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Rosalia Juskin had been axed to death while she slept on the first floor of the home. Michael Juskin was found dead in the bathroom after he turned the edge of a knife on himself, police said — an exceptionally rare case of extreme violence by the elderly.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico On Tuesday, Bergen County Prosecutor John Molinelli said that autopsies confirmed the incident was a murder-suicide, according to the Associated Press, which added that the motive was still under investigation.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In recent years, Michael Juskin’s health was deteriorating, neighbors and family told the Record. “Sometimes he was lucid, and sometimes he wasn’t,” a family member noted. _[In an Iowa courtroom, an astonishing case of sex and Alzheimer’s]_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Rosalia Juskin told another neighbor that her husband was “not well” but didn’t specify what was wrong. Another family member told the Record that the 100-year-old suffered from dementia. Bergen County prosecutor John L. Molinelli said in a tweet that there was a history of domestic problems in the home.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The couple had lived part-time in Florida so they could be near their daughter. Then, about a year ago, they sold their Gulfport condo, neighbors told the Record. _[116-year-old Gertrude Weaver dies just five days after becoming the world’s oldest person]_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Michael Juskin is one of the oldest people ever accused of homicide, the Record reported. It is highly unusual for an elderly person to be accused of such a violent, grisly crime. In recent years, there have been a few other incidents — including one involving a 98-year-old accused of murdering her 100-year-old roommate at a Massachusetts nursing home. Nearly five years after the 2009 incident, 102-year-old Laura Lundquist faced charges in the death as the oldest murder defendant in the state’s history until she was deemed incompetent to stand trial.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico And, the Record noted, in 2011, a 96-year-old Florida woman was charged with fatally shooting her nephew. The second-degree murder charge was dropped two years later, after the woman was found to be mentally incompetent.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **[This post has been updated.]**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

We cannot ignore the need for serious reform of law enforcement

Another police shooting in Fairfax County, this time of a mentally disturbed man who had told a police officer earlier on the day he was shot that he was suicidal [“Family of man shot by Fairfax deputy says he had sought help,” Metro, Aug 25]. Is this going to be the tipping point where we actually make changes so that citizens in crisis don’t get killed and our law enforcement officers don’t kill them? The fatal shooting of Giovanny Martinez was outrageous. So were the deaths of Natasha McKenna, a mentally ill inmate who died in the Fairfax County jail last year, and John B. Geer, who was shot in the doorway of his Springfield home in 2013. Shoot-to-kill is not an acceptable way to defuse a crisis, and the police in Fairfax County (and elsewhere) need better tools and training to serve and protect the community. Non-lethal technology exists, so why isn’t it being used in these types of situations? There is no good excuse when the alternative is the death of someone’s loved one. The Martinez family is mourning this time, but it easily could be any of us. After the requisite investigation, let’s have the courage to make some real changes this time. ****Benjamin W. Glass III** , Fairfax Station**

What results from assisted-suicide laws

As a former three-term state representative in New Hampshire, I was alarmed to see that Maryland is being urged to adopt an assisted-suicide law similar to those in Oregon and Washington  state [“ Controlling the end of life ,” Local Opinions, July 6]. Four months ago, the New Hampshire House rejected such a law by a 219 to 66 vote. Many representatives in the Democratic-controlled House initially thought they were for the bill but became uncomfortable when they studied the issue further. Contrary to promoting “choice” for older people, assisted-suicide laws are a prescription for abuse. They empower heirs and others to pressure and abuse older people to cut short their lives, especially when they have money. No assisted-suicide bill could correct this huge problem. ****Nancy Elliott** , Merrimack, N.H.** ● Dr. Ken Stevens wrote that a patient who asked for his aid in dying in 2000 is still alive 14 years later because he counseled her [“The danger of assisted- suicide laws,” letters, July 9]. I think this wonderful outcome was the result of the Oregon Death-With-Dignity Act . Because the law was in place, the patient was comfortable bringing up the topic with her physician, who then appropriately dissuaded her. But what if the patient had chosen suicide, instead of aid in dying, without the benefit of discussions with her doctor and family? The law helped Dr. Stevens and his patient. It would be presumptuous to second-guess the interaction Dr. Stevens described between his wife and her oncologist. If the law had been in place, perhaps the conversation that they found so offensive would not have happened. The value of the law for all of us in Oregon is that it takes some of the loneliness out of the dying process because it facilitates healing conversations. For the vast majority of us, it’s not about taking a drug to die; it’s about being able to share our deepest fears and most poignant concerns with our doctor and our family. ****Peter Reagan** , Portland, Ore.**

‘Lethal love’: Harold Henthorn had two wives. Both died in bizarre, brutal ways.

When Harold Henthorn’s first wife was crushed underneath the family car, her death was ruled a freak accident. When his second wife supposedly slipped down a cliff, however, cops started to get suspicious. And when investigators found an “X” marking the spot of her fatal fall on his hiking map, the jig was up. On Monday, a federal jury in Colorado convicted Henthorn, 59, of murdering his second wife in September 2012 in an elaborate but ultimately unconvincing plot. During the two-week trial, prosecutors hammered away at the “eerily, creepily” similar circumstances in both cases: freak “accidents” in remote locations, sizable life insurance payouts, quick cremations and identical words of mourning from Henthorn, the widowed husband and only witness. “It didn’t meet the common-sense barometer,” juror Peter Christofolo told the Denver Post after the trial. “Harold’s love was lethal,” said Grace Rishell, Henthorn’s sister-in-law. “If you got married to him you would probably be the next one.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Monday’s verdict was a rare moment of clarity in a 20-year murder mystery. The strange saga of Henthorn and his two ill-fated wives began back in the spring of 1995. On May 6 of that year, Henthorn and his first wife, Sandra Lynn, were driving through the dark Colorado countryside after a daylong outing when Henthorn supposedly sensed something wrong with one of the car’s tires. The tire was “flat,” “soft,” “mushy” or “spongy,” according to his various statements, Westword reported.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Henthorn pulled over to change the tire. Somehow, Sandra ended up underneath the car when catastrophe struck: as Henthorn put the tire into the trunk, the car supposedly slipped off the jack and landed on Sandra, crushing her. Paramedics flew Sandra to a hospital, but it was too late — she died during surgery. On its surface, the incident appeared to be a terrible accident tearing apart a young, happy and handsome couple. But when Douglas County sheriff’s deputies examined the crime scene, they found one strange clue. “On the front passenger fender of the vehicle, right behind the wheel well of the missing wheel, was an apparent partial foot print type mark,” wrote investigator Robert McMahan. It was as if the car had been kicked. The clue would come back to haunt Henthorn, but not for two decades. That’s because despite some suspicions, investigators closed the 1995 case in just six days, ruling it an accident. Just a few months before Sandra’s death, she and Henthorn had taken out a $500,000 life insurance policy, Westword reported. So when she died, he inherited the money.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “My bride is gone,” Henthorn said after his first wife’s death, according to court testimony. He quickly had her cremated, then spread her ashes on Colorado’s Red Mountain. The incident likely would have faded into the past had it not been repeated in near identical fashion 17 years later. By 2012, Henthorn was again happily married, or so it seemed. His second wife, Toni, was a stunning southern belle: a successful and wealthy ophthalmologist with a stake in her family’s oil business who Henthorn had met on a Christian dating Web site. Henthorn, meanwhile, hardly worked. Although his business cards said he raised funds for churches and nonprofits, prosecutors later claimed in court that he lived off his wife. “Harold Henthorn travels frequently, even weekly, allegedly for work,” U.S. Attorney John Walsh said at trial according to Westword News. “However, there is no indication that he has actual clients. He has no business in his name, no partners able to be located by law enforcement to date, and no one interviewed to date knows who his clients are or were, yet he told investigators he was financially secure, and he was a fundraiser for nonprofits like churches and hospitals. At his wife’s funeral witnesses told investigators there were no attendees from Harold Henthorn’s work and witnesses interviewed by investigators revealed no one actually knew what his business was called, or any of his projects or clients.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico On Sept. 29, 2012, Henthorn’s marriage would be tragically — or intentionally, as prosecutors claimed — torn apart for the second time. Again, he and his spouse went for a trip. This time, Henthorn asked Toni to go for a hike with him. He took her up a trail at Rocky Mountain National Park, Henthorn would later tell the court. They ate lunch atop a ridge, then hiked down to a lookout point for “romantic time.” “According to Harold’s story, which is contained in court records, they took pictures of each other, passing the camera back and forth,” Westword reported. “Toni was telling Harold where to stand for a photo when he got a text message from their babysitter saying that their daughter’s soccer team had won, 5-1. Just then, Harold saw a blur and Toni was gone.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Toni plunged 128 feet down the cliffside, suffering horrific injuries. Henthorn hiked 45 minutes down to save her, he testified, calling 911 and giving Toni CPR until help arrived. Once again, however, it was too late: His wife died from her injuries. Once again, Henthorn was the only witness. And once again, the apparent tragedy was made suspicious by money, odd details and shifting stories. First there was Henthorn’s reaction: a near carbon copy to his first wife’s death. “My bride is gone,” he again told friends, according to court testimony. Just like 17 years earlier, he quickly had his wife’s remains cremated and scattered her ashes on Red Mountain. Then there was the life insurance payout — this time $4.7 million headed his way. This time, however, the case would not be closed in six days. An anonymous tip to the coroner about his first wife’s death ensured that investigators scoured the crime scene for clues and examined Henthorn’s comments for inconsistencies. There was plenty of both. Henthorn gave conflicting accounts of what happened on the cliffside, prosecutors claimed. More damning still, the evidence didn’t jibe with any version of his stories. Prosecutors showed that Henthorn sent text messages about his wife being “injured” even after he knew she was dead. A coroner testified at trial that Toni’s body showed no sign of Henthorn performing CPR: her lipstick was still in place. There weren’t even any photos in the camera recovered by police. But perhaps the most damaging evidence for Henthorn was his map. On a topographical map showing the elevation of the park’s various cliffs, Henthorn had drawn an X at the precise point where his wife suffered her alleged accident. When asked about the map and the X, Henthorn “appeared at a loss for words” and “could not explain why there was an ‘X’ on the map,” according to an affidavit.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico There was more, including a secret and allegedly fraudulent life insurance policy Henthorn took out on his sister-in-law, a disappearing diamond ring and allegations that Henthorn had tried to kill Toni previously by dropping a wooden beam on her, breaking her back. The accumulation of evidence quickly swayed the jury, which on Monday found Henthorn guilty of murder. “Some of it was circumstantial, but we were instructed to use our common sense,” Kim Thiessen told the Associated Press. One juror even crossed the courtroom to hug Toni’s mother, Yvonne Bertolet.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico After the judge dismissed the jury, the courtroom erupted with applause, the AP reported. Toni’s family members also shouted “Bye, Harold!” at Henthorn as he was led away in handcuffs. But Henthorn’s attorney, Craig Truman, said the prosecution had not proven its case and that his client was likely to appeal, according to the Denver Post. “Where is the evidence that she was pushed off a cliff?” he said during the trial, arguing that there was none.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Henthorn now faces a mandatory sentence of life in prison without parole, to be handed down on Dec. 8. And in one final twist to the two-decade murder mystery, authorities say they have reopened their inquiry into the 1995 death of Sandra Lynn, his first wife. That investigation suggests there could be more surprises to come in the unraveling stories. His future, however, is likely to be less eventful. “Today’s conviction means that Harold Henthorn will never hurt or kill another woman,” assistant U.S. attorney Bob Troyer said after the trial, according to CNN. “Instead, he will likely spend the rest of his natural life in a prison cell.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico More from Morning Mix    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Yongki, endangered Sumatran elephant and loyal ‘park ranger,’ killed by poachers    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico ACLU: Kentucky clerk Kim Davis is meddling with county’s marriage licenses    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Jack Larson, gay actor tormented by ‘Jimmy Olsen’ role on TV’s ‘Superman,’ dead at 87    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Apparent murder-suicide in L.A. claims rapper and his actress wife

A rapper and his wife were found dead in an upscale Los Angeles apartment on Monday in an apparent murder-suicide, police said. Songwriter Earl Hayes and Stephanie Moseley, an actress and dancer on VH1’s drama series “Hit the Floor,” were discovered Monday morning after police responded to a call reporting gunshots. Los Angeles police officer Liliana Preciado told The Washington Post investigators are treating the shooting as a murder-suicide in which Hayes, who once signed with professional boxer Floyd Mayweather’s record label, allegedly killed his wife before turning the gun on himself. The motive is unknown.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “I suddenly heard screaming,” Hayes’s neighbor Charles Segal told NBC Los Angeles, “and then the screaming stopped and the next minute cops all over.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The initial caller reported about 10 shots in the Park La Brea housing complex on Hauser Boulevard, police told CBS Los Angeles. Officers arrived at about 7:30 a.m. and, once inside, heard two more shots. A room in the apartment was locked, and officers believed someone was barricaded inside. A SWAT team later entered a bedroom and found two bodies.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The investigation is “moving very slow and methodical … because they want to get it right,” LAPD Sgt. Barry Montgomery told NBC Los Angeles. Burrel L. Wilks said he was Hayes’s life coach and knew the couple well. “I’ve had sit downs with both of them so whatever happened behind those doors we’ll never know, but I heard out of her own mouth, he never raised a hand on her so this is kind of stunning,” he told the station. Moseley starred on “Hit the Floor,” a show about NBA cheerleaders, and danced for many artists, including Beyonce, Jennifer Lopez, Rihanna, Britney Spears as well as Chris Brown, who paid tribute to the dancer on his Instagram.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “RIP baby girl,” Brown wrote. “Danced with me on tour and was always the coolest person. My prayers go out to you and HAZE family.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Celebrities such as Ashley Tisdale, 50 Cent and “Dancing With the Stars” performer Allison Holker also commented on social media. “Today we bow our heads and send prayers to our special Stephanie and her beautiful family,” Holker wrote on Instagram. “Stephanie was a bright, inspiring, talented woman and I am honored I could call her my friend. We shared cries, laughter and more importantly a friendship that I will never forgot. Moseley you taught me so much, and I will hold our memories close to my heart. Heaven is lucky to have you. I love you.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Debating what ‘death with dignity’ means

Regarding the Nov. 2 Metro article “Council gives initial approval to ‘death with dignity’ legislation”: D.C. Council members who have held the hand of a dying loved one, hospiced and morphined to the max but still in misery, will not hesitate to vote “yes.” Those of us who have done so as well implore the council to vote compassion over tradition. Where is it written “Thou shalt suffer”? ****Virginia Levy** , Washington** **Physician-assisted suicide** , we’re told, is a good thing: It’s about autonomy, quality health care and the dignity of the dying. But it’s not. Assisted suicide creates risks for the weak, the poor, the elderly, the disabled and the marginalized. The American Medical Association rejects the practice. “Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer,” the AMA states . Dozens more professional medical associations agree. Assisted suicide also fails to respect autonomy. A New York state task force unanimously concluded that it “would pose profound risks to many patients,” especially “those who are poor, elderly, members of a minority group, or without access to good medical care.” If adopted, the District’s law would be ripe for abuse. A family member or friend who might benefit financially from a patient’s death could act as a witness that a patient voluntarily requested a lethal prescription. Doctors could judge patients to be “qualified” to receive a lethal prescription under the law, even if they had never before met the patient. And the law would set no safeguards to ensure competence or to guard against coercion at the time the deadly drug was taken. We should respond to suffering with true compassion. We should offer appropriate psychiatric care and human presence. For those in physical pain, palliative medicine can manage symptoms effectively. For those for whom death is imminent, hospice care and fellowship can accompany them in their last days. Anything less falls short of what human dignity requires. ****Ryan T. Anderson** , Washington** _The writer is a senior research fellow at the   Heritage Foundation’s Institute for   Family, Community and Opportunity._

Maryland weighs ‘Death With Dignity’ legislation

Terminally ill patients and those who have cared for them asked Maryland lawmakers on Friday to give people facing death the right to end their lives on their own terms. The emotional testimony comes as the Maryland General Assembly weighs a “Death With Dignity” bill, a measure that would allow doctors to prescribe lethal medications to terminally ill patients. “I urge you to vote for this bill to give me and others some control over our final days,” said Kelly Lange, a resident of Annapolis who has stage 4 breast cancer and volunteers as a patient advocate. “Most people that I have worked with are not afraid to die. More often, they are afraid of pain, and they are afraid of losing control of their lives and bodies.” Maryland joins the District and more than a dozen states that are considering what advocates call “aid in dying” statutes — also known as assisted suicide — this year. Momentum across the country has increased since 29-year-old Brittany Maynard, who suffered from an inoperable brain tumor, moved to Oregon to die under the state’s Death With Dignity law. The Maryland legislation is modeled after Oregon’s law. Although its ratification chances appear slim this year, similar measures have been approved in Washington state and Vermont over the last 10 years, and judges in New Mexico and Montana have authorized them. Under the Maryland bill, a patient who is certified to be mentally competent and who has only six months to live would be eligible for a prescription. The lethal drugs would have to be self-administered, according to the bill. “It gives people a choice,” said Del. Shane E. Pendergrass (D-Howard), the bill’s sponsor. “It allows people to exercise some control over . . . how and when they die.” Many delegates said they were sympathetic to those facing death, but they worried about the ability of someone who is in pain, and possibly depressed, to make a death decision. Several asked why there is no provision for the patient to see a mental health professional prior to approval. Others raised questions about the dispensing of medication. Who would receive it? What happens to it if the person decides not to take it? Del. Dan K. Morhaim (D-Baltimore County), one of the doctors in the General Assembly, said he didn’t understand why those questions were being raised. Dangerous prescriptions are handed out every day for various illnesses, he said, and no one raises concerns about who is picking up the prescription. Del. John W.E. Cluster Jr. (R-Baltimore County) questioned a doctor’s ability to predict the endpoint of life. He said his mother-in-law will celebrate her 94th birthday next week, four years after she was placed in hospice and the family was told her death was imminent. The bill is opposed by the Maryland Psychiatric Society, the Suicide Prevention Initiatives and the Maryland Disability Law Center. “What patients need is not a right to assisted suicide but the right to adequate end-of-life care,” said Herbert Hendin, the chief executive officer of Suicide Prevention Initiatives, said in written testimony. Maryland has taken a strong stance against assisted suicide in the past. State lawmakers outlawed physician-assisted suicides in 1999 as part of a national backlash against Jack Kevorkian, the doctor who assisted in the suicides of dozens of terminally ill patients. Even if the controversial measure makes it through the General Assembly, Gov. Larry Hogan (R), who is a Catholic, said before he was elected that he would oppose attempts to legalize aid in dying. “I believe a physician’s role is to save lives, not terminate them,” Hogan told the Catholic Standard, an archdiocesan newspaper, in October.

America’s deadly game on guns

A SPARE few paragraphs in the local and national media described the death of Shelby Elizabeth Sims. The 23-year-old South Carolina woman was killed early on Nov. 14 by her husband when, as police recounted, his gun fired while he waved it around during a card game. Her death demands attention not because it is an anomaly but rather an example of the tragically commonplace: pointless deaths that occur when guns are readily available. Jeremy Sims, 25, who has been charged by Spartanburg County authorities in his wife’s death, was drinking alcohol and smoking marijuana before his gun went off, police said. Had Mr. Sims not had access to a gun, probably the worst consequence of his behavior would have been a hangover. Instead, his wife of four years is dead, their child was placed in protective custody and he faces a murder charge. Most of the national debate about gun violence has centered on mass shootings; but for all their unquestioned horror, they account for just a fraction of the carnage that results from guns. Nearly 300 people a day are shot in murders, assaults, attempted and successful suicides and unintentional shootings. Every day, on average, nearly 90 people die from gun violence. Particularly heartbreaking, as we have written, are the instances of children who are accidentally killed, too often by other children. The numbers — and the tragedies behind them — are a result of U.S. gun policies that allow and even encourage firearms to circulate freely. We do not know why Mr. Sims had a gun or why, as police said, he brought it to a card game. Perhaps, like many Americans who have bought into the argument of the gun lobby, he thought it necessary for self-defense. But having guns in homes actually increases risks. There is a higher chance that a gun in the home will result in an accidental shooting, be used in a suicide or a suicide attempt, or escalate an argument to a lethal end than that it will be used for self-protection. This country can continue to ignore those facts, but, in doing so, it plays a deadly game. **Read more about this topic:** The Post’s View: Shot and killed over a puppy The Post’s View: Keeping guns out of children’s hands E.J. Dionne Jr.: The conservative evasion on guns Fareed Zakaria: Change your gun laws, America The Post’s View: The argument against common-sense gun control crumbles

Unwarranted deaths in Fairfax

IT TOOK well over a year for officials in Fairfax County to notice the stunning absence of accountability in the case of John Geer, an unarmed man who was shot to death by a county police officer in August 2013. Recently, they have begun taking steps to close that accountability gap. Now the clock is ticking on another apparently senseless death, this time involving Natasha McKenna, a mentally ill woman who died a month ago after being repeatedly shot with a stun gun by sheriff’s deputies in the county jail. Ms. McKenna, an unimposing 37-year-old woman, had resisted a specially trained team of six sheriff’s deputies who went to extract her from her cell. It should not have been necessary to subdue her with a stun gun, let alone fire it multiple times. So far, no charges have been filed, and no resolution reached, in either case. And while critical information has finally been made public (after months of stonewalling) in the Geer case — including the identity of the police officer who pulled the trigger and the accounts of witnesses — it is still being withheld in the McKenna case. The most encouraging sign of progress is the establishment of a commission to review police policies governing the use of force and the department’s disclosure of information in shootings by officers. The broadly representative commission, created at the instigation of Sharon Bulova, the Democratic chair of the county’s Board of Supervisors, is to issue its recommendations by Oct. 1. At the same time, the supervisors have made known their displeasure with their lawyers in the county attorney’s office, whom they blame for advising the police not to cooperate with county prosecutors investigating Mr. Geer’s death. Yet by focusing their ire almost exclusively on a deputy county attorney who was handling the case — Cynthia L. Tianti, a 25-year veteran of the office — they seem to have settled on a scapegoat. Do not the police chief, Edwin C. Roessler Jr., and the county attorney himself, David P. Bobzien, deserve at least equal shares of the blame for months of obstruction and foot-dragging? In the death of Ms. McKenna, a mother of a young daughter, the supervisors may have somewhat less leverage. The jail guards under investigation, who have not been disciplined in any way, are employees of the sheriff’s office, led by the independently elected sheriff, Stacey Kincaid. Their actions preceding Ms. McKenna’s death are under investigation by the police. But the policies of the sheriff’s department governing the use of force, including deployment of stun guns and extraction of inmates from their cells, are not subject to county review. That means it is up to Sheriff Kincaid to launch an assessment of how deputies at the county jail go about their jobs, with an eye to ensuring that incidents like the one culminating with the death of Ms. McKenna do not recur. Rather than repeat the police department’s stonewalling mistake, she should act to initiate that assessment. **Read more:** The Post’s View: A death in the Fairfax jail renews questions about transparency The Post’s View: What happened to Natasha McKenna?

China wants to stop domestic violence. But the legal system treats it as a lesser crime.

LUYI COUNTY, CHINA — In a courtroom in the Chinese heartland, a defense attorney made his final pitch. That his client, Zhang Yazhou, killed his wife was not in question. At 5:25 in the evening on Feb. 21, Zhang walked into his wife’s hospital room. They argued. He strangled her, digging his fingers deep into the flesh of her neck. By the time nurses entered the room, Zhang was gone and Li Hongxia, just 24, was dead. Since Zhang confessed on television and in court, the issue at hand was the sentence. Li’s family and their lawyer asked for the death penalty, which is common in China, describing a year of escalating abuse that culminated in a brutal murder. The defense asked for leniency on the grounds that Zhang had admitted his guilt and that Li’s death was different than “regular” acts of violence — because she was Zhang’s wife. In the end, the court in Henan province took a relatively tough line, sentencing Zhang to death with a two-year reprieve — meaning he could get life, or a shorter, fixed-term sentence if he behaves in jail — consistent with Chinese law, lawyers said. Yet the court’s written judgement, provided to Li’s family this week and reviewed by The Washington Post, which has previously reported on the case, says plainly that Zhang’s penalty was indeed reduced because it was a domestic case. Zhang got a reprieve, not immediate execution, because the case was “caused by family conflict and the defendant Zhang Yazhou turned himself in,” the judges wrote. The ruling illustrates how the Chinese state is struggling to handle a public health crisis often dismissed as private, personal scandal. The government estimates that 1 in 4 Chinese women are beaten, a figure experts consider low because many never report it and it excludes sexual, psychological and emotional abuse. In China, domestic violence has long been ignored by the legal system. In fact, Li’s family was so certain her death would be brushed aside that, after her murder, they refused to bury her body, keeping her corpse aboveground in a desperate bid to shame the state to act. The government of President Xi Jinping has promised to address the problem, last year passing a first-of-its-kind anti-domestic-violence bill. The law was hailed by advocates as a step in the right direction. It includes provisions such as restraining orders that, if implemented, could have offered Li some help. But a Post investigation into Li’s killing showed the limits of using the law alone to keep women alive. In the last year of her life, Li knew she needed to leave her husband but was told by those around her — family and friends, neighbors and nurses — to go quietly back to Zhang. Now, the handling of her murder reveals how the state’s effort to stop domestic violence is undermined by the persistent belief that domestic abuse is somehow a lesser form of violence, that it is not as serious as “regular” crimes. Until that sentiment changes, tens of millions of people are at risk. In the months since Li’s murder, local officials have repeatedly shirked responsibility for her death, dodging questions, blaming Li and playing down her husband’s culpability. The head of Li’s village, an official named Li Jie, called the dead woman “cowardly” for failing to report previous beatings. She could and should have saved herself by “saying no to domestic violence,” he said after her death. She should have reported abuse to the village council or the All-China Women’s Federation, a Communist Party-backed body, he added. “Both could have helped her protect her rights and interests.” Yet there is little evidence that the council, the Federation, or other state-linked bodies would have helped her leave safely. Chinese law enforcement has taken a cavalier approach to investigating violence against women. In 2011, an American woman named Kim Lee went public with an account of beatings by her Chinese husband and the indifference of local police. In a 2014 essay, Kim recalled going to the police station after an attack, only to be told to go home and sort it out. “As far as the police were concerned,” she wrote, “no crime had occurred.” The Federation campaigned hard for the anti-domestic-violence bill, but also encourages women to get and stay married — even, in some cases, when there is evidence of abuse. Asked about Li’s death, the head of the Federation’s Luyi County office, Guo Yanfang, blamed Li for not reporting her husband, but also said she advises abused women to work things out with their spouses. If a man is “not going to kill you or harm you, if he is good in nature but just being young and impulsive,” a woman should try to win him back “to save the family,” she said. “Isn’t every family like this?” she said. “There is always smoke coming from the kitchen stove.” In Luyi County, the legal system as a whole seemed to see domestic violence as both normal and inevitable. In statements to the court, the defendant, Zhang, and lawyer Cui Xiaolin played up the fact that the couple fought before the murder, presenting Li’s death by strangulation as distinct from other more cold-blooded crimes. “It was a crime of passion; the two had a dispute and then this thing happened,” Cui said after the trial. Zhang, the confessed wife-beater and murderer, was not a particularly “malicious” man, he added. Cui argued that Zhang should be spared the harshest sentence because the couple had a 2-year-old daughter who needed him. “She already lost her mom, she can’t lose her dad,” he told the court. Chinese lawyers who work closely with survivors of domestic violence said the case sent a mixed message. On one hand, the punishment was not light — a sign, they hoped, that judges will take violence seriously, even violence against a wife. On the other, many involved showed a limited understanding of the ideas outlined in the anti-domestic-violence law. Lu Xiaoquan, a Beijing-based lawyer who specializes in domestic violence but was not involved in Li’s case, said the level of knowledge about intimate-partner violence in China remains “pathetic.” “A law, no matter how good it is, is only a piece of blank paper without implementation,” he said. “If the law cannot be effectively implemented, similar cases will appear.” That’s exactly what Li’s family feared. They worried that the murder of a poor woman in rural China would be swept away like dust, making it easy for the next abuser to strike. They wanted her death to change that — she deserved as much. Although the family is glad Zhang will do time, they are outraged and demoralized by the legal process as a whole, said Li’s older sister, Yan Jinjin, after they received a copy of the judgment. “We don’t think my sister got the justice she deserved,” she said. Gu Jinglu in Luyi County and Jin Xin in Beijing contributed to this report. ****

Euthanasia supporters and detractors

Mars Cramer [“Euthanasia was the right decision for my wife,” Health, Oct. 23] described the anguish of watching his wife become ill, her condition worsening until it reached the point where they decided that voluntary euthanasia was the best solution. Mr. Cramer is from the Netherlands, where euthanasia is legal. There are several reasons I hope that euthanasia will not be legalized across the United States. First, every human life is inviolable; no matter how impaired it is, every human life remains of great value. Intentionally ending an innocent life is wrong. Second, we trust doctors to make decisions for our well-being; their purpose is healing. When a doctor, whose job is to heal and comfort, participates in killing a patient, trust between the doctor and other patients is jeopardized. Third, commitment to palliative care and to protection of the sick and aged would better serve society. The American Geriatrics Society notes that legalization of euthanasia “may open the door to abuse of the frail, disabled, and economically disadvantaged, encouraging them to die prematurely, rather than to burden their families or society.” Life is not a burden, and it should not be seen as one. Lastly, euthanasia is not a good choice because it is a step on the slippery slope.Legalizing euthanasia could lead to acceptance of this practice for the comatose, demented or severely handicapped, and even for the competent without consent. ****Mariah Naegele,** Alexandria **

No dignity in living with extreme dementia

Michael Gerson’s Sept. 19 Washington Forum column on suicide, “Meeting one’s end too quickly,” mentioned the “hardest cases.” These people have lost, through disease or injury, those elements that are uniquely human. The autonomy that is perhaps overly prized in permissive views of euthanasia is gone, and they are incapable of exercising the freedom to end lives that they never would have wanted to live out. I watched my father live years longer than he would have considered acceptable, having clearly stated that if he ever “lost his mind” he would not want to live. In my work as an Episcopal priest, I have seen many others in this sad state. There was no dignity in their mindless existence, nor were they inspiring “examples of fortitude and faith.” As we live longer and an increasing proportion of the population suffers extreme dementia, I hope we will allow for assisted suicide if that has been clearly stated by the person while he was of sound mind. In these cases, “the human right to cease to be a human being” is a compassionate response to a disease that has already taken that away. ****Susan Mann Flanders** , Washington**

Ruling on competency of Albrecht Muth, held in wife’s death, could come Thursday

The judge overseeing the trial of Albrecht Gero Muth, accused of fatally beating and strangling his 91-year-old wife in their Georgetown home last year, could soon rule on whether Muth — who maintains that he is an Iraqi army general and his wife’s death was an Iranian hit — is mentally competent to stand trial on murder charges. D.C. Superior Court Judge Russell F. Canan’s ruling could come as soon as Thursday. If he rules that Muth is competent, a trial could begin in March. If not, he could be sent for further evaluation. Canan must consider whether Muth’s apparent mental instability is a strategic ruse to avoid the prospect of a life sentence or a sign of an illness that could prevent him from obtaining a fair trial. During Muth’s competency hearings, which ended Wednesday after nearly a week of testimony, prosecutors presented six mental-health experts and other witnesses who said that Muth, 48, was capable of assisting in his defense. They have characterized him as a master deceiver — a narcissistic and pathological con man who invented characters to ingratiate himself with Supreme Court justices, White House officials and other Washington luminaries for years before killing Viola Herms Drath on August 12, 2011. Prosecutors say that Muth adopted at least seven “personas,” including a German spy and count. Prosecutors and Muth’s own attorneys say they believe that there is no evidence that the German-born Muth was ever in the military or the nobility. Muth’s attorneys, from the District’s Public Defender Service, have said that at times, Muth is incapable of working with them. They called three experts, who testified that they believed his personas could be the result of an undiagnosed head injury, seizures, alcoholism or another medical condition. The competency hearings at times resembled a tennis match, experts hitting their opinions back and forth. Muth’s attorneys argued that unlike defendants who feign mental illness after a crime has been committed, Muth has maintained his personas for years — to the dismay of his wife’s family and their friends and neighbors. Prosecutors disagreed. “There is no mental illness here,” argued Assistant U.S. Attorney Glenn Kirschner. “There is no delusional disorder here. This is a career of cons, and this is the latest con the defendant has taken.” Defense attorneys and prosecutors also battled over a diagnosis by doctors at the District-run St. Elizabeths Hospital, where Canan ordered Muth sent from jail after his arrest. Over about six months, doctors there maintained that Muth was not competent to stand trial. After doctors hired by prosecutors called him competent, St. Elizabeths doctors did the same, saying they did not have the information prosecutors’ doctors had during their initial evaluations. During the hearings, Michelle Godwin, a clinical psychologist at St. Elizabeths, said her diagnosis changed after she received more information about Muth. But Dana Page, a Muth attorney, said staff members at St. Elizabeths changed their diagnosis only after being “schooled” by doctors commissioned by the government. Canan, too, acknowledged Wednesday that he was perplexed by Godwin’s explanation for the change in the hospital’s diagnosis. “I didn’t get a straight answer from her,” Canan said. Muth has told doctors that if he is found competent, he plans to represent himself. He has also told officials that he would seek a bench trial rather than be tried by a jury. Should that happen, the proceedings could be colorful. Muth’s attorneys said during the competency hearings that he wants to prove he is in the Iraqi military and plans to subpoena friends and acquaintances from Washington who he believes would support his claims. Those individuals, attorneys say, could include Supreme Court Justice Antonin Scalia and retired Gen. David H. Petraeus. Prosecutors argue that Muth’s personas helped him access rarified circles and gain uncommon social access in Washington, obtaining choice restaurant reservations and invitations to embassy parties. During the hearing, Muth often sat with his eyes closed and his head against the wall behind him. At times, he nodded and smiled during others’ testimony. Doctors said that Muth has been working on a memoir and has written hundreds of single-spaced pages. He also told at least one doctor that he envisions Leonardo DiCaprio or Matt Damon playing him in the movie he expects to be made about his life. At one point during the hearings, an audio recording of an interview doctors conducted with Muth was played. In a thick German accent, he said he did not expect to win a trial because nobody will believe that Drath was assassinated. “I expect to be found guilty, because there is no defense,” Muth said.

Death of a toddler raises questions in Montgomery, Pr. William

PRINCE McLEOD RAMS, age 151 / 2 months, was taken off life support after being declared brain-dead at 8:38 p.m. Oct. 21 at Inova Fairfax Hospital. A day earlier, paramedics had found him unresponsive, cold and without a pulse at his father’s home in Manassas, where he had been on his fourth unsupervised visit permitted by Montgomery County Circuit Court amid a bitter custody battle. His mother had fiercely opposed unsupervised visits. “If anything happens to Prince, he can’t say anything. He’s not old enough to be talking,” Hera McLeod of Gaithersburg testified at a court hearing on July 12. The cause of Prince’s death is yet to be determined. Officials at Prince William Hospital, where the boy was first brought on Oct. 20, notified Child Protective Services, citing, according to records, “obvious unexplainable injuries.” Prince William County Commonwealth’s Attorney Paul B. Ebert said a criminal investigation is underway. The probe, a spokesman for the Manassas police confirmed, is being coordinated with an investigation into the 2003 murder of the father’s ex-girlfriend, with whom he had a child, and apparently new questioning about the 2008 death, ruled a suicide, of his mother. The father, Joaquin S. Rams, did not return calls in recent days seeking comment. It’s not known yet whether Prince’s death could have been prevented, but the case should cause soul-searching by officials in Montgomery County family court who lifted supervision of the toddler’s visits and by Prince William law enforcement agencies who investigated earlier incidents involving the father. “A faulty and callous legal system,” Prince’s grandfather wrote the judge, sent the boy to a death that was “at best . . . neglect. At worst . . . murder.” Whether or not the grandfather’s suspicions prove to be founded, there is an all-too-typical script to family court battles: Distraught mothers often are dismissed, and seemingly competent fathers overvalued, by courts understandably reluctant to deny parents access to their children. Women who warn of danger are seen as vengeful or “crying wolf.” Traumatized by abuse, many of them don’t make ideal witnesses. Fathers pleading to be a part of their children’s lives are welcomed as a refreshing change from the deadbeat dads courts are accustomed to. These stories play out in courts that are often seen as undesirable by the people who work there. “I’m in Family Law because I have to be. It’s a required 18-month rotation. I don’t like it. And if I could choose not to do it, I would not do it,” said Circuit Court Judge Michael J. Algeo, who oversaw the custody battle over Prince, on March 14. Ms. McLeod, an intelligence analyst for defense contractor Booz Allen Hamilton, met Mr. Rams through an online matchmaking service in February 2010. She became pregnant in October, and the couple became engaged in December and she moved in with him. On July 17, 2011, two weeks after Prince’s birth, Ms. McLeod’s sister, then 19, said Mr. Rams forced her to have sex. He countered it was consensual. Ms. McLeod moved out, hired an investigator and sought custody of their newborn. It turned out there was much about Mr. Rams she had not known. At the custody proceeding, a Manassas police detective testified that Mr. Rams was a suspect in the still-unsolved 2003 murder of his ex-girlfriend Shawn Katrina Mason because he had motive and opportunity. Mr. Rams testified that he is innocent. A report by a Prince William social worker noted that Mr. Rams believed himself (wrongly) to be the beneficiary of Ms. Mason’s life insurance policy. Mr. Rams acknowledged that adult pornography was produced in his home. He lived, according to information presented in court, on Social Security benefits to his other son and savings from his mother’s life insurance policy. “It seems,” Ms. McLeod’s attorney told the court in November 2011, “that people around him . . . sometimes die under mysterious circumstances.” Judge Algeo awarded Ms. McLeod sole legal and primary physical custody of Prince in March. A court evaluator had concluded that her safety concerns were justifiable, and a retired Montgomery County police officer was appointed to supervise weekly, three-hour visits at a county mall. Just months later, Mr. Rams was allowed unsupervised, all-day visits at the Virginia home he shared with his other son and the couple that owned the property. Any review has the benefit of hindsight, and investigators have yet to conclude what role, if any, neglect or intent played in Prince’s death. But hours of court testimony and pages of documents reveal unsettling issues about the decision to allow unsupervised visits. For the psychological evaluation, why was Mr. Rams allowed to pick a psychologist who specializes in working with children with autism-spectrum disorders and who belongs to the same practice as the therapist who works with Mr. Rams and his older son? Was there, as an expert called by Ms. McLeod testified, a failure to conduct tests that could more properly identify possible risks? Should the court evaluator who found safety risks in March have been consulted again before the child was taken out of state to a home that had not received a site visit? Judge Algeo, through a spokesman, declined comment, citing judicial canons. It’s apparent from transcripts of the June 29 and July 12 court hearings that he was reassured by testimony from the retired police officer, who saw no problems during the supervised visits and expressed no concerns. He was pleased with Mr. Rams’s claims of having a job and taking down a pornography Web site, noting, “He has done what I asked him to do.” Ms. McLeod has started a blog to call out those who she believed failed her baby and to call attention to a broken system that trusted her enough to give her legal and physical custody of a child but didn’t trust her warnings of danger. “The courts refused to treat me like anything but a vengeful woman,” she said. Tragically, she now believes she has cause to be one. ****

‘I hope… I can be forgiven’: Man gets 100 years for ‘mercy killings’ of wife, sister

Lance Holger Anderson had come to pay his sister one last visit. On the morning of Dec. 11, 2013, Lisa Nave lay in a vegetative state in a nursing home north of Los Angeles, as she had since suffering a heart attack five years earlier.  Then he raised a pistol to her head and pulled the trigger.  When Nave’s family learned she had been fatally shot, they asked police to check on Anderson’s ailing wife, who had dementia. When they did, officers found Bertha Maxine Anderson in the couple’s apartment, also dead from two gunshots to the head. The double slaying shocked friends and neighbors, who knew Lance Anderson as a doting husband and brother. In an interview with police, Anderson admitted to the crimes but said they were acts of kindness, not cruelty.  Last month, a Los Angeles County judge found Anderson guilty of two counts of murder. And on Wednesday, Anderson, 63, was sentenced to 100 years to life in prison. As with other so-called mercy killings, the case has stirred debate over euthanasia.  In court, however, prosecutors successfully argued that Anderson had taken his wife and sister’s lives into his own hands, and that neither had asked to die. Those who knew Anderson said there was little sign of his intentions. Neighbors said he was a caring husband whose life revolved around Maxine.  Marianela Solis, a cleaner at a condo where the Andersons lived, said the only times Lance got angry was when Solis was loud. “He said the noise bothered his wife,” she told the Signal. “He told me to be quiet.”  “He treated her like she was a jewel … because she was so fragile,” Madrigal said. There was only one hint of the horrors to come, she said. Two weeks before the murders, Anderson offered Madrigal his artificial Christmas tree. The couple wouldn’t be needing it this year, he said. On the night of Dec. 10, neighbors heard two loud but distant booms, like thunder on the horizon. “I came out on the balcony,” Jay Johnson told the Signal. “I was waiting and waiting and I saw and heard nothing.” It wasn’t until police cars arrived the next day that Johnson learned what had happened: Anderson had shot his wife in the head twice with a small pistol. The morning after killing his wife, Anderson took a cab 15 miles south to Lisa Nave’s nursing home, according to police. Once there, he used the same weapon to kill his younger sister.  Anderson made no attempt to escape.  It didn’t take investigators long to learn that there was another victim.  During his news conference, Vernon said he was calling the slayings “mercy killings” only because he wanted the public to know there was no threat. “The motives and rationale for this kind of shooting can never be justified legally,” Vernon said. “Mr. Anderson made a unilateral, fateful decision to take two lives and forever alter his and so many others who loved his wife and his sister.” Anderson was charged with two counts of murder. Despite his recorded confession, he pleaded not guilty.  Anderson’s attorney, Lawrence Forbes, argued the facts were not in dispute but that the deaths were “mercy killings.” Anderson had told investigators that he killed his wife because she had brain damage, breast cancer and other health problems, according to the AP. His sister, meanwhile, was “dependent fully” on the nursing facility, receiving nourishment through a feeding tube and unable to hold a conversation, Forbes said. “This is not a case where there was a hope for monetary gain,” Forbes said of the slaying of Maxine Anderson. “His wife was miserable, she didn’t like the way she was living, and he ended her life after hearing all of the evidence.” Forbes asked Zacky to find Anderson guilty of manslaughter, not murder.  Anderson had been preparing to kill his wife for weeks before he shot her, prosecutors said. He had gone to a gun range and planned funerals for both women before he killed them, including which flowers would be laid on their caskets, Assistant District Attorney Julie Kramer argued. Perhaps most important, prosecutors said Maxine Anderson was not terminally ill, as her husband had told people.  Zacky sided with the prosecution, finding Anderson guilty of murdering his wife and sister. In Wednesday’s sentencing hearing, Zacky heard statements from the victims’ families. “This man has destroyed every aspect of my life,” said Maxine’s son, Jason King, according to the Times. “Every day that he has spent in a cell, I’ve spent in a cell in my own mind.” King, who was serving overseas in the military when the murders took place, never got a chance to say goodbye to his mother. “Two bullets took away everything that was important to me,” he said. Anderson, who arrived in court with the aid of a walker after suffering a stroke and heart attack in jail, could be seen wiping away tears during the hearing, the Times reported. He declined to address the judge directly during the hearing. Instead, Forbes read a statement on his behalf. “All I can add at this time is the fact that no words can explain or fully express the range and depth of the heartfelt sorrow, regret and remorse I truly feel for the pain I’ve caused my family,” the statement said. “I hope someday that I can be forgiven.” Again, the judge came down against Anderson, sentencing him to 100 years, to be served in a prison medical facility in Northern California. When announcing his decision, Zacky revisited the moment Anderson killed his own sister. When Anderson told Lisa Nave he was “sending her home,” a single tear rolled down her cheek, Zacky said. But the judge denied that the tear meant what Anderson had claimed.  “That’s [an answer] we’ll never know.”

Review: In ‘On My Own,’ Diane Rehm argues for the right to die

“On My Own” is the deeply felt and thoughtfully written account of the illness and death of U.S. State Department attorney John Rehm, and of the first year of widowhood for his wife, Diane Rehm. The author, host of the nationally syndicated “Diane Rehm Show,” writes candidly about her husband’s decision to die when Parkinson’s disease had deprived him of the ability to “in any way care for himself on his own,” and his frustration at the discovery that in the state of Maryland his doctor could not assist him in dying. The only option that John, 83, had was to refuse food, water and all medication except morphine until he caused his own death. This was the course he followed for the 10days it took to end his life. His wife supported his decision. “I sat by his side, never forgetting that he had chosen to die. . . . It was excruciating to witness.” It is not easy for a terminally ill person to die deliberately, even in a profoundly weakened condition. In most parts of the country, it is still against the law for medical personnel to give any assistance whatsoever to anyone, at any point of illness or incapacity, who is intent on suicide. The result of this legal prohibition is that individuals like John who no longer wish to exist in a painful and hopeless state must literally starve themselves to death. Though his doctor tried to keep her husband as comfortable as possible during the process, Rehm nonetheless writes, “I rage at a system that would not allow John to be helped toward his own death.” Following her husband’s passing, after the family gatherings and the public memorial service and testimonials were over, Rehm began to reflect on his last, difficult days, on their marriage of 54 years and on the complex process of her own grief. “One of the first feelings that strikes me is Guilt with a capital G,” she admits, along with the conviction, shared by many surviving spouses, that she should have cared for her husband herself during his last months of life, rather than moving him into the facility where he eventually died. But like most people in her situation, she really had no choice: At a certain point in her husband’s illness, she was unable to care for him at home, something he and their children fully understood. Still, and inevitably, there was guilt. At the time of her husband’s departure from their shared apartment, there was also a curious mixture of apprehension and relief. The relief will be familiar to all those who have finally made the decision to “place” a loved partner or parent in a setting that is better equipped than the home to provide appropriate care. The apprehension, for the author, had to do with living alone after half a century of marriage. Rehm writes eloquently about the changing landscape of grief, not only her own sorrow but that of friends such as retired television news anchor Roger Mudd, who lost his wife, E.J., after only a few weeks of illness, or another close friend, Jeff Stann, who went through a long dying process with his wife, Patsy, just as Diane had done with John. In looking toward the future, Diane realizes that there is no spouse to take care of her someday, as she cared for John during his final illness and as he supported her in her struggles with spasmodic dysphonia, the neurological disorder that affects her voice. “The Team of Rehm is no longer,” she writes. She must make her own preparations for the future. Rehm vividly describes the roller coaster of emotions she has felt following her husband’s death: the inability to concentrate, the grief coming in waves while she was in the midst of an on-air conversation, the overwhelming need to be alone. “I don’t want to be in the company of others, even close friends, who are laughing and sharing ideas and stories.” As she reflects on the many decades of her marriage, both good times and bad, the author also recognizes that she is in a new phase of her life, with a new purpose inspired by the manner of her husband’s death. She promises that once she has retired from her radio show, “I shall do all I can to promote the right of aid in dying.” “I don’t believe in closure,” she writes. “Some part of me will grieve forever.” But she chooses to live fully the richness of her own experience and to share it with others in this clear, moving and completely honest account. Diane Rehm has again found her voice, and, as she has always done, she speaks passionately and courageously about issues that concern us all. **Diane Rehm** will talk about her book March 2 at Sixth & I, tickets and $20 minimum registration. sixthandi.org. ******Reeve Lindbergh** has written a number of books for children and adults, including “Forward From Here: Leaving Middle Age — and Other Unexpected Adventures.” _Read more_ : When a friend asks you to help her die The role of John Rehm’s doctor in his death Californians gained the right to die, but the terminally ill who wanted it have to wait By Diane Rehm Knopf. 162 pp. $23.95

A suicidal vet’s plight

LIKE SO MANY PEOPLE, including too many veterans in this country,Sean Duvall found himself incapacitated by the illness of depression. Mr. Duvall’s part-time job as a cook on the Virginia Tech campus had come to an end and, with it, the means to pay for his apartment. On June 1, the 45-year-old left his home and began walking the streets of Blacksburg. In his backpack: a cellphone, a letter to his family and an eight-inch pipe he had designed to shoot one bullet when slammed against a wall. That bullet, Mr. Duvall thought, would bring an end to his misery. Fortunately, Mr. Duvall, who enlisted in the Navy during the Persian Gulf War, did not take his own life. Shortly after midnight on June 8, he called a Veterans Affairs confidential crisis hotline. Minutes later, a Virginia Tech officer arrived, and Mr. Duvall alerted him to the makeshift gun. The call likely saved Mr. Duvall’s life, but it also led to a legal showdown with the federal government that could land Mr. Duvall in prison for 40 years. Virginia originally charged Mr. Duvall with carrying a concealed weapon without a license — a misdemeanor that carries a possible 12-month sentence and $2,500 fine. Even this charge seems uncalled for, given the circumstances and the fact that Mr. Duvall never threatened or attempted to harm anyone else. The travesty was multiplied when state prosecutors dismissed their case to allow the U.S. Attorney’s Office for the Western District of Virginia to press federal charges. Federal prosecutors obtained a four-count indictment that included charges for possessing and manufacturing a “destructive device”; each count carries a possible 10-year sentence. Mr. Duvall’s lawyers argue unconvincingly that a federal judge should dismiss the case because it is “a violation of due process” for the United States to promise confidentiality for hotline callers only to “use statements and evidence provided in reliance on that assurance . . . as the basis for a criminal prosecution.” Taken to an extreme, this argument would foreclose charging a veteran who called the hotline and then murdered his family. This cannot be right. But it should not take a judge’s intervention to see the charges dismissed; U.S. Attorney Timothy J. Heaphy should do that on his own. In court papers, Mr. Heaphy’s office argues that “the law must be applied with equal force to all in this country.” In the same document the office acknowledges that the United States also “has discretion in determining which charges to bring.” Exactly: Prosecutors wield enormous power, and with that power comes an obligation to ensure that justice is done. Mr. Heaphy and his office are right to be alert to the danger of guns near or on the Virginia Tech campus, given the 2007 massacre that took the lives of 32 people and injured two dozen more. But they’re also obliged to evaluate each case judiciously. In the Duvall case, the prosecutor has transformed what should be a tool for justice into a cruel and blunt instrument. ****

The Brittany Maynard effect: How she is changing the debate on assisted dying

_Marcia Angell is a senior lecturer in social medicine at Harvard Medical School and a former editor in chief of the New England Journal of Medicine._ When my husband was diagnosed with metastatic cancer in February, he asked physicians whether they would provide him the means to end his life quickly if he chose. They either evaded the question or said they were unable to comply. They then hastened to assure him that he would not suffer. But that was not his question. My husband, Arnold S. Relman, was a distinguished physician who had been chairman of the department of medicine at the University of Pennsylvania and editor in chief of the New England Journal of Medicine; he knew very well what lay ahead of him. His concern was not so much with suffering as with having his mind affected by the drugs he would need to prevent suffering. He was asking for the option of ending his life in the way he chose. In June, he died at home in Massachusetts, with hospice care, but not in the way he wanted. I see no reason he should have been denied that final measure of control. The case of Brittany Maynard, however, may finally signal a shift in this debate. Whereas hastening an inevitable death was once regarded almost exclusively as a medical issue, we are beginning to focus on what patients want, on their right to self-determination. And people are increasingly asking why anyone — the state, the medical profession, religious leaders — would presume to tell someone else that they must continue to die by inches, against their will. Maynard, the 29-year-old with incurable brain cancer, is the new face of the movement to give dying patients the choice to end their lives faster and more humanely. Her youth and attractiveness have helped make her a national media story. She also represents, and seems to have had a particular impact on, a generation that tends to support the rights of individuals to make personal choices, in matters such as same-sex marriage and marijuana use. When Maynard learned she had a fatal disease that would rob her of control over her body and mind, she and her husband decided to move from California to Oregon — one of five states where she could legally obtain a prescription for a barbiturate to end her life peacefully before the cancer destroyed who she was. This was not a matter of choosing death over life. Indeed, Maynard and many other people prefer the term “assisted dying” to “assisted suicide.” Oregon’s Death With Dignity law applies only to patients who are close to death, and Maynard was told in April that she had six months to live. The question was simply how she would die. The Supreme Court has twice maintained that that’s a medical question and as such should be left to the states, which regulate medical practice. The medical profession, meanwhile, has been among the main obstacles to more laws like Oregon’s. The American Medical Association’s official policy is that physician-assisted suicide is “fundamentally incompatible with the physician’s role as healer.” Sixty-five percent of New England Journal of Medicine readers who responded to an online poll last year were against it. One possible explanation for this opposition, particularly among palliative care specialists, is that assisted dying underscores their limitations in dealing with suffering at the end of life. But that stance puts the focus in the wrong place. This is not primarily about physicians or their self-image; it’s about patients — specifically patients for whom healing is no longer possible. We give patients the right to hasten their deaths by refusing dialysis, mechanical ventilation, antibiotics or any other life-sustaining treatment. Why deny them what is essentially the same choice, especially since it is limited to terminally ill patients? Moreover, there is no requirement in any state for physicians to participate if they do not wish to do so. The laws simply provide one more choice for physicians and patients as they deal with terminal illness. In 2012, I was among the lead petitioners to put a Death With Dignity law on the ballot in Massachusetts, and I campaigned hard for its passage. Until a month before the election, polls showed overwhelming support. But in the final weeks, the Catholic Church, both nationally and within the state, began pouring money into TV ads implying that people would be coerced into killing themselves, and physicians and pharmacists would be required to help them. After opponents outspent proponents by about five to one, the referendum lost. However, as people learn more about the real impact of these laws, and take notice of stories like Maynard’s, it will become harder to sway public opinion like that. We know, for instance, that the law in Oregon is rarely used. From 1998 through 2013, it accounted for 752 deaths — 71 last year, or one out of every 500 deaths in the state. Most of these patients were suffering from cancer, and the prognosis was clear. Far from being disadvantaged — a concern when the law was first proposed — they were relatively affluent, well-educated and well-insured. Nearly all were receiving hospice care, and nearly all died at home. One common objection to these laws is that patients who request an earlier death may simply be depressed. It’s extremely difficult to diagnose depression in dying patients because the symptoms overlap almost entirely with those of terminal illness. But studies from Oregon — which requires referral for counseling if a physician believes that depression is impairing a patient’s judgment — show that depression is no more common in patients who request assisted dying than in other terminally ill patients. And a recent study showed that dying patients who receive a prescription for lethal medication become less depressed and anxious than those who don’t. Of great importance, about a third of those in Oregon who obtained prescriptions didn’t end up ingesting any lethal medications. Many patients say that just having a prescription at hand provides peace of mind and a sense of control. “Now that I’ve had the prescription filled and it’s in my possession, I have experienced a tremendous sense of relief,” Maynard wrote in a recent op-ed for CNN. Although she had planned her death for Nov. 1, on Wednesday she released a video saying, “I still feel good enough, and I still have enough joy, and I still laugh and smile with my family and friends enough that it doesn’t seem like the right time.” Maynard’s imminent death (whether she takes the medication or not) is tragic, but in making her story public with such grace and dignity, she has greatly helped future patients who want the same choice. _[Editor’s note, 11.2.14: A spokesperson said in a statement late Sunday that Maynard had taken the medication anddied at home with her family on Saturday.]_ **outlook@washpost.com ** Read more from Outlook and follow our updates on Facebook and Twitter.

Matt Miller: To prevent future massacres, focus on mental illness

In August 1966, a 25-year-old man named Charles Whitman brought a trunkful of guns and bullets with him to the top of the University of Texas tower in Austin. Near the observation deck he killed a receptionist with a gun butt. Then he started shooting at tourists below. He shot a pregnant woman. He shot the people who came to help those he’d hit. By the time police assembled and were able to kill Whitman, he had killed 14 people and wounded more than 30. Then the story got even worse. Before his deadly visit to the tower, Whitman had killed his mother and stabbed his wife to death while she slept. As with Newtown, the killings shocked the nation. As was not the case with Adam Lanza, however, Whitman left a remarkable record of his mental state. As recounted by neuroscientist David Eagleman in his fascinating 2011 book, “Incognito: The Secret Life of the Brain” (from which these details are drawn), Whitman knew something had gone wrong inside of him. He’d been an Eagle Scout and a Marine. His typed suicide note read in part: “I do not really understand myself these days. I am supposed to be an average reasonable and intelligent young man. However, lately . . . I have been a victim of many unusual and irrational thoughts.” After killing his wife, Whitman added by hand: “It was after much thought that I decided to kill my wife, Kathy, tonight. . . . I love her dearly, and she has been as fine a wife to me as any man could ever hope to have. I cannot rationally pinpoint any specific reason for doing this.” Whitman noted in a diary he left behind that he had seen a doctor a few months earlier “and tried to convey to him my fears that I felt overcome by overwhelming violent impulses.”  He saw the doctor only once. “Since then I have been fighting my mental turmoil alone,” he wrote, “and seemingly to no avail.” Whitman requested in his suicide note that an autopsy be performed because he suspected something had changed in his brain. He was right. The medical examiner found a nickel-size tumor had damaged his amygdala, a region of the brain that, as Eagleman explains, helps regulate the emotions, particularly fear and aggression. “If my life insurance policy is valid please pay off my debts,” Whitman’s note went on.  “[D]onate the rest anonymously to a mental health foundation. Maybe research can prevent further tragedies of this type.” As President Obama and Vice President Biden advance an agenda to reduce gun violence, I share this story at length to raise the point that Eagleman forces us to reckon with. I’m all for universal background checks, tighter assault- weapon bans, limits on high-capacity magazines, and ambitious and well-funded gun-buyback programs. But unless we also find more effective ways to identify and treat people who are dangerously mentally ill, we’ll never stop tragedies like Newtown (or Aurora, or Tucson, or Virginia Tech). There’s been lots of loose talk about Adam Lanza being “evil.” But, as Eagleman argues, science increasingly shows us that the biology of mental illness undermines traditional notions of culpability. Pretending otherwise only distracts us from taking steps to protect society, irrespective of how we judge dangerous people’s blameworthiness. “Millions of 20-year-olds on this planet play video games, have divorced parents, are eccentric, have access to guns, and so on,” Eagleman wrote recently on his blog. “But Lanza tops the news because his actions are so exceptionally rare. Such abnormal decision-making unmasks abnormalities in brain function. To assume that prayer in schools and tough-love parenting is a meaningful solution to brain abnormalities [as some have suggested] is to miss the boat entirely.” Characterizing Lanza and his ilk as “sick” rather than “evil” isn’t a way of medicalizing character flaws and excusing abhorrent behavior. It’s about letting science update the way we think about moral assessments that may not apply and do little to help us protect ourselves. To be sure, the scientific view of mental illness poses huge challenges for how we think about law and the criminal justice system. Our legal system is designed to punish and isolate those who commit harmful actions, not unstable people who have yet to act. As we learn more about the biological markers of mental illness, there’s a slippery slope to the world of the film “Minority Report,” where prophecies of behavior are enough for “Precrime” squads to lock up dangerous people before they can do harm. Obviously we don’t want to go there. But the way we deal with mental illness today leaves too many suffering people with no lifeline, and too many innocent Americans vulnerable. As the political fight over guns heats up, it’s crucial to find ways to diagnose and treat the next Adam Lanzas if we’re serious about avoiding future tragedies. _Read more fromMatt Miller’s archive or follow him on Twitter._ **Read more on this issue:** Tim Kaine: Are we ready to reduce gun violence? Jason Ross: Limiting magazine size can save lives Martin E.P. Seligman: Don’t confuse crazy with evil Philip Caputo: Semiautomatic guns are weapons of mass destruction

Planning for a death with dignity when faced with Alzheimer’s

Regarding the March 11 Metro article “Hogan says he’s taking ‘serious look’ at ‘Death With Dignity’ measure”: I was diagnosed with early-onset Alzheimer’s disease in December 2013. I have recently begun to deal with issues I need to address in anticipation of my disease progression. I have been investigating nursing homes. I have also investigated prepaying for my funeral. And I have looked into the issue of assisted suicide, also known as “Death With Dignity.” This is currently only allowable in three states, my home state of Virginia not being one of them. The law requires a physician to diagnose that a patient has less than six months to live and is capable of making and communicating his or her decision. I have been told my life expectancy is eight years or so. I am sure that, by that time, my disease will have progressed so that I will not be able to communicate Death With Dignity as my option of choice. Those of us with Alzheimer’s deserve some consideration in the Death With Dignity discussion. And this option should be legal in Virginia, if not throughout the nation. The time has come to help people with Alzheimer’s however we can. ****Anne Bloom,** Falls Church**

Troubling trend of suicides in D.C. jail

ON MONDAY, D.C. corrections officials announced the death of Mike Johnson, 53, who’d been charged with two counts of sexual abuse and who was discovered hanging in his cell. Mr. Johnson’s death is the fourth apparent suicide in the D.C. jail in the past year, a troubling fact that warrants immediate attention and action. In the wake of a suicide earlier this summer, at the time the second in less than two weeks, Corrections Director Thomas N. Faust announced changes aimed at reducing suicide risks. Except in cases of extreme security concerns, every prisoner now shares a cell, and the frequency of security checks has been increased from every 30 minutes to every 15 minutes. Officials have also begun paying particular attention to mental assessments and sharing information about individuals prior to incarceration. Both changes emerged as issues in the June 18 death of Paul Mannina, a Labor Department lawyer who was charged with the sexual assault of a co-worker. Hours before Mr. Mannina was found with his throat slashed, he appeared at a hearing in D.C. Superior Court in which issues about his mental state were raised. That information apparently was not shared with jail officials, and somehow Mr. Mannina had access to a razor. Why prisoners were issued disposable razors in their first week at the jail remains unclear, but shaving equipment is no longer distributed until jail workers have collected all the necessary mental health information on inmates. As Mr. Faust told The Post’s Keith Alexander, “If the worst thing that happens for the first five or seven days is that they have a beard, then so be it.” It’s commendable that D.C. corrections officials have taken steps to guard against suicide at the D.C. jail. But we have to wonder why it took so many tragedies before officials awoke to the need for increased protections. And now, even after implementation of Mr. Faust’s reforms, there is another death. That has to raise questions of whether the changes are sufficient or on point. Although some progress may have already been made, Mr. Johnson’s death should spur a deeper review of what the jail is doing and how it can better equip its staff to deal with the risk of suicide when someone is placed in a cell. Corrections leadership can’t possibly need any more prodding. **Read more from Opinions:** The Post’s View: D.C. jail death of Paul Mannina raises many questions The Post’s View: Virtual visits for inmates? Colbert I. King: Death without dignity in D.C. jail Colbert I. King: How and why did Jonathan Magbie die?

The constitutional crisis in Florida we’re all missing

_Karl Racine is the D.C. attorney general. Beth McCann is the district attorney for Denver. Miriam Aroni Krinsky is the executive director for Fair and Just Prosecution._ This March, Florida State Attorney Aramis Ayala announced that she would not seek the death penalty in any case before her office. Instead, Ayala said she would revisit the issue if the chaotic circumstances surrounding Florida’s death penalty — recently struck down twice — changed. Florida Gov. Rick Scott (R) didn’t approve, so he unilaterally reassigned about two dozen homicide cases from her jurisdiction to a state attorney known for his death penalty advocacy. Now the two are facing off at the Florida Supreme Court in what has become just the latest constitutional crisis in our country with potentially dire consequences for our criminal-justice system. At stake is the authority of elected prosecutors to make decisions about how to handle their criminal cases. A decision in the case may come as soon as this week. Scott argues that he gets the authority for this unprecedented move from a statute that has historically been used for consensual reassignments. But that statute does not cover the impartial, reasoned, entirely appropriate exercise of discretionary decision-making that Ayala engaged in here. The governor has no authority under any statute or the Florida Constitution to usurp Ayala’s prosecutorial autonomy, which comes directly from the constitution. The governor admitted as much when he previously said that only voters could remove an elected public defender found to have violated ethics rules. That is why we, along with dozens of former prosecutors and judges, including four former Florida Supreme Court justices and two former U.S. solicitors general, joined in an amicus brief urging the court to protect prosecutorial independence and reject the governor’s attempt to override a duly elected state attorney’s exercise of discretion. Ayala was overwhelmingly elected to serve Orange and Osceola counties. She made her decision after weighing the heinousness of the crimes, the lack of deterrent value in pursuing the death penalty, the best interests of victims and their family members, and the millions of dollars needed to reach execution, concluding that death penalty prosecutions were not in the best interest of her community. This was a transparent and reasoned exercise of her discretion as an elected prosecutor. Legislatures establish the crimes that can be prosecuted and the range of punishments sought. But it is the locally elected prosecutors who must decide which prosecutions and punishments to pursue. These decisions are an inherent part of the independent exercise of prosecutorial autonomy — decisions that must be free from political or executive intrusion. Prosecutors can’t prosecute every crime and must determine fair, smart and consistent ways to employ limited resources. Examples of blanket pleading, charging and sentencing decisions — inherent in the independent autonomy and exercise of discretion by elected district and state attorneys — arise every day. As a case in point, New York’s Manhattan district attorney, Cyrus Vance Jr., announced last month that his office would no longer prosecute turnstile jumping. In this blanket announcement, which ends prosecution of about 20,000 low-level offenders annually, Vance made a reasoned decision that, in his mind, best advanced public safety and accounted for inherently limited prosecutorial resources. All prosecutors make decisions based on the local community’s challenges and needs. In Houston, Harris County District Attorney Kim Ogg recently put in place expansive policies to divert certain marijuana users, avoiding the human and fiscal cost of criminalizing drug addiction. In Chicago, Cook County State’s Attorney Kim Foxx has changed charging practices for certain theft offenses, in an effort to dramatically reduce the number of incarcerated individuals in her county. And Ayala’s decision on the death penalty is not without precedent. Locke Bell, the district attorney for Gaston County, N.C., made a similar announcement on how his office would handle these cases. Denver District Attorney Beth McCann (one of the authors of this piece) announced in her campaign this year that she would not seek the death penalty and was elected with more than 70 percent of the vote. Larry Krasner, the presumptive next district attorney of Philadelphia, has also made that pledge. This is the essence of prosecutorial discretion. What Florida’s governor has done deprives local voters of their right to choose a state attorney who aligns with their values. Indeed, one poll found that a majority of Orange and Osceola county voters support life imprisonment over the death penalty. If these voters do not like how the state attorney is using her discretion, they can choose a different representative in the next election. Preserving prosecutorial independence does not mean that everyone will like or agree with every decision. But the governor’s decision, if left unchecked, could fundamentally subvert the independence of prosecutors to pursue justice — and that is a dangerous place to be. **Read more:** Eugene Volokh: The constitutional limits of prosecutorial discretion Glenn Harlan Reynolds: Prosecutors have too much power. Juries should rein them in. Charles Lane: The age of mass incarceration may actually be abating Radley Balko: The debacle in Arkansas reaffirms that the death penalty is arbitrary, unchecked and unfair The Post’s View: Living without the death penalty

‘Leave us alone!’ — D.C. leaders fight congressional efforts to limit their power

“Leave us alone!” That’s the message city leaders and their progressive allies brought to Congress on Monday as part of an annual news conference to decry what they see as lawmakers’ meddling in D.C. business. Mayor Muriel E. Bowser and Del. Eleanor Holmes Norton, the city’s nonvoting representative, both Democrats, are fighting efforts to block District laws that govern legal marijuana, firearms, assisted-suicide, abortion for low-income women and sewer-clogging disposable wipes. City supporters say they are accustomed to assaults from Congress, but the stakes are higher than ever with President Trump in office. Before he was elected, the city relied on President Barack Obama as a backstop against laws limiting the city’s powers of self-determination. “I expect the president to sign whatever comes before him,” Norton said. “Have we discussed this with Donald Trump? That must be a rhetorical question. We like in the Congress to ride below the horizon. The president hasn’t paid a lot of attention to the District of Columbia and we hope that he won’t.” Under Trump’s budget proposal, released in May, the District would be barred from spending its own tax dollars to implement its assisted-suicide law, known as Death With Dignity. “We were disappointed that he chose to comment on the Death With Dignity bill and future conversations with the White House will emphasize that he doesn’t need to get involved on that conversation,” Bowser said. The mayor’s December meeting at Trump Tower with the then-president elect was only an introductory meeting and she has no plans to meet with him again. Late last year, Bowser signed legislation to make the nation’s capital the seventh jurisdiction where it is legal for doctors to prescribe fatal medication to terminally ill residents. Rep. Jason Chaffetz (R-Utah), who recently resigned from Congress, introduced a measure to block the bill, but it never made it to a vote on the House floor. As the influential chairman of the House Oversight and Government Reform Committee, Chaffetz relished needling the District over a host of issues. Another frequent District antagonist, Rep. Andy Harris (R-Md.), has said he will try to block the assisted-suicide bill through the appropriations process, as well as a bill intended to prevent wet wipes from causing backups on the city’s sewer system. Harris sits on the House Appropriations Committee. A subcommittee with jurisdiction over the District will meet Thursday to discuss its budget bill. Its chairman, Rep. Tom Graves (R-Ga.), declined to comment on Norton’s news conference. He has said he hopes the full House can pass a governmentwide spending bill before the August recess — a goal Congress has not achieved in years. Including Monday, the House is in session for 13 full and partial days before taking a break. Norton and Bowser were joined Monday by supporters who said they hope to leverage constituencies within the city and around the country to fight what they see as congressional overreach. “Part of what is helping to protect D.C. is the fact that [Death With Dignity is] authorized in six other jurisdictions,” said Kim Callinan, chief program officer at the national group, Compassion & Choices. “If Congress infringes on D.C.’s right, they could do the same thing to their right.”

A man was suffocated to death in the hospital. The suspect? His wife, a retired nurse.

When Henry “Butch” Sochalski’s heart monitor started to sound, hospital personnel rushed into his room, where they said his wife, a former nurse, had been hovering for weeks — micromanaging Sochalski’s medications and hindering his doctors from doing their jobs. A nurse later told police that she had seen Jan Sochalski lying across her husband’s chest with one hand on his nose and mouth. Another nurse said it appeared she was pinching her husband’s nose.  He was pronounced dead about 8:30 a.m. May 19, with his wife nearby.  On Monday, Jan Sochalski, 61, was arrested on a second-degree murder charge, after police said she suffocated her husband while he was recovering from elective back surgery. Daytona Beach Police Sgt. Scott Goss said an initial investigation showed “she did things consistent with trying to end his life.” “She admits certain involvements but recuses herself of other involvements that would have caused his death,” Goss told The Washington Post. Sochalski told police that she had neither suffocated her husband nor done anything else to cause his death, according to the police report. The Volusia County Public Defender’s Office said Tuesday that Sochalski has not yet been assigned a lawyer in the case. Authorities said they are still trying to determine whether she killed her husband in cold blood or was merely a grieving soon-to-be widow who wanted to end her husband’s suffering.  He was a retired New Jersey police officer who had been with the Trenton Police Department for nearly 25 years. He loved motorcycles. And he loved Jan, “his childhood sweetheart,” it said. He died, it said, “surrounded by his loving family.” On April 7, Sochalski went into the hospital for back surgery, but doctors expected him to make a full recovery, according to the police report. To help, doctors gave him a powerful pain medication, dilaudid, which was administered through his IV when he pushed a button at his bedside. A nurse said she saw Jan Sochalski giving him the drug and told her to stop. One nurse told police that “the pain medication machine was checked and it was found to have been pressed 264 times in an 8-hour period, whereas it should have only been pressed 6 times an hour,” according to the report. However, the nurse added that “the machine has a built in safety mechanism that ensures that the machine does not dispense more medication than the doctor prescribed, even if the button is pressed multiple times.” But it’s still unclear why, by April 9, Henry Sochalski had gone into respiratory and cardiac arrest, according to the report. After a month with little or no improvement, he was placed in “comfort care” at the hospital, where his wife waited by his side. Hospital workers said Jan Sochalski, a nurse for 40 years, had been unhappy with her husband’s care. One day, hospital security was called to his room because, a nurse said, Jan Sochalski had been complaining about her husband’s treatment and threatening to get his gun and shoot people, according to the police report. Later, she requested pain medications for her husband but would not allow his medical team to administer other medications, such as antibiotics, that doctors had prescribed. A nurse told police that Jan Sochalski asked for medications that would “decrease his respirator status.” The nurse said that “such a request was basically asking her to kill the patient, because if someone can’t breathe then that is not compatible with life,” according to the report. Then on May 18, Jan Sochalski signed a “Do Not Resuscitate” order; that same day, a nurse said, Sochalski would not let medical personnel into her husband’s hospital room. Jan Sochalski told police that she had spoken with her husband’s nurse and that the two came to the same conclusion — that Henry Sochalski’s condition was worsening and he did not have much time left to live. In the early morning hours of May 19, Sochalski said, she went home to rest. But, she later told police, she could not sleep and returned to his room. At about 8 a.m., she said, she lowered her husband’s bed, removed his humidifier, and lay down on top of him and hugged him around his neck — wanting to be near him. It was apparently around that time that nurses said it appeared as if she was pinching her husband’s nose. Sochalski later told police that her husband’s heart monitor alerted nurses that something was wrong.  He added: “There are several things that she did along the way that don’t seem to match up with her trying to help him get better.” Autopsy results showed that Henry Sochalski died from asphyxia, and his death was ruled a homicide, according to the police report. Joe Mullin of the Volusia County Medical Examiner’s Office told investigators that Jan Sochalski called him and asked whether her husband was brain-dead when he died. “Joe Mullin stated that he did not know, and then Jan Sochalski stated that she wanted to be sure that she had made the right decision,” according to the police report. If convicted of second-degree murder, authorities said, Jan Sochalski could face life in prison. Court records show she is being held on $250,000 bail.

The difference between advocacy and murder

The best The Post could do on the latest cycle of violence in and around Israel was an Associated Press dispatch about the fatal shooting of an Israeli Arab who seemed to be “retreating” from Israeli security forces [“Alert level raised after Arab protests,” World digest, Nov. 10]. The AP missed the part, conveyed by other news sources, that he allegedly had attacked with a lethal metal weapon. Over the past three weeks, there has been a succession of vehicular and stabbing attacks on Jews and, in one case, a Druse, waiting innocently for transportation. This succession of attacks was preceded and accompanied by Palestinian leaders’ calls for such attacks and followed by praise. This pattern is completely submerged in the media focus on “provocations” involving the holy places of Jerusalem; translation: Look what happens when the Jews upset the Arabs by wanting to pray — not kill anyone — at their historic places. Isn’t it time to point out the contrast between peaceful advocacy and murderous assaults? Or will The Post continue to righteously cluck-cluck about the “tragic cycle of violence” in the Middle East? ****David Hornestay** , Silver Spring**

Virginia’s governor still has time to save a mentally ill man from execution

ON JULY 6, Virginia is scheduled to carry out its third execution under Gov. Terry McAuliffe (D) and 113th since 1976. The inmate, William C. Morva, was convicted of fatally shooting two men — a deputy sheriff and a hospital security guard — in 2006. His guilt is not in question. What is less clear is if jurors would have sentenced him to death had they been aware of the true extent of his mental illness. At varying points, Mr. Morva reportedly believed that he was meant to lead a distant indigenous tribe; that he was gifted with special powers to carry out an unidentified quest; that he was unjustly persecuted by local officials and the administration of President George W. Bush; and that his real name was Nemo, which is Latin for “nobody.” These are not signs of a rational mind, but rather one afflicted with debilitating mental illness. A mental-health expert who assessed him after his conviction diagnosed him with delusional disorder, a serious psychotic condition similar to schizophrenia. We have previously written that capital punishment is dehumanizing. But the execution of a man suffering from severe mental illness is an act of particular barbarism — especially if his condition may have been misdiagnosed in trial. According to Mr. Morva’s attorneys, the mental-health experts who provided statements to the jury did not receive his full case history and diagnosed him with a personality disorder rather than psychosis. Despite his personal opposition to the death penalty, Mr. McAuliffe is committed to upholding Virginia law, a stance we understand and respect. He commuted a death sentence in April, however, after he found flaws in the sentencing process of Ivar Teleguz. His predecessors — then-Gov. James S. Gilmore III (R) and now- Sen. Tim Kaine (D-Va.) — had granted clemency on grounds of mental illness. Mr. Morva’s case raises many of the same questions and adds fodder to the national effort to abolish capital punishment for people with serious mental illnesses. Mr. McAuliffe should look favorably on the petition for clemency before him and commute Mr. Morva’s sentence to life in prison without the possibility of parole. He should also ensure that Mr. Morva receives the mental-health treatment he so obviously needs. The killing of two devoted public servants is a tragedy, but the state of Virginia will not right this wrong by getting more blood on its hands. **Read more on this topic:** The Post’s View: Even Dylann Roof should not receive a death sentence Charles Lane: Most Americans don’t like the death penalty, right? Wrong. Bob Taft and Joseph E. Kernan: End the death penalty for mentally ill criminals Nicholas Cote: Executing a severely mentally ill man would be an injustice The Post’s View: Arkansas’s state-sponsored killing spree

Congress is stepping on religious freedom and home rule in the District

Congressional moves to block the District’s Death With Dignity Act not only tread on home rule but also violate the religious rights of D.C. residents [“A blow to D.C. law on assisted suicide,” Metro, Feb. 14]. We are all mortals. If we are lucky, we remain in good health into old age and then die painlessly and without warning. But many of us will suffer long, painful declines or dehumanizing loss of control over our lives before we die. What could be more personal than how we face our own deaths? For some people who are suffering and have no hope of recovery, death with dignity may be a rational choice. Others may find the idea of taking their own life unacceptable under any circumstances. It is a matter of personal philosophy and, often, of religious faith. It is also none of the government’s business. If people who are dying want help passing in comfort, it presents no threat to anyone or to society as a whole. In the absence of any public interest to be served, Congress has no right to impose a particular set of religious or philosophical beliefs on the dying. It is a question of freedom of belief, and if Congress overturns the Death With Dignity Act, the District should make that argument in court. ****Bruce Levine** , Takoma Park**

Mother who suffocated children with plastic bags and duct tape sentenced to 45 years

About four days after police took Sonya Spoon for an emergency mental health evaluation because she had threatened to kill herself and her daughter, doctors said she had been treated and prescribed antidepressants and was ready for release from the hospital. But Spoon’s mother pleaded with medical professionals to keep her daughter. “There is no change,” Pavi Spoon recalled telling hospital staff as she raised objections. “She’s in a state of mind that had me commit her in the first place.” Thirty-six hours later, Spoon wrapped her young children’s heads with plastic bags and duct tape and suffocated them before attempting suicide. On Wednesday, she was sentenced to 45 years in prison on two counts of second-degree murder in the 2014 deaths of her daughter and son — Kayla Thompson, 3, and Ayden Spoon, 1. “I don’t know exactly what’s wrong with me,” Spoon said in an apology during her sentencing hearing. “What I did was horribly wrong. I wasn’t well and couldn’t see clearly what was going on.” The case culminated in the “unthinkable,” said Prince George’s County State’s Attorney Angela Alsobrooks. The children were in the hands of their mother, who had mental health problems. A man who had been convicted of child abuse was seeking custody of one of the pair. And a “gaping loophole” in state law left child welfare unaware of Spoon’s threats. “The saddest aspect of this case is that these two babies . . . they never had a chance,” Alsobrooks said. Susan Fiester, a Maryland psychiatrist, said in court that Spoon had several problems that prevented her from thinking clearly the day she killed her children. Spoon suffered from attachment disorder after being abandoned as a 4-month-old by her Russian parents who went to a New Year’s party and left her in the family’s apartment. After three years in an orphanage and an adoption by American parents, Spoon sustained a traumatic brain injury in a car crash at the age of 18. And after the birth of her children, she was drawn into a custody battle with the father of her daughter while dealing with postpartum depression. It was the prospect of losing custody of her daughter to a man that was abusive that caused Spoon to panic, Fiester testified. “She was so distraught, and the depression became so severe that she actually became suicidal,” Fiester said. Spoon crumbled emotionally, prompting her mother to call police to take Spoon in for an emergency mental evaluation. After her short commitment, medical professionals released her, saying her antidepressants soon would make her feel better. Less than two days later, Spoon killed her children. “The significant thing here is Sonya has been abandoned twice in her life,” Pavi Spoon said. “At 4 months by her biological parents and at 25 by medical health caregivers.” Prince George's County Circuit Court Judge Lawrence V. Hill said while he believed Spoon is remorseful and endured unfortunate circumstances, she still was responsible for her actions. “I had a pang of nausea when I heard what happened,” Hill said about the way in which the children died. Hill also questioned why Spoon did not frantically try to remove the bags from her children’s heads after coming to her senses and abandoning her suicide attempt. Spoon had taped a plastic bag around her own head and duct-taped her hands, but went running to her mother to free her before rushing to get help for her two children. “Her reaction was selfish,” said Hill, who gave Spoon the option of serving her sentence at the Patuxent Institution, a prison that offers inmates mental health services. At the time of her hospital release in 2014, Spoon was discharged without child welfare officials knowing of the threats she had aimed at her children. Maryland law does not require law enforcement or medical professionals to report threats against children — only suspected neglect or abuse. Prince George’s County officials have tried to change state law for the past three years to require social workers, medical professionals and police to report verbal threats of “imminent severe bodily harm or death to a child,” but the legislation has never received enough backing from politicians to make a change. Spoon’s case represents a failing of the mental health and criminal justice systems, said her lawyer, Mirriam Seddiq. “We have a crisis of not being able to handle mental health issues in this country.” Spoon was not ill enough to be declared incompetent at trial, Seddiq said, but was not a hardened criminal who would deserve to serve life without parole. “It’s all or nothing,” Seddiq said. Read more: He thought he was going to buy a computer, then he was killed. Maryland homeowner checks midnight surveillance video, sees naked man rattling door. Woman who left MGM casino with someone else’s $15,000 fur coat pleads guilty Two honor roll students fatally shot in Maryland on eve of high school graduation

When falling through cracks in the mental health system ends in violence

_Julia M. Klein, a cultural reporter and critic in Philadelphia, is a contributing editor at Columbia Journalism Review and a contributing book critic for the Forward._ The Tony Award-winning actor Norbert Leo Butz was rehearsing “Catch Me If You Can” in Seattle in July 2009 when he received devastating news: His sister Teresa, a resident of a tight-knit working-class neighborhood at the city’s southern edge, had been raped and murdered in an apparently random act of violence. Butz stayed with the Broadway-bound musical, channeling his grief into his performance as a dogged FBI agent and eventually winning a second Tony. He dedicated the award to his father, who was his model for the character, and to his sister. Eli Sanders’s coverage of the tragic incident for the Stranger, a Seattle weekly, earned him a Pulitzer Prize. In “While the City Slept,” Sanders delves more deeply into the story, portraying the events surrounding the crime with deftness and intimacy. Sanders begins with a scene-setting prologue on the South Park neighborhood and its response to the attack. He then traces the peripatetic lives of Teresa Butz and her fiancée, Jennifer Hopper, who survived rape and knife wounds to become a key witness at trial. Relying on interviews with Hopper, Norbert Leo Butz and other family members, Sanders paints a tender and revealing portrait of these two young women and their romance. Sanders also offers a sympathetic account of the blighted life of their convicted attacker, 23-year-old Isaiah Kalebu. With cooperation from Kalebu’s mother and half-sister, Sanders describes a bright but troubled man from a family scarred by violence, neglect and mental illness. Rather than demonizing Kalebu, Sanders chooses to see him and his family as victims. He directs our anger at what he convincingly depicts as the dysfunctional nexus of the criminal justice and mental health systems in the state of Washington and, by extension, across the country. To some extent, his indictment is a familiar one: The emptying of mental hospitals over the past few decades, coupled with more stringent requirements for involuntary commitment and the underfunding of community alternatives, has caused a slew of unintended consequences, including a rising prison population of the mentally ill. Sanders is very good at detailing just how badly the system failed Kalebu as well as those who had the misfortune of crossing his path. Before Kalebu murdered Teresa Butz, he gave abundant indications of his potential for violence. He threatened and attacked his sister and mother and was a suspect, though never charged, in an arson that killed his aunt and a boarder after the aunt evicted Kalebu from the house. Sanders introduces us to the many judges, psychiatrists and social workers who failed to intervene effectively. “No one could pay enough attention,” he writes. Along with systemic constraints, including overburdened courts and shrinking hospitals, inconsistent psychiatric diagnoses arguably played a role. As Kalebu cycled through mental hospitals and prisons, he was variously diagnosed as bipolar, narcissistic, borderline, sociopathic and suffering from “really bad affective instability,” which made him prone to mood changes. He was nevertheless repeatedly declared competent to stand trial. His mother, herself depressive and intermittently suicidal, believed that her often delusional son was schizophrenic, like his grandmother and other relatives. Further complicating the situation, some doctors became convinced that he was feigning mental illness when convenient — even though he rejected his lawyers’ attempts to use insanity as a defense. The muddled diagnoses, along with Kalebu’s resistance to psychotropic medication, ensured that he would never receive adequate treatment. Behavior that began as merely erratic was destined to spiral downward to the ugliest sort of violence. Counterpointing the tale of Kalebu’s deterioration is Sanders’s exploration of Hopper and Butz’s romance. Butz grew up with 10 siblings in a St. Louis Irish-German-Catholic family; tenacious, athletic, tough but soft-hearted, she led an itinerant life, bouncing among schools and jobs. Hopper, an only child, was raised by grandparents and a single mother addicted to painkillers and abusive boyfriends. Gifted with a rare soprano voice, she had a less-than-svelte figure, Sanders reports, that diminished her chances of a stage career. Both women came of age at a time when lesbianism was mostly closeted and stigmatized. Each struggled with her sexual identity, dating men and women; their families struggled, too. The two met in Seattle, fell in love and were planning a commitment ceremony in September 2009. With Butz, Hopper says, “I felt at home.” Then Kalebu, wielding a knife and a lifetime of rage, crawled through an open window and into their bedroom. The book’s emotional climax is Hopper’s testimony about the crime’s horrific details. Sanders exercises restraint and cuts short what could have been an even more gruesome recounting. Still, he relates more than enough to make Hopper’s compassionate stance toward Kalebu intensely moving. “I wish you peace every last day of your life,” she tells him in the courtroom. “While the City Slept” is an expertly crafted nonfiction narrative, marred only by Sanders’s unwieldy use of geological metaphors and his predilection for sentence fragments. His even-handed reporting and emotional commitment to the story make for gripping reading — and the systemic failures he highlights cry out for remedy, even if it’s hard to know just where to begin. By Eli Sanders Viking. 316 pp. $28

Murder-suicide suspected in father-daughter deaths

A former Fairfax County police sergeant and his 13-year-old daughter died in an apparent murder-suicide, shot as they sat in a sport-utility vehicle in a relative’s Annandale driveway early Monday, Fairfax County police said. A family member found the bodies of John Jackson, 40, and his daughter, Alexis Jackson, shortly after 1 a.m. outside the brick home in the 3800 block of Forest Grove Drive, where Jackson’s wife had been living with her parents since November. Jackson and his daughter, of the 5900 block of Summers Lane in Falls Church, are believed to have died between midnight and 1 a.m. Officers were called to the scene about 1:15 a.m., police said. Fairfax County court records show that Jackson and his wife were going through a bitter divorce last summer but that they dropped the proceedings in January. Detectives said the evidence points to John Jackson as the shooter, but they were waiting for the state medical examiner to rule on the cause and manner of the pair’s death. Police declined to discuss a possible motive. Jackson was a 16-year veteran of the county police force before he resigned in June 2010, said Officer Shelley Broderick, a police spokesman. Broderick said the department could not discuss Jackson’s performance or why he left the force because personnel records are confidential. But those who knew him said he had served with distinction. Edward J. Nuttall, the former longtime attorney for the Fairfax police officers union, said the incident was “absolutely shocking. He was a hard-working officer, a good supervisor. This one’s hitting a lot of nerves.” Nuttall said Jackson worked as an undercover narcotics detective early in his career and was promoted to sergeant in 2006. He was last stationed in Mount Vernon. A 1997 Associated Press article said a county officer named John Jackson saved the life of a choking toddler by performing the Heimlich maneuver at a restaurant. Police officials would not say whether it was the same John Jackson who died Monday, but they said there were no other officers on the force with that name. Jackson was presented with a Valor Award by the Fairfax County Chamber of Commerce for saving the child. The plaudits were in stark contrast to the private life detailed in divorce proceedings. Jackson’s wife filed for divorce in July, alleging that he treated her in a “cruel and abusive manner.” In an incident in January 2010, she alleged in court papers, her husband made her take off her clothes, drenched them in water and would not let her dress until the next morning. He also brandished a rifle in front of his wife and daughter, according to court papers. Jackson filed a divorce complaint of his own, saying that his wife had had numerous affairs. Alexis Jackson was a seventh-grader at Glasgow Middle School in Lincolnia. Grief counselors were at the school Tuesday and will be available for the rest of the week, according to county school officials. “On behalf of Glasgow Middle School, I have extended our sincere condolences to the family,” Principal Deirdre M. Lavery said in a letter to parents. “A sudden loss like this can have an effect on students. For that reason, we hope that you will listen to your son or daughter as well as discuss with them their feelings and reactions to this tragedy.” Staff writers Tom Jackman and Jimm Phillips and staff researcher Magda Jean-Louis contributed to this report.

Should people with acute mental suffering be allowed to die?

Euthanasia advocates often assert a distinction between dying with dignity (good) and suicide (bad), drawing on the community’s twin commitment to permitting euthanasia in some circumstances and preventing suicide. But rather than being distinct, euthanasia and suicide are points on a continuum of death decisions that overlap uncomfortably where intractable mental suffering is asserted as grounds for assisted dying.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The tension between the two was played out recently in Australia, where the local Civil and Administrative Tribunal is considering whether to uphold the Medical Board of Australia’s suspension of Philip Nitschke’s medical license after a three-day hearing.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The suspension came after Nitschke discussed assisted suicide with 45-year-old Perth man Nigel Brayley, even though he knew Brayley did not have a terminal illness. Brayley reportedly told Nitschke in an e-mail that he was “suffering” in the sense that he was deeply unhappy in his life. Nitschke did not refer to him to a psychiatrist or offer any other help.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **More complex than it appears**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Nitschke’s actions have been roundly criticized, particularly by other euthanasia advocates, who seek to distance themselves from existential justifications for assisted suicide. However the idea that euthanasia should not be offered for mental suffering is not universally agreed upon, and it requires some further consideration.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In the Netherlands and Belgium, where euthanasia is legal, assisted dying for emotional suffering is permitted. Approval will only be granted in cases where applicants are of age, mentally competent and their suffering constitutes an “incurable condition” that causes continuous and unbearable anguish. Of the 1,432 recorded cases of euthanasia in Belgium in 2012, 52 were on psychological grounds. In the Netherlands, the figure was 42 out of a total of 4,829 cases in 2013.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Still, the idea – and practice – remains deeply controversial. Concern often focuses on a lack of confidence in the notion that mental illness or emotional pain should ever be regarded as “incurable.” A troubling question then arises as to whether we might be too carelessly privileging the right to autonomy, and undermining our responsibility to protect vulnerable people from harm.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Others have suggested that if we extend the right to die beyond those who are actually already dying, we risk setting off down a “very dangerous path and one that’s extremely slippery.” This worry seems to be that we slide into a situation in which marginalized and vulnerable people’s right to life will not be sufficiently protected.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **A fine line**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico But too stringent an approach risks locking people with mental illnesses out of the right to make decisions about the end of their lives – and this might be discriminatory. In a troubling 2012 case in Britain, for instance, a hospital was ordered to cease a palliative care program consented to by a 32-year-old woman with anorexia nervosa and to forcibly feed her despite her deep distress at the prospect. The woman had consistently refused re-feeding over the past several years, experiencing it as a violent assault.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The court decided the fact that she had an eating disorder made her incompetent to make a legally enforceable decision to refuse treatment. The implication of the decision was that, by definition, people with anorexia cannot make an end-of-life decision, no matter how harrowing and intractable their illness becomes.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It was a conclusion that bitterly disappointed the woman’s parents, who said: Nitschke may well have made errors in his assessment of Brayley. These will be considered by the tribunal. But he had a reasonable point when he said that he had suffered a “political de-registration’ because “a government board … doesn’t agree with the beliefs of its citizens.” Certainly there are a range of defensible views on what is a good life and when assisted dying is acceptable. In any case, the fact remains that assisted dying for mental suffering is a long way from achieving broad acceptance in Australia. __    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

The toll and danger of suicide

As one who battled depression for years and survived, I take issue with the grim photo on the cover of the Jan. 22 Washington Post Magazine [“The end is near”]. The woman, described in the article as being “so utterly alive, funny, inquisitive, engaged in life,” is posed as though at the brink of taking her own life. I was fortunate not to have seen this photo or read what amounts to a how-to guide when I was searching for a means of suicide myself. My plan failed, and 15 years later, after getting help, I have a full, rich and happy life. The Post would do well to be mindful that its audience includes not only readers who may consider this a morbidly curious human-interest story, but also those who struggle to make it through another day. Providing such a graphic depiction of an easily accessible means of suicide was unnecessary and dangerous. At the very least, The Post should have included suicide prevention information so those faced with the compelling, immediate urge to choose death might within the same article have found an option of hope. I encourage anyone considering suicide to contact the National Suicide Prevention Hotline (www.suicidepreventionlifeline.org) at 1-800-273-TALK (8255). ****Kyle Walton** , Washington**

Taya Kyle’s story: New book serves as next chapter in ‘American Sniper’ saga

The morning after Navy SEAL veteran Chris Kyle and his friend Chad Littlefield were murdered, Kyle’s wife sat down with her two children on the family lawn. She had one sitting on each of her knees, and began crying before saying a word. “Daddy’s hurt,” Taya Kyle said, closing her eyes. “Is he dead?” her daughter blurted out. Taya nodded. “Daddy was helping someone,” the mother said. “There was something really, really wrong with that person and his brain. He shot and killed Daddy and Mr. Chad.” _ **[The fatal intersection of Navy SEAL Chris Kyle and the Marine veteran who killed him]**_    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It is one of the most wrenching passages in Taya’s new book, “American Wife: A Memoir of Love, War, Faith and Renewal.” Released Monday, it covers the life of a family that has been under a microscope ever since the SEAL, credited as the most deadly sniper in U.S. military history, published a memoir in 2012 that was turned into the blockbuster movie “American Sniper.” The SEAL’s book leaves off with him finding his footing after leaving the military, and the movie ends with his murder Feb. 2, 2013, by Eddie Ray Routh, a Marine Corps veteran whose mother had sought Chris Kyle’s help. Taya’s book covers her memories of the period, including the chaos and struggles after the murder. Routh was convicted in February of first-degree murder after his lawyers argued that he should be found not guilty by reason of mental insanity, citing his diagnosed schizophrenia and psychosis. Among the details recalled: **She insisted on seeing her husband’s body after the murder   **Taya said she was told repeatedly by police that she should stay ~~~~away from the murder scene and her husband’s autopsy. Eventually, though, she said she “exploded” and demanded to see him. The police relented and agreed to take her to the funeral home where Chris’s body had been taken.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “Was I wrong to insist that I needed to be with my husband?” she asks in her book. “I’d always loved him no matter what, and was willing to see him at his worst as well as his best. Maybe I was being irrational, but I had a deep emotional need — and if you’d asked me, I would have insisted that he needed me there as well.” Friends came to see her afterward, and she shared the experience in “torrent” of words, she wrote. “I got to feel his hair. His body was soft. I kissed his face,” she recalled telling them. “I told him I loved him. He wasn’t all cleaned up. I was glad — I was glad. I could see his eyes, his set jaw. I could see, I could touch…” The friends stayed with her as long as she needed, she said. **Frustration with critics   **Chris Kyle has been called racist and anti-Islamic for his portrayal of the Iraq War and calling insurgents “savages.” Taya wrote that she doesn’t understand that, but believes that accounts of Kyle’s sniper kills has something to do with it.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “The difference here was that there was a specific record and acknowledgement of each kill,” Taya wrote. “Somehow, that offended some people’s sense of propriety.” She adds: “Certainly Chris hated the terrorists and insurgents he was fighting. But that hatred didn’t translate into blind rage against all Muslims.” **One last practical joke   **Chris Kyle was buried after a funeral service at Cowboys Stadium in Arlington, Tex., that drew thousands. Taya said she struggled to decide what to bury him in, and eventually settled on a plaid shirt and pressed jeans. But her husband needed something more, she thought.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “There was a part of me that wanted the mortician to arrange his fingers so he was flipping people the bird,” she wrote. “Chris would have _loved_ that. And many of the people who knew him would have roared at the joke — it was very Chris, a last practical joke.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Discretion won out, she said, but she did find an alternative. Chris Kyle was buried wearing a gag T-shirt that Taya pulled from his closet. Its message: “DO I LOOK LIKE A @#$#$!@ PEOPLE PERSON?” “He wore that to his grave under his plaid button-down shirt, a silent last guffaw,” Taya wrote. **Seeing Routh’s family   **Taya recalled attending a preliminary court hearing for Eddie Ray Routh, her husband’s killer, and realizing that his mother wanted to speak to her.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico “I wasn’t ready to deal with that,” she said. “There had been reports in the media that her son had threatened people with violence, something I doubt Chris knew. That doesn’t make her responsible for what happened, but I have to wonder if things would have been different had Chris realized how severe her son’s problems were.” **On the Jesse Ventura lawsuit   **In “American Sniper,” Chris Kyle wrote that he punched out a celebrity he called “Mr. Scruff Face” after the man allegedly said that the SEALs “deserved to lose a few” in combat. Kyle later identified former Minnesota Gov. Jesse Ventura as that man, prompting a lawsuit from Ventura.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico A Minnesota jury awarded $1.845 million to Ventura in July, finding that Kyle defamed him. Taya Kyle said in her book that an insurer covered $500,000, but the rest falls to the Kyle estate to pay. Taya has appealed, and said that her husband used to say that someone else might win when facing him, but they would remember they had fought him. “At the end of the day, more than enough witnesses came forward to support what Chris had said,” she wrote. “Why the jury chose not to believe them or Chris — I can only shake my head. Would the result have been different if the trial had been held anywhere other than St. Paul, where Ventura’s portrait hangs in the state capitol? The experience has been an interesting introduction to our legal system, not to mention the world of haters and their hangers-on.” **RELATED TRIAL COVERAGE ON CHECKPOINT:   Marcus Luttrell, Navy SEAL friend of Chris Kyle, warns killer Eddie Routh following verdict**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Texas Ranger recalls finding drugs in Eddie Ray Routh’s home**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **At least two gunshot wounds suffered by Chris Kyle were fatal**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Jury shown videos of standoff, chase involving Eddie Ray Routh**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Police describe high-speed chase to capture Eddie Ray Routh**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Portrait emerges of Chad Littlefield, friend killed alongside Chris Kyle**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **Taya Kyle, wife of slain Navy SEAL Chris Kyle, delivers tearful testimony**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico **‘This dude is straight-up nuts’: Chris Kyle’s text message about Eddie Ray Routh**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Maryland’s broken death penalty

ON PAPER, Maryland courts are empowered to impose the death penalty in certain murder cases. In practice, the state’s death penalty is in remission. Five convicts remain on death row, and defendants can be prosecuted for capital murder and sentenced to death, but the state lacks any legal method of carrying out executions. No one has been put to death in Maryland since 2005. That status quo seems acceptable to the power brokers in Annapolis, who would rather not add to a list of controversies that now includes legalizing same- sex marriage and subsidizing higher education for illegal immigrants. But by ducking the issue, they are leaving in place a costly, inefficient, unjust and dysfunctional system that exacts a terrible toll on the families of murder victims. Rather than legislating and leading, state lawmakers are in denial. Three years ago, an effort to abolish the death penalty narrowly failed in the General Assembly, which instead restricted it to cases where there is DNA evidence, a videotaped confession or video linking the suspect to a murder. But the legislature’s reform fixed nothing; if anything, it codified a system even more arbitrary than the one it replaced. Now the nature of the evidence, rather than the barbarity of the crime, is the critical factor. So a murder conviction based on DNA evidence might result in a death sentence, but not a Virginia Tech-style killing spree whose perpetrator is identified by multiple witnesses. Nor did the changes in the Maryland law address the racial and jurisdictional disparities in the death penalty’s application. And there is no evidence that the death penalty is more effective at deterring murders than is a sentence of life without parole. The broken system is particularly burdensome for the families of murder victims, who face years, even decades, of litigation. Three of the state’s five death-row prisoners were sentenced nearly 30 years ago; the others were sentenced in the mid-1990s. Whatever moral convictions one holds about capital punishment — and we think it is wrong — Maryland has failed to find an evenhanded, just and fair-minded way to apply it. As a recent report by some of Maryland’s most prominent attorneys concluded, the state’s current law “is likely to increase the arbitrariness of the imposition of the death penalty because persons who commit the most heinous crimes — the ‘worst of the worst’ — are not necessarily the same people who will be eligible for the death penalty.” A majority of the Maryland General Assembly favors an end to capital punishment in the state. Still, legislative leaders are reluctant to allow consideration of a bill that would repeal the death penalty and shift the anticipated savings in the state budget to programs to benefit victims’ families. The leaders would rather leave in place a system that is a disgrace to justice, and to Maryland. ****

Laws governing treatment for the mentally ill must be reformed

Thank you for publishing  the very informative article  “ The man in the house” [front page, June 29 ], which vividly illustrated the problems that parents  and spouses  can face when they seek treatment for a family member who is mentally ill. In the early 2000s, my wife was diagnosed with schizo-affective disorder, but as with many of those who are mentally ill, she was unable to recognize her illness and often refused to accept treatment or take prescribed medications. Although in a crisis situation I was able to have her treated in local psychiatric institutions, this care was generally very short-term, and laws gave her the right upon discharge to refuse follow-up care. Sadly, my wife’s life ended in March 2004 when she waded into the Mediterranean Sea and drowned. The local newspaper called it a suicide. In my view, it would have been more accurate to say that, in a state of constant, intense, untreated psychic pain, she was unable to understand what she was doing and the consequences of her actions. My hope is that articles such as this will bring the problem of untreated mental illness to the attention of the general public and lead Maryland legislators to pass more effective treatment laws for those who are truly in need but unable to comprehend their illness. ****Roger Russell** , Silver Spring**

Critical questions regarding assisted suicide and the terminally ill

Regarding Kathleen Parker’s June 12 op-ed, “The right to regret”: Most people don’t know how they would react to a terminal diagnosis. But many find great comfort in knowing that the choice is theirs and a solution is at hand should the situation become intolerable. That few ultimately resort to ending their lives merely illustrates that it is a difficult and complex decision. That’s where respect for the individual becomes most critical and where Ms. Parker’s argument was lacking. I watched my father-in-law and my stepfather take different paths to the end. One was in hospice care for more than two years. The other dispensed with life support except oxygen and pain medication and died in 17 days. Each did what was right for him. Neither took a route I would, but I respected each too much to have substituted my judgment for his. Both died with dignity and the respect of their families. Is there a “slippery slope” here? Of course. Any human right can be extrapolated to the absurd. But with appropriate safeguards against undue outside pressure, and with decent medical care to alleviate pain as much as possible, respecting a dying person’s right to choose when to end his or her time is the ultimate in humanity. ****Karen Mazze** , Potomac** **In her June 12 op-ed** , Kathleen Parker conceded, “I’d like to have the means to end my own life on my own terms.” But, she added, “I’m just not sure I like the idea of the state and doctors lending a hand.” But having a doctor “lend a hand” is not only necessary, it’s critical. It is the doctor who cares for a dying patient and often stands in the way of a patient’s decision to hasten death. Furthermore, terminally ill patients and their families and doctors in the 45 states where physician-assisted suicide is illegal risk criminal prosecution for helping people let go on their own time and their own terms. The only role of government is to ensure safeguards and not impede such legislation if it is the will of the people. Also, many people find themselves dying in long-term care or assisted-living facilities or hospitals where licensure and regulations concerning life-ending medications can contradict the wishes of the terminally ill patient. The “slippery slope” argument suggests that the right to die leads to “unintended consequences” — code for killing someone off or making old people feel disposable. Experience does not suggest that death-with-dignity statutes would be abused. Safeguards are in place, and nobody is killing off old people or proposing to extend the definition of terminal illness. Kudos to Ms. Parker for raising the topic. Let’s keep talking about it. ****Patrice Hirsch Feinstein** , Washington** _The writer is a grief counselor._ ****Tara Sonenshine** , Chevy Chase** **Kathleen Parker could clarify** her muddled thinking about death with dignity by considering two questions: In which cases does modern medicine prolong death rather than prolong life? And who has greater moral authority than I do to determine how I must die? ****Jim Klumpner** , Silver Spring**

Suicide is a tragedy, not a crime

The compelling and disturbing report about the high rate of suicide of children on reservations [“ Childhoods lost ,” front page, March 10] and an accompanying photo caption used the typical language  about suicide, front and center: “[A] Native American girl and her father committed suicide.” “Committed suicide” implies that the victim has completed a crime, as in “committed homicide.” The Post should consider using less accusatory tones. As the article noted, the vast majority of victims suffer from severe mental illness. It is tragic that so many die by suicide. ****Elizabeth Morrison** , Chevy Chase ** The writer is a past president of the Washington   Psychiatric Society.

Nancy Lanza needed help, too

Ruth Marcus got it partially right about Nancy Lanza, the mother of the man responsible for the mass killing at Sandy Hook Elementary School [“A mother tragic — and infuriating,” op-ed, Nov. 27]. Upon reading the Connecticut state’s attorney’s report on Sandy Hook, one does look with a mix of sympathy, pity and admiration on Ms. Lanza’s “fierce efforts” to help her troubled child. But those of us who have mental illness in our families understand that her behavior, including her misguided efforts to reach her son by encouraging his interest in weapons, probably was the result of the effect his extreme behavior had on her life. Yes, she accommodated his odd behaviors, but if he were your son, what would you have done? Could you have walked away, leaving him behind? Surely she must have sought the help of her ex-husband, her relatives, her community, her church or synagogue, medical providers, the police — but if anyone reached out to help her as the years passed, to lift her out of the spiral in which she was falling, we do not know of it. Where was the help she needed to extricate herself from the role that probably became more nightmarish each day? Adam Lanza’s mental illness may have gone untreated for a long time. But do not say that his mother failed at getting him the help he needed. She — and he — were both failed. Mental illness — particularly severe, untreated mental illness — takes a huge toll on other family members. It is impossible to judge Ms. Lanza unless you have walked in her shoes. ****Nancy L. Wolf** , Chevy Chase**

Family featured in medical news stories found dead in apparent murder-suicide

A Pennsylvania couple featured in news stories about their difficulties getting medication for a daughter who had a heart transplant were found shot to death in their home along with their three children in an apparent murder-suicide, authorities said. District Attorney John Adams said a handwritten note that “appeared to be a ‘murder-suicide’ note” was found in the family’s home in Sinking Spring on Saturday afternoon. Police said they found all five dead of gunshot wounds and a handgun near one of the adults, but they didn’t say who they think was the shooter. Police went to the home to check on the welfare of the family after receiving a call from a relative concerned that the woman had not shown up for a lunch date. Mark Short Sr., 40; Megan Short, 33; and their children — Lianna, 8; Mark Jr., 5; and Willow, 2 — were found dead in the living room, Adams said. A dog also was found dead. The district attorney’s office said the married couple had been having “domestic issues.” In an April 13 post on Philly at Heart, Megan Short wrote of her emotional struggles over her daughter Willow’s condition. When only days old, Willow had a heart transplant for a congenital defect. Her family was featured in articles in the Reading Eagle in 2014 and in the New York Times last year about her condition and the Shorts’ difficulties obtaining anti-rejection medication for her. **— Associated Press** The son of a Kansas state lawmaker died Sunday on a water slide that is billed as the world’s largest, according to officials and the boy’s family. Authorities did not immediately identify the boy, who died at Schlitterbahn Waterpark in Kansas City, but Kansas state Rep. Scott Schwab and his wife released a statement saying it was their son Caleb Thomas Schwab. “Since the day he was born, he brought abundant joy to our family and all those he came in contact with,” said the statement, which asked for privacy as the family grieves. Schlitterbahn spokeswoman Winter Prosapio said the boy died on one of the park’s main attractions, Verruckt, a 168-foot-tall water slide that has 264 stairs leading to the top. The slide’s name means “insane” in German. Officials haven’t provided specific details about what led to Caleb’s death. Kansas City police spokesman Cameron Morgan said he did not have any information. The park will be closed Sunday and Monday, Prosapio said. An investigation is ongoing. **— Associated Press** **— Associated Press**

A man called police to help his distressed wife. They wound up killing her.

The man told a 911 operator that his wife was in distress. He wanted a mental health officer sent to their south Austin apartment to help calm things down. Austin police changed their tactics when the man warned that the situation had grown perilous: His wife, he said, had picked up a gun. Instead of the mental health officer responding to the Club at Summer Valley apartments, two other officers crept closer to building 744. They put cover between themselves and the distraught woman’s apartment, cautious as they tried to make contact. The woman, identified Monday as Micah Dsheigh Jester, found the police first, emerging suddenly from a breezeway — her arm extended, a gun pointed at officers. Police later said that it was a replica semiautomatic BB gun. But the responding officers didn’t know that during the tense and, ultimately, fatal encounter.  “The officers were giving her verbal commands the whole time telling her to drop the weapon.” Instead, Gay said, she edged closer to them. Both officers fired, Gay said. Jester fell to the sidewalk, wounded. But she still had the BB gun. “The female was still moving,” Gay said. “The weapon was still underneath her. And she . . . was still a threat.” Other officers had arrived by that point, and the group tried to disarm Jester without getting shot, Gay said. On the ground, she continued to ask officers to kill her. “As they were approaching her to disarm her, the female had the weapon in her hand,” Gay said. An officer fired several more shots. Jester, 26, was pronounced dead at a hospital a short time later. “Our hearts go out to everyone involved in this tragic incident,” Austin police said in a statement Monday. Police identified the officers involved in the shooting as Richard Smith and Deborah Lindeman, a mental health officer. They have been placed on paid administrative leave during the investigation, per departmental policy.  Meeley said Jester had two daughters — a 4-year-old and a toddler who hasn’t yet turned 1, according to the American-Statesman. The department hasn’t said what, if any, mental illness Jester had. But police say her husband requested an officer specially trained to deal with people having mental health issues.  Zorado Plaza, who has lived in the apartment complex for six years, said the gunfire woke him. “I just heard gunshots. I woke up from my heavy sleep and I’m like, did I hear that correctly? And then I heard it again,” he told KVUE.  Police shootings in general have been under the microscope amid a national debate about whether officers are too quick to use force, especially against blacks.  The project found that officers often lack the training to approach mentally unstable people.  Although recruits typically spend nearly 60 hours learning to handle a gun, according to a study by the Police Executive Research Forum, they receive only eight hours of training to deescalate tense situations and eight hours learning strategies for handling the mentally ill.

As more hospices enroll patients who aren’t dying, questions about lethal doses arise

_This is the fourth story of an ongoing Washington Post series on the hospice industry in America called the “Business of Dying.” _    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico MAIDEN, N.C. — Clinard “Bud” Coffey, 77, a retired corrections officer, did the crossword in The Charlotte Observer after breakfast every morning, pursued his hobby of drawing cartoons, talked seven or eight times a day to his son Jeff and, just two weeks before his death, told a pal that he still felt “like a teenager.” He did, however, have some chronic back pain, and in late March he was enrolled in hospice care “essentially for pain management,” his doctor said. Over a two week period, he received rising doses of morphine and other powerful drugs, grew sleepy and disoriented, and stopped breathing, dying peacefully at home, according to his family and medical records they provided. His death certificate, which was signed by the hospice doctor, listed the cause as “renal cell carcinoma” or kidney cancer. But that doctor had never examined Coffey, his family said, and medical records from just a few weeks earlier do not mention it. “My dad wasn’t dying of cancer,” said his son, Jeff Coffey. “Once he was on hospice, their answer for everything was more drugs. Everything we know about his death is consistent with an overdose.” An attorney for the hospice company, Curo Health, said it could not comment on the case without authorization from Coffey’s family. When Jeff Coffey authorized the company to comment, however, the attorney said that the company would not comment because the Coffey family had hired an attorney in preparation for a lawsuit. The hospice industry in the United States is booming and for good reason, many experts say. Hospice care can offer terminally ill patients a far better way to live out their dying days, and many vouch for its value. But the boom has been accompanied by what appears to be a surge in hospices enrolling patients who aren’t close to death, and at least in some cases, this practice can expose the patients to the more powerful pain-killers that are routinely used by hospice providers. Hospices see higher revenues by recruiting new patients and profit more when they are not near death.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico There are no statistics on how often such abuses may be occurring. But complaints from around the country illustrate the potential dangers of enrolling patients in hospice even though they are not near death, the families involved say.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico — In South Carolina, famed college football coach Jim Carlen, who was suffering from Alzheimers but could walk with a walker and speak, died days after entering a hospice as an in-patient because, according to family attorney Eric Bland, Carlen’s diabetes and blood pressure medicine were withdrawn and replaced with lethal doses of morphine and klonopin, an anxiety medicine. An attorney for the hospice said they would dispute the allegations. “We are proud of the care we provide to our patients, including Coach Carlen,” said Sam Outten, Greenville-based attorney representing Tidewater Hospice. — In Tennessee, Shalynn Womack has testified to the state legislature about her mother, who had been receiving hospice care under a diagnosis of “failure to thrive.” She entered an inpatient hospice for what was supposed to be a brief stay — a “respite” — but died after being given what her daughter called a “toxic cocktail” of morphine and other drugs. — In Maryland, Beverly Gargiulo, 62, of Pylesville, was admitted to the hospital for ulcers, was mistakenly advised to get hospice care, and then was given excessive doses of pain-killers and died, according to a family lawsuit. A jury last year awarded the Gargiulo family more than $900,000. The hospital “provided Ms. Gargiulo with compassionate and clinically appropriate care,” a statement from University of Maryland Upper Chesapeake Health said. “We are confident that the case will be overturned on appeal.” Several other cases document patients who emerged from hospice alive, sometimes with addictions to the pain-killer morphine, which is frequently used in hospice care. But the harm in enrolling patients in hospice even though they aren’t dying is also financial. Multiple lawsuits have sought to recover more than $1 billion in federal money from hospices that have billed for patients who were admitted but not near death, attorneys said. Medicare rules require that doctors certify that hospice patients are likely to die within six months. J. Donald Schumacher, president and chief executive of the National Hospice and Palliative Care Organization, said family satisfaction surveys rate most hospice care very highly, “reflecting the high standard of quality care the vast majority of hospices across the nation provide.” “Hospice is consistently rated as one of the best health care services available to patients near the end of life,” he said. *** As the hospice industry has grown, hospices are more frequently enrolling patients who aren’t near death. To track how often this happens, Medicare, which pays for the vast majority of hospice care in the United States, counts how many patients leave hospice care alive.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico At least some of these patients simply get better, unexpectedly. But the proportion of so-called “hospice survivors” has been increasing, and experts believe some hospices are purposely enrolling and keeping patients who are not actually dying. For each patient like Coffey, who stayed at home, the hospice can bill the government about $155 a day, regardless of whether anyone from the hospice visits. At hundreds of U.S. hospices, more than one in three patients were released alive, according to a new study funded by Medicare.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In 2010, for example, more than 63,000 patients left hospice alive, did not re-enter hospice and were still alive six months later, according to the study. Betty Mathews, 76, a retiree from a Las Vegas casino, was diagnosed last year with colon cancer, received chemotherapy treatments and then was enrolled in a hospice in August 2013. The hospice sent a nurse every Friday, Mathews said. “I kept telling them to give me a blood test to see if I still had cancer,” Mathews said “They gave me pain-killers but I never took anything. My hair was growing, I was gaining weight. But they wouldn’t give me the test. The hospice people kept coming every Friday. I thought I was going to die.” Last month, nearly a year after enrolling in hospice, the agency finally did a blood test. It indicated that she did not have cancer, she said. Had she known she was healthy, “I would have got up out of this bed and started living. I’ve got a new great grand-daughter — and I haven’t even seen her.” *** In the fragmented U.S. health-care system, where patients are sometimes shuffled from doctor to doctor and place to place, the details of a patient’s condition can get lost in translation. Bud Coffey’s diagnosis appears to have changed when he was enrolled into hospice. The Coffey family provided The Post with records of Coffey’s last visit to his primary care doctor, the notes of the hospice nurses, a list of his medications, hand-written tallies of what drugs family members administered to him and a copy of the doctor’s order referring him to hospice. For years, he’d been living under the shadow of knowing that he had an aortic aneurysm, a bulge in his body’s critical artery that seemed poised at some point to rupture and cause sudden death. Medical references put the annual risk of an aortic aneurysm like Coffey’s rupturing at 30 to 50 percent. “It would be fatal almost instantly,” Coffey wrote to a friend in March. But he said he felt healthy, and his interest in life — and the Carolina Panthers — was avid. Videos of Bud Coffey taken just weeks before his death show him out for a drive with his son, slow and frail, but walking with a cane and talking. On March 17, just a few days before he was enrolled in hospice, Coffey’s primary care doctor listed three diagnoses: an “unspecified disorder” of the kidney, the aortic aneurysm and chronic back pain. The report also noted numerous kidney stones. The list of diagnoses did not mention cancer. The diagnosis of an unspecified kidney ailment arose after a scan showed a two-centimeter spot on his kidney. Even if it had proven to be cancer, a spot that small is generally considered to reflect an early stage of the disease, doctors said. In rare cases, it could have spread. On March 20, Coffey’s primary care doctor referred him for hospice care, “essentially for pain management,” because he was taking Percocets and still felt some pain, according to records. “Hopefully they can manage his pain better,” the notes on his medical record say. The doctor referred the family to Community Home Care and Hospice, which in May 2012 had been acquired by Curo Health, a company formed through acquisitions by a private equity firm. When a few days later Coffey was formally enrolled at the hospice, however, his diagnosis appears to have changed. The hospice’s insurance verification form lists the diagnosis as “kidney cancer,” according to a copy of the document. For the hospice to be reimbursed by Medicare, the diagnosis must involve a terminal condition that is likely to lead to death within six months. Then, throughout the rest of his two weeks under hospice care, workers for the hospice referred to “the cancer,” his family said. After Bud Coffey refused to eat a hot dog from one of his favorite restaurants, and the next day rejected another of his favorites, “the hospice nurse relayed the doctors message that the cancer was spreading to his stomach,” Jeff Coffey said. “When his neck hurt, they said it had spread to his bones. “Looking back I can’t believe I didn’t see how ridiculous it was,” Jeff Coffey said. Bud Coffey was not in extreme pain, according to the medical records. The nursing notes say he ranked his pain as a three on a scale of 10 on some days, and some days as a four. The response to any discomfort, the family said, was to use more drugs. After rising doses of morphine and other drugs, Bud Coffey appears to have become confused.  Three days before he died, the hospice nurse recorded that Coffey “has not been eating well…has been talking to people who aren’t there…did not recognize a family member today.” The family, worried, requested that the hospice send a nurse who could stay with him. The request was denied, the family said. On his last day, the family said they were, under the hospice’s direction, giving Bud Coffey 40 milligrams of liquid morphine every three hours, a substantial increase over his previous dosage, according to notes taken by the family. They had also stopped giving him his breathing medication, the family said. He died peacefully. “Patient died at home with family at his side,” the hospice notes say. “Wife reported he was calm when he stopped breathing.” The next day, the hospice doctor signed the death certificate, listing the cause of death as renal cell carcinoma, or kidney cancer. The family said the doctor never examined Coffey during his time on hospice, and that based on the manner of his death and other information, the cause of death was not cancer, and not the aneurysm which would likely have caused a sudden death, but the effects of a drug overdose. That much morphine could have been fatal, independent doctors told The Washington Post, but the lethal threshold varies from person to person. The family was stunned by his sudden decline, Jeff Coffey said. His father may have been, too. On March 24, he wrote an e-mail to a childhood friend. “I know that usually hospice is called in only when death is imminent, but hospice was called in this time to monitor my medications, vital signs, etc,” he wrote. “I still feel like a teenager and if I didn’t know what was happening inside me [the aneurysm] I’d feel like I was a perfect example of good health.” **Email the author:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico peter.whoriskey@washpost.com **Read more:**    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Terminal neglect? How some hospices treat dying patients      *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Is that hopsice safe? Infrequent inspections mean it may be impossible to know    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Rising rates of hospice discharge in U.S. raise questions about quality of care    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico

Katherine Harris’s husband dead in apparent suicide

Sarasota, Fla., police say they are investigating the apparent suicide of former Florida Secretary of State Katherine Harris's (R) husband. Sven Anders Axel Ebbeson, 68, was found dead Tuesday morning. Police are calling it an "alleged suicide."    *[WSU]: Wayne State University The police also quote the family's pastor saying Ebbeson had been suffering from an illness. Sarasota Police Chief Bernadette DiPino said Harris "wanted the community, her family and friends to know that her husband is no longer suffering." Harris was instrumental in the 2000 Florida recount which eventually resulted in George W. Bush winning the presidency. She won a congressional seat in 2002 and later ran for Senate in 2006, losing to Sen. Bill Nelson (D-Fla.).

A domestic violence victim took steps to protect herself, but died nonetheless

THE DEATH of a Prince George’s County woman, allegedly by her estranged husband last week, did not become big news until the rampage extended beyond her family, with two more people killed. There tends to be a complacency about domestic violence as posing a risk not to the general public but rather only to “other people.” That is wrong on many levels — including because partner murders often presage crime sprees that affect “other people.” Let’s hope last week’s terrible events serve as impetus for bettering ways to combat domestic violence; of paramount importance is more effective means of disarming abusers. Gladys Tordil, 44, was shot to death on the afternoon of May 5 in the parking lot of the Prince George’s high school where she was picking up her children; a bystander who tried to help was wounded. Police said the shooter was Eulalio “Leo” Tordil, 62, who fled the scene and, while being sought by authorities, killed two more people and wounded two others in carjacking attempts in Montgomery County. The shootings are far from an anomaly, as mass shootings often begin with a domestic homicide. Everytown for Gun Safety studied mass shootings in the United States from 2009 to July 2015 and found that in 57 percent of the cases, the shooter killed an intimate partner or other family member, in addition to other victims. What is particularly scary about the Maryland shootings is that, in many respects, Ms. Tordil took the available steps to protect herself and authorities responded — but that still wasn’t enough. She went to court in March to tell a judge that her estranged husband had repeatedly threatened to kill her and had abused her and her daughters. The court issued civil protective orders, which generally have proved to be effective safeguards and which required Mr. Tordil to surrender all his firearms. The Federal Protective Service, which employed Mr. Tordil, stripped him of his service weapon, and the Prince George’s County Sheriff’s Office took possession of seven guns, more than had been listed by Ms. Tordil. But Mr. Tordil had access to other guns, including a .40-caliber Glock that was legally purchased in Las Vegas in 2014 and that prosecutors said was used in the Montgomery shootings. Sheriff’s deputies can’t be faulted for not knowing about that gun because, thanks to the national gun lobby and the cowardice of Congress, there is no federal database of who owns what guns. Only a handful of states, including Maryland, have registries of varying thoroughness. This case underscores why law enforcement should be able to know whether a person prohibited from possessing guns has surrendered all their firearms. Another question is whether Ms. Tordil’s claim of abuse of her daughters, including a minor, was vigorously investigated by police or child protective services. Authorities in Montgomery County told us they have a process in place to ensure such charges are carefully examined; Prince George’s officials would do well to follow that lead. **Read more on this topic:** The Post’s View: The horrifying toll of domestic violence The Post’s View: An extra safety measure for domestic violence victims Petula Dvorak: Police officers are killed dealing with domestic violence and other problems we ignore Lisette Johnson: A change in Virginia’s gun laws that makes a big difference for domestic violence victims

Agonizing over the right to die

Maryland, a state where lawmakers abolished the death penalty and made same-sex marriage legal, would seem fertile ground for an aid-in-dying bill. But the state also has deep Catholic roots and a large African American population, and both of those communities have long opposed assisted suicide for the terminally ill. At a hearing Friday on a bill that would make Maryland the sixth state to legalize aid in dying, dozens of witnesses waited hours to testify. There were terminal patients who said they deserve the option to legally end their lives and caregivers who described loved ones committing suicide to cut short their suffering. There were religious leaders and disability advocates who argued that “every life” is precious, and a young woman who survived brain cancer as a child after doctors said she had little time to live. “Guess those doctors were pretty wrong,” she said. And then there was the Rev. Eric King, an African American minister from Baltimore who last year watched his wife, diagnosed with Stage 4 breast cancer, testify in favor of assisted suicide in defiance of their church’s teachings. That bill never made it out of committee. Marlene King died last fall, her body withered to 90 pounds, her last days full of pain. “I want to carry on her work,” King told delegates at a joint hearing Friday of the House Judiciary Committee and the House Health and Government Operations Committee. “God allows choices. . . . I look at it as there are two types of healing. One is for a person to be restored to a quality of life and wellness. And death is also a form and act of healing. Death is God’s grace for people of faith, for anguish and suffering to end and to be in the presence of our Creator.” Maryland’s bill is modeled on the measure approved in California last year after the highly publicized case of Brittany Maynard, a 29-year-old Bay Area woman with terminal brain cancer who moved to Oregon to legally kill herself. Aid in dying is also permitted, with varying restrictions, in Washington state, Vermont and Montana. In Maryland, the legislation appears to face an uphill battle. Sponsors say they are optimistic about its chances in the House of Delegates, where it has the support of one Republican, Del. Christopher R. West (Baltimore County), who considers aid in dying a liberty issue, and many first-term Democrats. They are less certain about the legislation getting out of the 11-member Senate Judicial Proceedings Committee, which has scheduled a hearing for Thursday. Five committee members oppose the measure, including all four of the committee’s Republicans. Two panel members, both Democrats, are co-sponsors. For the bill to move forward, advocates must persuade the four undecided Democrats: Sen. Robert A. Zirkin (Baltimore County), who is the committee chair, and Sens. Susan C. Lee (Montgomery), C. Anthony Muse (Prince George’s) and Victor R. Ramirez (Prince George’s). But opponents of the bill are lobbying those lawmakers, too. Ramirez, who is Catholic, said two constituents expressed their concerns to him during a dinner sponsored by the church. “Same-sex marriage was about treating people the same. The death penalty was where we have an imperfect system, and the government shouldn’t be in the business of deciding life or death,” Ramirez said. With aid in dying, he said, “we could be going down a slippery slope. Once you allow someone to perform this procedure, you can’t reverse it. . . . Are we going to look back in 10 years and wonder did we do the right thing?” The Maryland Catholic Conference and disability rights advocates say the bill could open the door for mistreatment of the disabled, elderly and minority communities, which they say already experience disparities in health-care access. “Legalizing suicide as a medical course-of-action will only serve to further erode the healthcare that vulnerable people currently receive, especially since it is much less expensive than continuing treatments,” said a statement that was given to the 300 Catholics who came to Annapolis this month for Catholic Lobby Night, an annual event at which members of the church talk to lawmakers about bills. The main focus this year: stopping “physician-assisted suicide,” a term listed on their documents and one that proponents of the bill abhor. At the hearing Friday, Georgetown University School of Medicine doctor Kevin Donovan called the bill “discriminatory and not progressive.” “It creates, by law, a class of people whose lives should no longer be preserved,” Donovan said. “It favors the white elite, not the sort of thing that progressives want to get behind.” Proponents of the bill say safeguards have been added to the measure to ensure that no one is taken advantage of. They say there have been no reported instances of coerced death in Oregon, where legislation was approved in 1994, or in any of the other states that have legalized aid in dying. About three dozen volunteers from the nonprofit group Compassion & Choices, which is leading the effort to build support for the bill, recently held a lobbying day, spending hours knocking on legislators’ office doors. One volunteer met with Muse, the Judicial Proceedings Committee member and an African Methodist Episcopal minister. She said the lawmaker told her that he is “open” to the idea of aid in dying — a statement she counted as a small victory. Asked about the legislation on Friday, Muse said he remains undecided. Lobbyist W. Minor Carter is working for the bill pro bono, in memory of his friend, Richard E. Israel, a former assistant attorney general who died last summer after a long bout with Parkinson’s disease. Carter said he has run into more than a few roadblocks as he tries to sway lawmakers with whom he normally discusses insurance and other, less-fraught issues. Some flatly refused to meet with him. “They say there is no need to waste my time,” Carter said. “They’re Catholic, they say.” So Carter moves to the next name on his list. He knows that House Speaker Michael E. Busch (D-Anne Arundel), a Catholic, reversed his position on the aid-in-dying bill last year after reflecting on his own life and the deaths of two friends. Carter said he hopes that there are other lawmakers out there ready to be persuaded. Gov. Larry Hogan (R), who is in remission after a bout with non-Hodgkin’s lymphoma last year, has not taken a position on the bill. Hogan, who is also Catholic, indicated as a candidate that he would oppose aid-in-dying legislation. But he said in March — before his cancer diagnosis — that he could see both sides of the issue. He has since become an outspoken advocate for cancer patients, spending hours with people who are fighting the disease. Several black and Hispanic lawmakers said they have not heard from constituents either for or against the bill. That could change if the legislation makes it out of committee and comes before the full Senate or House for consideration. “The black community is generally of the position — when it’s your time, it’s your time, God won’t take you no sooner than your time,” said Del. Charles E. Sydnor III (D-Baltimore County), a member of the House Judiciary Committee who is African American. “It’s not going to be an easy vote.”

Mr. Trump’s offensive innuendos

My late husband was a patent and trademark lawyer. He had degrees in engineering and law. He achieved all this while suffering from bipolar depression. He was appalled at any suggestion that President Clinton or then-first lady Hillary Clinton could have been responsible for the death of their dear friend Vincent Foster. Like me, he would have applauded the courage that Sheila Foster Anthony displayed in her May 27 op-ed, “ Donald Trump should be ashamed,” condemning Mr. Trump for his disgraceful innuendos. ****Joan L. Selman** , Alexandria**

Jerry Brown just signed right-to die-legislation in California. Here’s how we got here.

The most populous state in the nation will soon allow terminally ill patients to end their own lives.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Calling it a "gut-wrenching" decision, California Gov. Jerry Brown (D) on Monday signed into law so-called "right-to-die" legislation, handing the death-with-dignity movement one of its most politically significant victories ever.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Supporters of the law were no doubt helped by one of their highest-profile champions, the late Brittany Maynard, a 29-year-old Californian who in her dying days graced magazine covers and the Internet in late 2014 advocating for right-to-die laws.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Maynard certainly helped swing the tide of public opinion to her side, and it's very possible her victory won't be contained just to California. Here's everything you need to know about California's new medical reality -- and its potential impact on the rest of the nation:    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico California joins Oregon, Washington, Vermont and Montana.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico That means when California's law goes into effect, likely in early 2016, one in 10 Americans will live in a state that allows terminally ill patients to end their own lives, according to the right-to-die advocacy group Compassion and Choices. __    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico And it's plausible that more states could soon follow California's lead. At least 20 state legislatures have recently considered similar legislation, and California has been proven as a testing ground for controversial laws in the past.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico A big reason this is advancing now: Public opinion would now seem to be on right-to-die supporters' sides, after a clear shift. Americans' opinions on it have changed drastically, Pew Research Center notes. In the graph below, the shift upward notably happened around the time of or after Maynard's death. Before she became a national figure in late 2014, 51 percent of Americans supported doctor-assisted legal suicide; today about 68 percent do.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico As far as shifts on issues like this go, that's a huge and rapid change. In fact, the law almost didn't come to fruition. A similar proposal had failed several times in the state legislature and on a ballot question. This time around, the right-to-die bill didn't advance in this year's state assembly session, but when lawmakers convened a special health-care session, it got a second chance.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico It's opposed by most Republican lawmakers on moral and religious grounds, and even Democrats were split. In fact, according to the Los Angeles Times's Patrick McGreevy, the law divided much of the state: Religious leaders, physicians, ethicists, regular people. Among the dramatic testimony on either side was a dying former Los Angeles police detective, who is unsure if she'll make it to law's effect date but wanted to see it implemented for other people.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico When the bill did pass the state legislature, what to do with it was a tough and incredibly personal decision for California's governor. Brown is a lifelong Catholic and once went to Jesuit seminary school to study to be a priest. Torn, Brown said he spoke with everyone from his own doctors to Archbishop Desmond Tutu before finally deciding approving the law.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico "In the end, I was left to reflect on what I would want in the face of my own death," he wrote in an emotional statement. "I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill."    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Among those opposed to the law are religious groups and advocates for people with disabilities, who worry it could open the door to all kinds of terrible scenarios, such as premature suicide, coerced early death and overriding God's will.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Proponents argue there are safeguards against that: Patients must be mentally competent, and their imminent death (within six months) must be confirmed by two doctors.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico As for how California's actual doctor-assisted death will work: Doctors prescribe the lethal drugs, patients administer it. A patient must sign off on his or her intention to take the drugs 48 hours in advance and has to physically take the drugs on his or her own.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico As we mentioned above, right-to-die laws haven't had much luck in California or anywhere else in recent years, though advocates argue the fact they're even being considered in state legislatures is a plus. It's likely Maynard's case was at least part of the reason the bill finally succeeded.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico The young Californian was losing a battle to brain cancer and had decided to end her own life when she and her family came up against the fact that California doesn't allow it. So she and her husband of two years, David, moved to Oregon, where it was legal.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico On her way out the door, Maynard filmed a video advocating for right-to-die laws, saying, "I want to make sure no one else has to do what I did and pack up their family and move to another state to not die horribly.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Like some of the most effective messengers, Maynard was an unusual case for her cause. For one, she was young and her story particularly tragic. The Washington Post's Lindsey Bever points out that in Oregon, where she died, the median age of someone who uses doctor-assisted suicide is 71.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico In her final days, Maynard traveled to the Grand Canyon, blogged, wrote op-eds on CNN, did photo shoots with People Magazine and partnered with Compassion & Choices.    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico Before Maynard died in her bedroom on Nov. 1, 2014, "peacefully, in the arms of her loved ones," she wrote: "I didn’t launch this campaign because I wanted attention. I did this because I want to see a world where everyone has access to death with dignity, as I have had. My journey is easier because of this choice.”    *[WSU]: Wayne State University   *[Tue]: Tuesday   *[Wed]: Wednesday   *[UNM]: University of New Mexico That choice will now be available to many more Americans.

‘I didn’t want to see them suffering’: Mother confesses to suffocating her three young children

Three-month-old Niall was the first to die, on July 22, 2014. His brother, 4-year-old Gavin, died nine months later, on April 6, 2015. Noah was next: He was born just after Gavin’s death — and died on Aug. 18, 2015. The mother of all three children, Brittany Pilkington, confessed to killing them over a 13-month period, Ohio prosecutors say. The same day her third son died, the 24-year-old mother from Bellefontaine told police that she put a blanket over all three of the children’s faces and placed her hand over their noses and mouths. Pilkington’s videotaped confession was played in court this week. Her attorneys argued that the confession was coerced and, therefore, unconstitutional; it shouldn’t be used at trial, they say. Pilkington was indicted on three counts of aggravated murder. If found guilty, she could face the death penalty. “Every case is awful when you’re talking about child deaths,” Logan County Chief Assistant Prosecuting Attorney Eric Stewart told The Washington Post. “This one, obviously, is unique in the way that the deaths didn’t happen all at once. It’s still just terrible to think about what happened.” The first two deaths stymied authorities in Bellefontaine, about 60 miles northwest of Columbus. Because there were no physical injuries or any other signs of trauma, the coroner’s office could not determine how they died, Stewart said. But police and child welfare officials had become highly suspicious of the mother of the dead children. Her husband, Joseph Pilkington, was at work when they died, and she was the only one at home with the children, Stewart said. After the deaths of Niall and Gavin, Logan County Children’s Services took custody of Pilkington’s daughter, Hailey, who is now 5, and Noah, who was then a newborn. Stewart said child welfare officials took the boy from the hospital just after he was born. The parents fought for several weeks to get the children back, and a judge ultimately sided with them. “The court is also concerned about what’s going on in the home,” Stewart said. “Two deaths, two unexplained deaths. [But] we’ve not proven any criminal intent at that point.” Noah died when he was three months old. Stewart said the infant had only been home a week. Brittany Pilkington was interviewed for two hours at the Bellefontaine Police Department, where she told detectives that she had accidentally rolled over Niall, the first child who died. “That’s something that she’s never told the police before in previous investigations,” Stewart said. Pilkington was interviewed for another two hours at the Logan County Sheriff’s Office, where she ended up confessing to killing the boys by suffocation, Stewart said. In the videotaped statements played in Logan County Common Pleas Court on Wednesday, Pilkington described how Gavin, her first son, kicked his legs as he struggled.  It took “a few minutes” for the boy to stop moving, she said.  Noah, her youngest son, was in his crib when she put a blanket over his face, she said. When asked why she used a blanket, Pilkington said she “didn’t want to see it.” “I didn’t want to see them suffering,” she said in the tape. Stewart said that Pilkington suffocated her sons because she was jealous the boys were getting more attention from their father than she and her daughter were. She also said her own father beat her as a child, and she feared her sons might grow up to do the same, Stewart said. Pilkington sat motionless during the first half of the interview at the police department, Stewart said. She later became emotional and was crying throughout her interview at the sheriff’s office. She told investigators she’d been depressed and had been thinking about killing herself, the Columbus Dispatch reported. She said she loved her sons. “I should’ve hurt myself,” she said. Kort Gatterdam, Pilkington’s attorney, said the way police interrogated her “lends to the possibility of a false confession.” Gatterdam said that during the lengthy interrogation, detectives put in Pilkington’s mind what she ultimately confessed to doing. “Being there all day with no sleep, having just watched the kid, with no food, no drink, she finally started agreeing with them,” Gatterdam said. “Her statements are basically what the cops told her happened.” Gatterdam also said that Pilkington made the statements to police without first talking to her attorney. Had she been able to do so, she would have been advised to not talk, Gatterdam said. “The other issue is there’s no evidence of a crime being committed apart from her statement,” Gatterdam said. “Without her statements, I don’t think they have a case.” Stewart, the prosecutor, disagreed. Pilkington was not forced to say anything, he said, adding that she was given food and drink throughout the interview. He also said that Pilkington was advised of her rights twice and she understood what she was doing when she agreed to talk to detectives. A judge will likely decide this month whether the videotapes can be used as evidence at trial. Pilkington’s defense team is also asking the judge to find death penalty in Ohio unconstitutional. Gatterdam also said detectives didn’t sufficiently investigate Pilkington’s husband who, police say, found his children dead after coming home from work.   At that time, the two were not yet married and he was in a live-in relationship with Brittany Pilkington’s mother. Joseph Pilkington pleaded guilty last July to a reduced charge of sexual imposition, a misdemeanor, court records show. Brittany Pilkington’s trial is scheduled to start on Feb. 27 and is expected to last a little more than a month. She’s being held in Logan County Jail on a $1 million bond.

He killed his mother to ‘spare her the pain of eviction.’ Now he wants her life insurance.

When it appeared that bedbugs were infesting his 89-year-old mother’s apartment, the Minneapolis man believed “there was no way out.” Fearing she would be evicted from her home, he decided to “send her to heaven,” according to court records, striking her with a sculpture of himself, smothering her with a pillow and suffocating her to death. More than a year after admitting to killing his mother, Michael Gallagher is trying to get her life insurance.  The wrinkle in the case is that he was not convicted. Although there was no doubt that Gallagher killed his mother, a judge ruled in July he was not guilty by reason of mental illness, stating he “was unable to understand that his actions were wrong.”  The case has left a court with a baffling question: If a man clearly killed his mother but was not convicted, is he still entitled to his inherited benefits? Unable to find a judicial precedent, insurance company Horace Mann, which holds the policy, filed a lawsuit in Hennepin County District Court against Gallagher last week in an attempt to block his claim, the Star Tribune reported. Gallagher’s mother, Patricia Gallagher, listed her son as the primary beneficiary of her life insurance policy for about $3,600. If the court decides that he should not receive the money, Horace Mann said the mother listed two brothers as contingent beneficiaries.  He became convinced that his mother’s apartment was infested by bedbugs, even though the landlord had inspected the home and found no evidence of them. He also worried that his mother was experiencing Alzheimer’s disease symptoms. Gallagher was so stressed that he could no longer work at his job as a lawyer and chose to work at a temporary agency instead.  He said his attempts to remedy the eviction “created a nightmare” and a “vicious circle” of desperation and guilt. He feared that after the landlord read the letter, his mother would be evicted. Since he “didn’t have the resources” to find alternative housing for his mother, he decided to “spare her the pain of the eviction.” “It was an impossible situation,” he said, according to court records. “There was no way out so I was going to send her to Heaven and spare her the problems of the impossible situation we were in.” When he was helping his mother clean her apartment Dec. 18, 2015, he climbed on top of her, held her down and hit her five times with the sculpture, according to the criminal complaint. The woman called out for her own deceased mother, asking him to stop. After that didn’t kill her, he grabbed a pillow and tried to smother her with it. He put both hands on her neck and strangled her. Then, finally, he grabbed a garbage bag and held it over her face. Five hours after her death, he called 911.

Former MWAA chief and wife with Alzheimer’s ‘deliberate’ about end-of-life plans, daughter says

Three years ago, Adrienne Snelling wrote letters to her children and grandchildren explaining how she and her husband, Charles D. Snelling, decided to cope with her Alzheimer’s disease. Adrienne was 79 then and had been battling the illness for about four years. Charles, her husband of nearly 60 years, was her primary caretaker at their home in Fogelsville, Pa. She was an accomplished fine arts photographer; he was prominent in Republican circles and had recently stepped down as chairman of the authority overseeing Reagan and Dulles airports and the construction of Metro’s new $6 billion Silver Line. “As you know I have Alzheimer’s. It is not a nice disease. So far I have held up pretty well. Dad and I are still having a pretty good life. There is no doubt where my sickness will end up for me,” Adrienne wrote in the Nov. 22, 2009, letter. She went on: “All of our lives, Dad and I have talked over our end of life beliefs. We are both in agreement that neither one of us wants to live after all reasonable hope for a good life is over. . . . We have had such a great life together and with all of you.” On Thursday, just over a week after their 61st wedding anniversary, Charles took his own life and his wife’s in their home, police and airport authority officials said. He shot himself, authorities said. They have not said how she died. One of the couple’s children, Marjorie Snelling, 56, of Philadelphia, said Friday that she knew her parents had talked about a plan to end their lives but that she and her siblings were stunned that it actually happened. There had not been “any specific signs.” Still, she said, her family believes the pair “were deliberate and thoughtful.” “They had a plan, and they were going to execute that plan without people knowing,” Marjorie said. “They’ve seen their peers and friends languish. . . . They had really been thinking about this for some time and keeping it a secret.” Charles, who had a pacemaker and had undergone two knee replacements, was his wife’s main caregiver, although he had hired helpers who came in about 14 hours a day, friends and relatives said. “They were always deeply committed to each other,” Marjorie said. “They had a fundamental bond. We always knew they were united at their core.” That romance began when they met at a prom at Cedar Crest College, in Pennsylvania. Both were with other people at the time, but in a December 2011 column in the New York Times, Charles described his wife as a “simply marvelous young lady: ravishingly beautiful, bright, well-groomed, well-spoken, mannerly, disciplined and circumspect.” He “pursued her with all the vigor at my command.” He courted her by pretending to study with her at a park. They were married on March 21, 1951, the first day of their spring break, and went off for a quick honeymoon in Bermuda. The two had five children — one every two years over the early years of their marriage — and 11 grandchildren. Adrienne, the daughter of a talented Italian marble craftsman, graduated from Cedar Crest, and photos she took appeared in two books. She later served on the Pennsylvania Council for the Arts. Charles was born into a successful family, the son of Walter O. Snelling, an aristocrat and scientist who invented ways to better use gasoline; he sold a patent to John D. Rockefeller for $200,000 in 1910. Charles told of having 16-cylinder Chryslers and Packards and traveling often as a child. Charles, a 1954 Lehigh University graduate, went on to have a vibrant career. He worked as an engineer and inventor and dabbled in real estate, running an orchard and a chain of restaurants. He held 20 issued patents and founded Cryo-Therm, a company in the thermodynamic energy-storage business. Over the years, he served as four-time president of the Allentown City Council and finance chairman of the Republican Party in Pennsylvania. He was appointed to the Metropolitan Washington Airports Authority board in 2003 by President George W. Bush and was chairman from January 2010 to December 2011. Even as he oversaw the board — with intense debates over a Dulles Airport Metro stop — Adrienne was never far away. He often would bring her and her caregivers with him when he traveled to the Washington area. “You could tell above everything else they were the best of friends,” said Mame Reiley, a longtime friend of the Snellings who also recently stepped down from the airports authority board. Reiley recalled that she had scheduled a dinner with Charles on Feb. 14 at the Ritz-Carlton in Pentagon City. It was the night before an airports authority board meeting, and he and Reiley often got together to discuss business. When Reiley realized that it was Valentine’s Day, she called Charles to say they didn’t have to meet. He told her, no, he wanted to meet as long as he could bring Adrienne. Reiley described Adrienne as a “dynamo” before Alzheimer’s. “She always kept his ego in place,” she said. “She was a gracious, smart and loving person.” In the New York Times column, Charles wrote that although he had “wonderful helpers” caring for his wife, “real care for a loved one with Alzheimer’s cannot be delegated. I did not need to be told that; I felt it in my bones.” “The Life Report: Charles Darwin Snelling. A Love Story and Redemption” was the title of the column. “It never occurred to me for a moment that it would not be my duty and my pleasure to take care of my sweetie,” he wrote. He described his wife in the column as a “very, very sick puppy,” but that she remained “a sweet, happy, loving and generous person.” He wrote that Adrienne had taken care of him “in every possible way she could for 55 years.” Now it was his turn, he wrote, and “certainly I have had the best of the bargain.” Ed Donley, retired chairman of Air Products and Chemicals and a friend of the Snellings for more than 50 years, said his wife, Inez has Alzheimer’s. Both men tried to enroll their wives in a clinical trial at Johns Hopkins, where some promising experimental research was being done, he said, but they were told that the women were too old and that the odds of slowing the progression of the disease were low. Several years ago, Donley and his wife moved to a senior living community that offered care for Alzheimer’s patients. Donley said he encouraged Snelling to consider moving with Adrienne there, but Snelling said he preferred to care for her at their home. “He felt Adrienne was so devoted to the home where they had lived together, and they had outside help,” Donley said. “He didn’t want to ask her to give it up.” He said he saw Snelling two or three times at Alzheimer’s support groups but that Snelling, whom he called “a very self-reliant person,” was not a regular attendee. Marjorie Snelling said that a few years ago, she noticed an exchange between her parents that made her realize “they were clinging to each other for dear life.” “They would still have a pat on the hand or a moment where you knew they were incredibly important to each other,” Marjorie said. On a recent Christmas, Charles and Adrienne sent out cards that showed them walking hand in hand with their backs to the camera, according to a close friend. It said, “going home.”