Saturday, September 5, 2015

The Financial Cost of ABX2-15 Could Be "Enormous."

Below please find a memo submitted to the California Assembly Finance Committee by Margaret Dore, Esq., on September 3, 2015. To view the original document as a pdf, please click here.


ABX2-15 seeks to legalize physician-assisted suicide in California. In Oregon, which has a similar law, government reports show an increase in other (conventional) suicides and suicide attempts, the financial cost of which is “enormous.”

If California enacts ABX2-15, the financial cost could also be “enormous.”  ABX2-15 should be rejected.


A.  In Oregon, Other (Conventional) Suicides Have Increased with the Legalization of Physician-Assisted Suicide.

In Oregon, physician-assisted suicide has been legal for 17 years.[1] According to the Oregon Health Authority, the number of physician-assisted suicides has been small, but is steadily increasing.[2] This increase is statistically correlated with an increase in other (conventional) suicides.  Consider the following:
∙Oregon's assisted suicide act went into effect “in late 1997.”[3]
∙By 2000, Oregon's conventional suicide rate was "increasing significantly."[4]
∙By 2007, Oregon's conventional suicide rate was 35% above the national average.[5]
∙By 2010, Oregon's conventional suicide rate was 41% above the national average.[6]
This documented increase in conventional suicides, correlated with a steady increase in physician-assisted suicides, is consistent with a suicide contagion in which the legalization of physician-assisted suicide has encouraged other suicides.

B.  Suicide is Contagious.

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

A contagion is more likely to occur when there is excessive graphic publicity about the suicide.[8] The apparent suicide contagion in Oregon makes sense, given what's been happening there, in which media reports and relentless advocacy by proponents focus on assisted suicides and the people doing them, for example, Brittany Maynard.[9]

C.  Suicide and Failed Suicide Attempts Are Expensive for the Government.

The financial significance of increased suicides is that they can be expensive. People who attempt suicide don't always succeed; they can be left injured or disabled, requiring hospitalization or long term care. Sometimes suicidal people take other people with them, for example, during a "suicide by cop." This is when a suicidal person threatens the police or civilians in order to be killed by the police. Consider, for example, Californian Andy Williams, who at age 15 decided that he wanted to be killed by the police.[10] He went to school with a gun, killed two schoolmates,wounded 13 others, but was not, himself, killed.[11] As of 2013, he was reported as incarcerated and not eligible for parole until age 65.[13] This was and continues to be a very expensive attempted suicide.

D.  In Oregon, the Cost of (Conventional) Suicide is “Enormous.”

According to the Oregon Health Authority, the financial cost of other (conventional) suicides and suicide attempts is “enormous” for Oregon, a state with just one tenth of California’s population. The Oregon Health Authority states:
The cost of suicide [and attempted, but unsuccessful suicides] is enormous [for Oregon]. In 2010 alone, self-inflicted injury hospitalization charges exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars.[14]
 E.  The Significance for California.

Oregon is the only state where there has been legalization of assisted suicide long enough to have statistics over time.  The significant financial cost due to increased conventional suicides in Oregon, positively correlated to physician-assisted suicide legalization, is a significant factor for this body to consider regarding the proposed bill, which seeks to legalize physician-assisted suicide in California.


If California, with its tenfold larger population, enacts the proposed bill and has the same experience as Oregon, the financial cost could be “enormous” for California, as much as ten times the current Oregon figures (to equal $410 million or more). ABX2-15 should be rejected.

* * *
[1]  See Oregon’s “Death with Dignity Act Report for 2014, p.1, line 1 (law “enacted in late 1997"), (Attached hereto at A-29) .
[2]  Id., p. 1.
[3]  Id., p. 1, line one.
[4]  See Oregon Health Authority News Release, September 9, 2010, at ("After decreasing in the 1990s, suicide rates have been increasing significantly since 2000"). (Attached hereto at A-72).
[5]  Id.
[6]  See page A-77, attached hereto.
[7]  Margot Sanger-Katz, “The Science Behind Suicide Contagion,” The New York Times, August 13, 2014, at
[8]  Id. and “Recommendations for Reporting on Suicide,” The National Institute of Mental Health. See also “Preventing Suicide: A Resource for Media Professionals, World Health Organization, at
[9]  Consider also the case of Lovelle Svart, whose decision to use Oregon’s act was featured in a three-month-long media series in The Oregonian, which is Oregon’s largest paper. The series conclusion featured her death in which online viewers were invited “to hear and see when [she] swallowed the fatal dose.” (See article at this link:
Such graphic coverage is a well known factor of suicide contagion.
[10]  Rebecca Jacobson, “School Shooter: ‘My Grand Plan Was Suicide by Cop,’” PBS Newshour, 02/18/13,
[11]  Id.
[12]  Id.
[13]  Oregon has 3.9 million people; California has 39 million people.
[14]  Oregon Health Authority, (Attached hereto at A-78)